Hypovitaminosis D Deleteriously Affect Pregnancy Outcome: A Proposed Role for Daily Vitamin D Supplementation to Improve Outcome.

Abstract

Objectives: To estimate serum 25-hydroxy vitamin D (25OHD) levels in newly pregnant women and to evaluate its relation to development of gestational diabetes mellitus (GDM) and maternal and fetal outcome. Patients & Methods: The study included 328 pregnant women, and at 6 th week gestational age (GA), women's clinical and obstetric data were collected and blood samples were obtained for estimation of baseline blood glucose (BG) and serum 25OHD levels. Studied women were divided into two equal groups: Group A included pregnant women received supplemental vitamin D3 in a daily dose of 1000 IU oral capsule starting since 6 th week GA till delivery. Group B included pregnant women who completed their pregnancy without vitamin D supplementation. All women underwent the 75g Oral Glucose Tolerance Test (75-OGTT) at the 20 th , 28 th and 36 th week for detection of GDM. All women were followed up till delivery and maternal and neonatal outcome. Results: Serum 25OHD levels were sufficient, insufficient and deficient in 42, 142 and 144 women, respectively. Forty-three women (13.1%) developed GDM and 62 women (18.9%) had emergency and 23 women had elective CS. Moreover, 48 neonates (14.6%) required NICU admission; 15 for respiratory-aid, 22 for phototherapy and 11 neonates for management of sepsis, but 4 neonates died. Women of group A showed significantly lower frequency of GDM with significantly lower BG levels, significantly lower frequency of CS especially emergency CS and significantly lower frequency of NICU admission. Conclusion: Low serum 25OHD levels are a widespread problem among pregnant women and are associated with higher frequency of GDM, CS delivery especially emergency ones and NICU admission rate. Supplemental vitamin D therapy did well for reducing the frequencies of these events. Supplemental daily dose of 1000 IU appears appropriate and convenient as it was taken in the form of oral capsules.