A Case Control Study to Evaluate the Association between Primary Cesarean Section for Dystocia and Vitamin D Deficiency
Journal of Clinical and Diagnostic Research 2015 | September | V 9 | #9 | Page : QC05 - QC08
Ajit Sebastian, Reeta Vijayaselvi, Yohen Nandeibam, Madhupriya Natarajan, Thomas Vizhalil Paul, B.Antonisamy, Jiji Elizabeth Mathews coronistrial at yahoo.co.in
1. Registrar, Department of Obstetrics and Gynaecology, Christian Medical College, Vellore, Tamilnadu, India. 2. Associate Professor, Department of Obstetrics and Gynaecology, Christian Medical College, Vellore, Tamilnadu, India. 3. Assistant Professor, Department of Obstetrics and Gynaecology, Christian Medical College, Vellore, Tamilnadu, India. 4. Assistant Professor, Department of Obstetrics and Gynaecology, Christian Medical College, Vellore, Tamilnadu, India. 5. Professor, Department of Endocrinology, Christian Medical College, Vellore, Tamilnadu, India. 6. Professor, Department of Biostatistics, Christian Medical College, Vellore, Tamilnadu, India. 7. Professor, Department of Obstetrics and Gynaecology Unit V, Christian Medical College, Ida Scudder Road, Vellore, South India.
Background: Milder forms of vitamin D deficiency could be responsible for poor muscular performance causing dysfunctional labor. The aim of our research was to study the association between vitamin D deficiency and primary cesarean section.
Materials and Methods: This was a case control study. Forty six women who delivered by primary cesarean section with dystocia as primary or secondary indication after 37 weeks of gestation were taken as cases and a similar number of women who delivered vaginally were taken as controls. Vitamin D deficiency was diagnosed when the serum 25(OH)D level was =20 ng/ml and this was compared between cases and controls.
Results: Median serum (OH) vitamin D levels was 23.3ng/ml among women who delivered by cesarean section and 26.2ng/ ml among controls (p=0.196). Baseline characteristics were similar in both groups except for a strong association between Body Mass Index (BMI) and cesarean section, (29.7kg/m2 in cases and 25.9kg/m2 in controls p=0.001) seen in multivariate analysis. Vitamin D deficiency was seen in 34.8% of cases and 21.7% of controls (p=0.165).
Conclusion: This small case control study did not show a significant association between vitamin D deficiency and primary cesarean section.
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- Caesarean birth much more likely if low Vitamin D - many studies which has the following chart
- Overview Pregnancy and vitamin D has the following summary
| IU | Cumulative Benefit | Blood level | Cofactors | Calcium | $*/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 |
c-section OR "caesarean section" 118 items as of Sept 2015