Birth asphyxia 2.4 more likely if low maternal vitamin D

Created September 2016

Maternal vitamin D deficiency and fetal distress/birth asphyxia: a population-based nested case-control study.

BMJ Open. 2016 Sep 22;6(9):e009733. doi: 10.1136/bmjopen-2015-009733.

Lindqvist PG1, Silva AT2, Gustafsson SA3, Gidlöf S4.

1Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden Department of Obstetrics & Gynecology, Karolinska University Hospital, Stockholm, Sweden.

2Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.

3Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.

4Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden Department of Obstetrics & Gynecology, Karolinska University Hospital, Stockholm, Sweden Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.

* Vitamin D once during pregnancy reduced infant health care costs (300 times ROI) – RCT Dec 2015 * Vitamin D is being used to prevent premature births – Baggerly interview – Dec 2015 * Ensure a healthy pregnancy and infant with as little as $20 of Vitamin D * Premature birth and infant mortality worse if dark skin (low vitamin D) - 2015 * Note - study on this page does not seem to consider with dark skin pregnancies Healthy pregnancies need lots of vitamin D has the following summary {include}

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OBJECTIVE:

Vitamin D deficiency causes not only skeletal problems but also muscle weakness, including heart muscle. If the fetal heart is also affected, it might be more susceptible to fetal distress and birth asphyxia. In this pilot study, we hypothesised that low maternal vitamin D levels are over-represented in pregnancies with fetal distress/birth asphyxia.

DESIGN AND SETTING:

A population-based nested case-control study.

PATIENTS:

Banked sera of 2496 women from the 12th week of pregnancy.

OUTCOME MEASURES:

Vitamin D levels were analysed using a direct competitive chemiluminescence immunoassay. Vitamin D levels in early gestation in women delivered by emergency caesarean section due to suspected fetal distress were compared to those in controls. Birth asphyxia was defined as Apgar <7 at 5 min and/or umbilical cord pH=7.15.

RESULTS:

Vitamin D levels were significantly lower in mothers delivered by emergency caesarean section due to suspected fetal distress (n=53, 43.6±18 nmol/L) compared to controls (n=120, 48.6±19 nmol/L, p=0.04). Birth asphyxia was more common in women with vitamin D deficiency (n=95) in early pregnancy (OR 2.4, 95% CI 1.1 to 5.7).

CONCLUSIONS:

Low vitamin D levels in early pregnancy may be associated with emergency caesarean section due to suspected fetal distress and birth asphyxia. If our findings are supported by further studies, preferably on severe birth asphyxia, vitamin D supplementation/sun exposure in pregnancy may lower the risk of subsequent birth asphyxia.

PMID: 27660312

Birth asphyxia 2.4 more likely if low maternal vitamin D

Maternal vitamin D deficiency and fetal distress/birth asphyxia: a population-based nested case-control study.

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