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
|0. Chance of not conceiving||3.4 times||Observe|
|1. Miscarriage||2.5 times||Observe|
|2. Pre-eclampsia||3.6 times||RCT|
|3. Gestational Diabetes||3 times||RCT|
|4. Good 2nd trimester sleep quality||3.5 times||Observe|
|5. Premature birth||2 times||RCT|
|6. C-section - unplanned||1.6 times||Observe|
|Stillbirth - OMEGA-3||4 times||RCT - Omega-3|
|7. Depression AFTER pregnancy||1.4 times||RCT|
|8. Small for Gestational Age||1.6 times||meta-analysis|
|9. Infant height, weight, head size |
within normal limits
|10. Childhood Wheezing||1.3 times||RCT|
|11. Additional child is Autistic||4 times||Intervention|
|12.Young adult Multiple Sclerosis||1.9 times||Observe|
|13. Preeclampsia in young adult||3.5 times||RCT|
|14. Good motor skills @ age 3||1.4 times||Observe|
|15. Childhood Mite allergy||5 times||RCT|
|16. Childhood Respiratory Tract visits||2.5 times||RCT|
RCT = Randomized Controlled Trial
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.
Banked sera of 2496 women from the 12th week of pregnancy.
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.
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).
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.
- Perinatal asphyxia Wikipedia
"Perinatal asphyxia happens in 2 to 10 per 1000 newborns that are born at term, and more for those that are born prematurely."
"WHO estimates that 4 million neonatal deaths occur yearly due to birth asphyxia, representing 38% of deaths of children under 5 years of age"