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Turkey has yet not learned to GIVE vitamin D DURING pregnancy (5 ng average) – May 2014

Severe vitamin D deficiency among pregnant women and their newborns in Turkey

Journal of Maternal-Fetal and Neonatal Medicine Posted online on May 14, 2014. (doi:10.3109/14767058.2014.924103)
Mesut Parlak, MD 1, Salih Kalay, MD 2, salihkalay at hotmail.com Zuhal Kalay, MD, MD 3, Ahmet Kırecci, MD 4, Ozgur Guney, MD 5, Esad Koklu, MD 6
1 Kahramanmaraş Necip Fazıl City Hospital, Department of Pediatrics, Division of Endocrinology, Kahramanmaraş, Turkey
2 Kahramanmaraş Necip Fazıl City Hospital, Department of Pediatrics Division of Neonatology, Kahramanmaraş, Turkey
3 Kahramanmaraş Necip Fazıl City Hospital, Department of Pediatrics, Kahramanmaraş, Turkey
4 Kahramanmaraş Necip Fazıl City Hospital, Department of Obstetrics and Gynecology, Kahramanmaraş, Turkey
5 Kahramanmaraş Necip Fazıl City Hospital, Department of Biochemistry, Kahramanmaraş, Turkey
6 Megapark Hospital, Department of Pediatrics Division of Neonatology, Kahramanmaraş, Turkey
Corresponding Author: Dr Salih Kalay, MD, Kahramanmaraş Necip Fazıl City Hospital, Department of Pediatrics, Division of Neonatology, Kahramanmaraş, Turkey., Email: salihkalay at hotmail.com

Objectives: Vitamin D deficiency is an important health problem in pregnant women and their infants in sunny countries. Low socio-economic status (LSES), covered dressing style, pregnancies in winter season and having dark skin are the major risk factors for vitamin D deficiency. The present study evaluated serum 25-hydroxyvitamin D3 [25(OH)D3] concentrations in pregnant women and in their newborns and determined the risk factors in LSES cities in Turkey.

Methods: Ninety-seven pregnant women and their newborns were included in the study between December 2012 and February 2013. All of the pregnant women had irregular follow up or had received no antenatal care, were pregnant during summer, had presented to the hospital after 37 weeks of gestation (WG) and had received no vitamin D supplementation. A detailed history was obtained, which included mothers’ age, number of births and dressing sytle. Maternal and cord blood samples were taken to measure 25(OH)D3 levels.

Results: All of the pregnant women were predominantly LSES, had covered dressing style and none of them had received vit D3 supplementation during pregnancy. The mean serum 25(OH)D3 level and mean cord blood level of of 97 mothers were 4,97± 3,27 ng/ml and 4,29±2,44 ng/ml, respectively. There was a strong positive correlation between maternal serum and umbilical cord 25(OH)D3 levels (r: 0,735, p<0,05). Ninety-five mothers had serum 25(OH)D3 below 20ng/ml and all cord blood serum 25(OH)D3 levels were below 20ng/ml. Level of 25(OH)D3 was not correlated with mother age, WG or newborn weight. Serum 25(OH)D3 concentrations in primigravida and multigravida were 3,71±1,88 and 5,2±3,4 ng/ml, respectively, with a significant difference between them (p<0,05).

Conclusion: Severe vitamin D deficiency is common in reproductive women and their newborns in LSES cities of Turkey. Covered dressing style, not receiving any vitamin D supplementation and primigravida women are at greatest risk. Vitamin D supplementation campaigns which should cover pregnant women and the newborn to prevent maternal and perinatal vitamin D deficiency should be implemented especially in risk areas.


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IU Cumulative Benefit Blood level CofactorsCalcium $*/month
200 Better bones for mom
with 600 mg of Calcium
6 ng/ml increase Not needed No effect $0.10
400 Less Rickets (but not zero with 400 IU)
3X less adolescent Schizophrenia
Fewer child seizures
20-30 ng/ml Not needed No effect $0.20
2000 2X More likely to get pregnant naturally/IVF
2X Fewer dental problems with pregnancy
8X less diabetes
4X fewer C-sections (>37 ng)
4X less preeclampsia (40 ng vs 10 ng)
5X less child asthma
2X fewer language problems age 5
42 ng/ml Desirable < 750 mg $1
4000 2X fewer pregnancy complications
2X fewer pre-term births
49 ng/ml Should have
cofactors
< 750 mg $3
6000 Probable: larger benefits for above items
Just enough D for breastfed infant
More maternal and infant weight
Should have
cofactors
< 750 mg $4

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