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.

(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

• C-section 4X more likely when vitamin D less than 37 ng – many items
• All items in Pregnancy and Vitamin D 918 items
• Cesarean (associated with low Vitamin D) increased asthma, obesity, miscarriage and stillbirth – meta-analysis Jan 2018
• 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