Pregnancy and low vitamin D in Qataris and women around the world – Sept 2013

Association between vitamin D insufficiency and adverse pregnancy outcome: global comparisons

International Journal of Women's Health, September 2013 Volume 2013:5 Pages 523 - 531,DOI: http://dx.doi.org/10.2147/IJWH.S51403
Bener A, Al-Hamaq AO, Saleh NM
1 Department of Medical Statistics and Epidemiology, Hamad General Hospital, Doha, Qatar;
2 Institute of Population Health, University of Manchester, Manchester, UK; 3Qatar Diabetic Association, Doha, Qatar; 4Department of Obstetrics and Gynecology, Women's Hospital, Doha, Qatar

Background: Vitamin D insufficiency has been associated with a number of adverse pregnancy outcomes, and has been recognized as a public health concern.

Aim: The objective of this study was to determine the impact of vitamin D deficiency on maternal complications like gestational diabetes mellitus (GDM), anemia, iron deficiency, and preeclampsia among pregnant women.

Subjects and methods: This was a cohort study undertaken at antenatal clinics at the Women's Hospital of Hamad Medical Corporation in Doha. A total of 2,487 Arab pregnant women above 24 weeks' gestation with any maternal complication were approached, and 1,873 women (75.3%) consented to participate in the study. Data on sociodemographic and clinical characteristics by interview and biochemistry parameters were retrieved from medical records. Multivariate logistic regression analysis was performed to determine the associated risk factors.

Results: Of the studied pregnant women, nearly half of them had vitamin D deficiency (48.4%). Younger women below 30 years old (43.2%, P = 0.032), housewives (65.3%, P = 0.008), and those on low monthly household incomes (QR5,000–9,999) (49.2%, P = 0.03) were significantly more likely to have lower vitamin D compared with those who had sufficient vitamin D levels. Exposure to sunlight (63.4%, P = 0.05), daily physical activity (64.4%, P = 0.05), and vitamin D supplement intake (89.7%, P < 0.001) were significantly lower in deficient pregnant women.
In the study sample of pregnant women,

• 13.9% had GDM,
• 11.5% had anemia,
• 8.6% had iron deficiency, and
• 6.9% had preeclampsia.

Severe vitamin D deficiency was significantly higher in pregnant women with

• GDM (16.5% vs 11%),
• anemia (17.1% vs 11%),
• iron deficiency (18.5% vs 11.2%), and
• preeclampsia (19.8% vs 11.4%)

when compared to the uncomplicated group.
Socioeconomic status was low in pregnant women with complications like GDM, anemia, iron deficiency, and pre-eclampsia.
Pregnancy complications like GDM (52.7%), anemia (53.2%), iron deficiency (55.6%), and preeclampsia (51.9%) were higher in Qataris.

Also, GDM (66.2%), anemia (66.2%), iron deficiency (68.5%), and preeclampsia (58.1%) were observed more commonly among housewives compared to working women.
Obesity was significantly more common in pregnant women with GDM (41.5%) and preeclampsia (41.1%).

Conclusion: The study findings revealed that maternal vitamin D deficiency in pregnancy is significantly associated with elevated risk for GDM, anemia, and preeclampsia.
The risk of vitamin D deficiency was higher in Qataris, housewives and those with low monthly household income.

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See also VitaminDWiki

• NONE of the pregnant Beijing women had adequate levels of vitamin D – April 2013
• Vitamin D levels in healthy populations around the globe – Aug 2012
• All items in Pregnancy and Vitamin D 924 items
• Pregnancy needs 4000 IU of vitamin D: current opinion - June 2013
• Pregnant women should have 4,000 IU of vitamin D – Topic review June 2013
• Overview Pregnancy and vitamin D which 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