Pregnant Women with Inflammatory Bowel Disease are at Increased Risk of Vitamin D Insufficiency: A Cross-Sectional Study.
J Crohns Colitis. 2018 Mar 13. doi: 10.1093/ecco-jcc/jjy030. [Epub ahead of print]
Lee S1, Metcalfe A1,2,3, Raman M3, Leung Y3, Aghajafari F1,4, Letourneau N1,3,5,6, Panaccione R3, Kaplan GG1,3, Seow CH1,3.
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BACKGROUND AND AIMS:
Vitamin D insufficiency is prevalent in individuals with inflammatory bowel disease, as well as in pregnant women; however, the prevalence of vitamin D insufficiency in pregnant women with IBD is unknown. This study assessed the prevalence of vitamin D insufficiency in pregnant women with IBD and the adequacy of recommended supplementation.
A cross-sectional study was conducted in pregnant women with inflammatory bowel disease (Crohn's disease=61, ulcerative colitis=41) and without inflammatory bowel disease (n=574). Chi-square tests and log binomial regression were used to examine the prevalence of vitamin D insufficiency. Covariates included ethnicity and season. Adequacy of vitamin D supplementation during pregnancy was also assessed.
The prevalence of vitamin D insufficiency (25-OHD ≤75 nmol/L) in those with Crohn's disease was 50.8% (95% CI: 38.4%-63.2%) and 60.9% (95% CI: 45.3%-74.7%) with ulcerative colitis compared to 17.4% (95% CI: 14.6%-20.8%) without inflammatory bowel disease.
Women with inflammatory bowel disease were more likely to be vitamin D insufficient after adjusting for ethnicity and season (
- Crohn's disease - adjusted relative risk [aRR]=2.98, 95% CI: 2.19-4.04;
- ulcerative colitis - aRR=3.61, 95% CI: 2.65-4.93).
Despite vitamin D supplementation, 32.3% (95% CI: 17.8%-51.2%) with Crohn's disease, 58.3% (95% CI: 37.1%-76.9%) with ulcerative colitis and 10.8% (95% CI: 6.9%-16.6%) without inflammatory bowel disease were still vitamin D insufficient.
Pregnant women with inflammatory bowel disease are at increased risk of vitamin D insufficiency compared with those without inflammatory bowel disease. The current guidelines for vitamin D supplementation may be inadequate for pregnant women with inflammatory bowel disease.
PMID: 29546360 DOI: 10.1093/ecco-jcc/jjy030