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Risk of Cesarean 2X higher if low vitamin D – April 2012

Maternal Vitamin D Status and Delivery by Cesarean

Nutrients 2012, 4(4), 319-330; doi:10.3390/nu4040319
Theresa O. Scholl 1 scholl at umdnj.edu , Xinhua Chen 1 and Peter Stein 2
1 Two Medical Center Drive, Department of Obstetrics and Gynecology, SOM, University of Medicine and Dentistry of New Jersey, Stratford, NJ 08084, USA
2 Two Medical Center Drive, Department of Surgery, SOM, University of Medicine and Dentistry of New Jersey, Stratford, NJ 08084, USA
Received: 29 November 2011; in revised form: 23 February 2012 / Accepted: 13 April 2012 / Published: 20 April 2012

Abstract: We examined the association of vitamin D deficiency to risk of cesarean delivery using prospective data in a cohort of 1153 low income and minority gravidae. Circulating maternal 25-hydroxyvitamin D and intact parathyroid hormone were measured at entry to care 13.73 ± 5.6 weeks (mean ± SD). Intake of vitamin D and calcium was assessed at three time points during pregnancy. Using recent Institute of Medicine guidelines, 10.8% of the gravidae were at risk of vitamin D deficiency, and 23.8% at risk of insufficiency. Maternal 25-hydroxyvitamin D was related positively to vitamin D and calcium intakes and negatively to circulating concentrations of parathyroid hormone. Risk for cesarean delivery was increased significantly for vitamin D deficient women; there was no increased risk for gravidae at risk of insufficiency.

When specific indications were examined, vitamin D deficiency was linked to a 2-fold increased risk of cesarean for prolonged labor.
Results were the similar when prior guidelines for vitamin D deficiency (25(OH)D < 37.5nmol/L) and insufficiency (37.5–80 nmol/L) were utilized.

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(AOR = Adjusted Odds Ratio)

PDF is attached at the bottom of this page
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Summary of RCT without enough participants:

400 IU ==> 25% Cesarean; 4000 IU ==> 14% Cesarean

See also VitaminDWiki

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

Attached files

ID Name Comment Uploaded Size Downloads
1254 Cesarean.jpg admin 20 Apr, 2012 34.59 Kb 1529
1253 Cesarean April 2012.pdf admin 20 Apr, 2012 854.68 Kb 1096