Association between vitamin D deficiency and primary cesarean section.
J Clin Endocrinol Metab. 2009 Mar;94(3):940-5. Epub 2008 Dec 23.
Merewood A, Mehta SD, Chen TC, Bauchner H, Holick MF.
Department of Pediatrics, Division of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, and Division of General Pediatrics, Boston Medical Center, Boston, Massachusetts 02118, USA.
BACKGROUND: At the turn of the 20th century, women commonly died in childbirth due to rachitic pelvis. Although rickets virtually disappeared with the discovery of the hormone vitamin D, recent reports suggest vitamin D deficiency is widespread in industrialized nations. Poor muscular performance is an established symptom of vitamin D deficiency. The current U.S. cesarean birth rate is at an all-time high of 30.2%. We analyzed the relationship between maternal serum 25-hydroxyvitamin D[25(OH)D] status, and prevalence of primary cesarean section.
METHODS: Between 2005 and 2007, we measured maternal and infant serum 25(OH)D at birth and abstracted demographic and medical data from the maternal medical record at an urban teaching hospital (Boston, MA) with 2500 births per year. We enrolled 253 women, of whom 43 (17%) had a primary cesarean.
RESULTS: There was an inverse association with having a cesarean section and serum 25(OH)D levels. We found that 28% of women with serum 25(OH)D less than 37.5 nmol/liter had a cesarean section, compared with only 14% of women with 25(OH)D 37.5nmol/liter or greater (P = 0.012). In multivariable logistic regression analysis controlling for race, age, education level, insurance status, and alcohol use, women with 25(OH)D less than 37.5 nmol/liter were almost 4 times as likely to have a cesarean than women with 25(OH)D 37.5 nmol/liter or greater (adjusted odds ratio 3.84; 95% confidence interval 1.71 to 8.62).
CONCLUSION: Vitamin D deficiency was associated with increased odds of primary cesarean section PMID: 19106272
VITAMIN D DEFICIENCY ASSOCIATED WITH GREATER RATES OF CESAREAN SECTIONS (news release)
Researchers from Boston University School of Medicine (BUSM) and Boston Medical Center (BMC) found that pregnant women who are vitamin D deficient are also at an increased risk for delivering a baby by caesarean section as compared to pregnant women who are not vitamin D deficient. These findings currently appear on-line in the Journal of Clinical Endocrinology & Metabolism.
At the turn of the 20th century, women commonly died in childbirth due to "rachitic pelvis" rickets of the pelvis. While rickets virtually disappeared with the discovery of vitamin D, recent reports suggest that vitamin D deficiency is widespread in industrialized nations.
Over a two-year period, the researchers analyzed the relationship between maternal serum 25-hydroxyvitamin D [25(OH)D] and the prevalence of primary caesarean section. In total, 253 women were enrolled in this study, of whom 43 (17 percent) had a caesarean section. The researchers found that 28 percent of women with serum 25(OH)D less than 37.5 nmol/L had a caesarean section, compared to only 14 percent of women with 25(OH)D greater than 37.5 nmol/L.
"In our analysis, pregnant women who were vitamin D deficient at the time of delivery had almost four times the odds of caesarean birth than women who were not deficient," said senior author Michael Holick, MD, PhD, director of the General Clinical Research Center and professor of medicine, physiology and biophysics at BUSM and Anne Merewood assistant professor of pediatrics at BUSM and lead author of the study.
According to Holick, one explanation for the findings is that vitamin D deficiency has been associated with proximal muscle weakness as well as suboptimal muscle performance and strength.
Wonder how many caesarean births are due to the birth canal being the wrong shape/too narrow due to low vitamin D before and after the mother was born
One study of SE Asia births found that 6.3% were due to cephalopelvic disproportion
MSNBC noted that 1/3 of the births in Asia, Latin American, and the US are now caesarean and it is now 1/2 = 50% of the births in China
See also VitaminDWiki
- Emergency Caesarean 2X more likely if less than 12 ng of Vitamin D – Aug 2020
- A Study of Relationship Between Maternal Vitamin D Status and Mode of Delivery in a Tertiary Care Military Hospital - June 2020  Download the PDF from VitaminDWiki
- Cesarean (associated with low Vitamin D) increased asthma, obesity, miscarriage and stillbirth – meta-analysis Jan 2018
- Pre-term birth 3X more likely and C-section 4X if less than 20 ng of vitamin D – May 2012
- All items in Pregnancy and Vitamin D
- Caesarean emergency risk 2 X higher for Indian women with low Vitamin D – Nov 2015
- Cesarean section 60 percent increased if low vitamin D – Sept 2015
- Unplanned c-section birth 40 percent less often if sufficient vitamin D – Sept 2014
- C-section 4X more likely if less than 20 ng of vitamin D – May 2012
- Unplanned cesarean 2X more likely if vitamin D deficient – April 2012
- Risk of Cesarean 2X higher if low vitamin D – April 2012
See also web
- The unnecesarean.com number of cesarean sections increased by 71% from 1996 to 2007
- 8 in 10 births at private hospitals in Iraq are C-sections MSNBC 8/2011
- UnneCesareans: Documented Causes of a Disturbing Trend Green Med info Dec 2012
Brazil: 97.8% in private hospital vs. 47% in public hospital
- Mercola May 2015
Cesarean sections have become the most common surgery in the US today, accounting for nearly one-third of all births.
In 1965, C-sections represented a mere 4.5 percent of all births.
A study in the British Medical Journal found that a woman's risk of death during delivery is three to five times higher during Cesarean section than vaginal delivery due to complications from blood clots, infection, and anesthesia.
- UNITED STATES MATERNITY CARE FACTS AND FIGURES
notice how C-section varies with mothers-to-be staying out of the sun: 23% in Alaska, 40% in Louisiana, 47% in Puerto Rico
Six of the ten most common hospital procedures in 2009 were maternity-related
- AVERAGE U.S. FACILITY CHARGES FOR GIVING BIRTH has the following chart