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Universal pregnancy vitamin D supplementation for a hospital in India – study stopped after 1 month – April 2016

A study of prevalence of Vitamin D deficiency among pregnant women and its impact on feto maternal outcome

Int J Reprod Contracept Obstet Gynecol. 2016; 5(4): 1174-1180doi: 10.18203/2320-1770.ijrcog20160880
Shailaja Nageshu, Kirtan Krishna, Krishna L., B. Shyamasundara Bhat, H. R. Suma, Surekha Reddy.

VitaminDWiki Summary
  • Vitamin D tests are expensive
  • Most pregnant women needed more vitamin D
    54% less than 10 ng 14% between 11-32 ng
  • Vitamin D levels less than 10 ng were 3 times more likely to have low birth weight
  • Vitamin D is very low cost and low risk
  • Concluded that all pregnant women should be supplemented
  • Stopped study after one month

Healthy pregnancies need lots of vitamin D in VitaminDWiki has the following summary

Problem
ReducesEvidence
0. Chance of not conceiving3.4 times Observe
1. Miscarriage 2.5 times Observe
2. Pre-eclampsia 3.6 timesRCT
3. Gestational Diabetes 3 times RCT
4. Good 2nd trimester sleep quality 3.5 times Observe
5. Premature birth 2 times RCT
6. C-section - unplanned 1.6 timesObserve
     Stillbirth - OMEGA-3 4 timesRCT - Omega-3
7. Depression AFTER pregnancy 1.4 times RCT
8. Small for Gestational Age 1.6 times meta-analysis
9. Infant height, weight, head size
     within normal limits
RCT
10. Childhood Wheezing 1.3 times RCT
11. Additional child is Autistic 4 times Intervention
12.Young adult Multiple Sclerosis 1.9 timesObserve
13. Preeclampsia in young adult 3.5 timesRCT
14. Good motor skills @ age 31.4 times Observe
15. Childhood Mite allergy 5 times RCT
16. Childhood Respiratory Tract visits 2.5 times RCT

RCT = Randomized Controlled Trial


Background: The aim of our study was to determine the prevalence of vitamin D among pregnant women and its impact on feto maternal outcome.

Methods: An observational study was conducted among 80 pregnant women at PESIMSR, Kuppam over a period of one month from first September 2014 to 30th September 2014. Our primary outcome was to study prevalence of Vitamin D deficiency in pregnant women and secondary outcome to study maternal and fetal outcome in pregnant women with Vitamin D deficiency. The subjects participating in the study were requested to complete a questionnaire that covered socio-demographic data, religion, obstetric history, lifestyle, dietary habits and psychosocial factors. Reliable serum 25-hydroxyvitamin D (25(OH) D) level was measured using an enzyme immunoassay method in the extra nine ml blood sample. Data on date of delivery, baby sex, birth weight, length and gestational age (based on ultrasound or on the timing of the last menstrual period) were collected prospectively.

Results: In the study period of the 80 women recruited, 3.8% were Christians, 78.8% were Hindus and 17.4% were Muslims. All women recruited for the study were >32 wks gestation. It was found that 53.8% had insufficient serum 25 (OH) D concentrations and 13.8% were deficient for vitamin D. The lowest 25(OH) D concentrations (insufficient levels) were found in those with only one-two hours of sun exposure (65.1%), and 54.5% had deficient levels. Highest concentrations (11.5%) were found in those with two-four hours of sun exposure. There were no significant associations between 25(OH) D concentrations and maternal outcome. The analysis showed a significant association between a deficient vitamin D status (45.5%) and low birth weight (<2.5Kg) compared to 15.4% who had normal vitamin D levels. An insufficient vitamin D status was also related to a lower birth weight, but the association was not statistically significant. Among babies born to study subjects 84.6% had a normal birth weight of 2.5-3.5 kg with normal maternal vitamin D levels, when compared to 36.4% with deficient maternal vitamin D levels. We did not find any significant association between Vitamin D levels and neonatal complications.

Conclusions: In our pilot study we found that prevalence of vitamin D deficiency was very high. Our sample size was too small to comment on impact of vitamin D deficiency on fetomaternal outcome. Hence we stopped our study and considered universal supplementation to all pregnant women.

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Hospital is 13 degrees North of Equator

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Attached files

ID Name Comment Uploaded Size Downloads
6537 Kuppam.jpg admin 07 Apr, 2016 12:10 37.43 Kb 419
6536 Low birth weight India.pdf PDF 2016 admin 07 Apr, 2016 12:09 389.48 Kb 416
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