Publication:

An observational study on the magnitude of vitamin D levels in first trimester of pregnancy and the outcomes

Background Vitamin D deficiency is a common public health concern during pregnancy and has been associated with impaired glucose metabolism, abnormal placentation, and adverse maternal and neonatal outcomes. This study assessed the magnitude of maternal vitamin D deficiency during early pregnancy and evaluate its association with maternal and neonatal outcomes.

Methods A prospective observational study was conducted among 302 singleton pregnant women attending the department of obstetrics and gynecology, ESIMC and PGIMSR Rajajinagar, Bangalore, over 18 months. Serum 25-hydroxyvitamin D levels were measured between 12-18 weeks of gestation. Participants were followed until delivery. The maternal outcomes evaluated included gestational diabetes mellitus, hypertensive disorders during pregnancy, anaemia, hypothyroidism, mode of delivery, and preterm birth. Neonatal outcomes included birth weight, low birth weight, Apgar score, and NICU admission. Associations were analyzed using chi-square tests.

Results Of the 302 participants, 63 (20.9%) were vitamin D deficient, 174 (57.6%) insufficient, and 65 (21.5%) sufficient, indicating that 78.5% had suboptimal vitamin D levels. GDM occurred in 63 (20.9%) women and showed a significant association with vitamin D deficiency (χ2=14.34, p<0.001). Preeclampsia (3.3%) was also significantly higher among deficient mothers (χ2=15.57, p<0.001). No significant association was observed with anaemia, hypothyroidism, low birth weight, preterm delivery, or mode of delivery. Among 286 live births, NICU admission occurred in 20.6% neonates and was markedly higher among deficient mothers.

Conclusions Vitamin D deficiency is a public health problem. Patient awareness and pre-pregnancy counselling with adequate supplementation will improve maternal and neonatal outcomes and minimize the complications.