Is First Trimester Maternal 25-Hydroxyvitamin D Level Related to Adverse Maternal and Neonatal Pregnancy Outcomes? A Prospective Cohort Study among Malaysian Women

Abstract

Information on the role of 25-hydroxyvitamin D (25(OH)D) in preventing adverse pregnancy/neonatal outcomes is limited in Malaysia. This study aims to determine the relationship between the level of maternal 25(OH)D in the first trimester of pregnant women and their pregnancy/neonatal outcomes. A total of 60 pregnant women in the first trimester were recruited and followed until the end of their pregnancy. The occurrence of any antenatal, delivery, and neonatal complications was recorded. Their blood was collected in the first trimester for total serum 25(OH)D determination using enzyme-linked immunosorbent assay. Overall, 10% of the women had vitamin D deficiency, while 57% had vitamin D insufficiency in their first trimester. No statistically significant difference in 25(OH)D level/status was observed between women with or without antenatal and delivery complications (p > 0.05). No difference in maternal serum 25(OH)D level and vitamin D status was observed between neonates with or without complications (p > 0.05). In conclusion, there is a high prevalence of vitamin D insufficiency among Malaysian pregnant women, but it is not associated with adverse maternal and neonatal outcomes. More comprehensive studies should be planned to verify this relationship.

Longitudinal Vitamin D Deficiency Among Malaysian Pregnant Women and Its Correlation With Neonatal Serum 25-Hydroxyvitamin D Levels

“…About nine out of 10 healthy pregnant women in urban Malaysia suffered from vitamin D deficiency throughout their pregnancy. Our findings verified the previous local prevalence studies whereby a high prevalence of vitamin D deficiency was reported in all trimesters ( 1 , 4 , 33 , 34 ). The current study revealed that the prevalence of vitamin D deficiency (25(OH)D <50 nmol/L) was 89.9% in the early pregnancy (≤20 weeks of pregnancy) and 92.2% at late pregnancy (28–40 weeks of pregnancy).…”

Barriers towards Sun Exposure and Strategies to Overcome These Barriers in Female Indoor Workers with Insufficient Vitamin D: A Qualitative Approach

“…The participants assumed that the UVA they are exposed to while driving in the car and sitting by office window (with glasses) might provide them with vitamin D. A previous study done in a Malaysian sub-urban setting among post-menopausal Malay women found that poor knowledge on vitamin D influenced their sun exposure behavior [ 33 ]. The similarity of the findings could be owing to the lack of knowledge regarding vitamin D health benefits compared to other groups of vitamins among both urban and sub-urban females in Malaysia [ 1 , 6 , 33 ].…”

“…The clinical evidence of vitamin D deficiency and nonskeletal health is not yet validated [ 5 ]. In countries where dietary vitamin D food intake and supplements are limited [ 6 ], and fortification of food with vitamin D is not compulsory, sunlight exposure is the primary source of vitamin D among the populations [ 6 , 7 ]. Government bodies often establish sun exposure guidelines to ensure a balance between the beneficial and harmful effects of sunlight [ 7 ].…”

“…This could also explain the lower vitamin D status among females compared to males as a result of higher body fat mass in females [ 16 ]. The limited sun exposure, especially in tropical countries, such as Malaysia, Thailand, Saudi Arabia and Iran, is mainly due to sun avoidance practice that is influenced by cultural, racial and religious backgrounds [ 2 , 6 , 8 , 9 ]. Malaysia is a unique multi-racial country, which is mainly composed of Malays, Chinese and Indians with various skin types.…”

“…Malaysia is a unique multi-racial country, which is mainly composed of Malays, Chinese and Indians with various skin types. The high-risk groups of vitamin D insufficiency in Malaysia are children [ 17 ], adolescents [ 18 , 19 ], females [ 19 , 20 , 21 ], urban population [ 17 , 21 ], indoor workers [ 6 , 21 ], obese [ 17 , 18 ] and Indian and Malay ethnicities due to higher skin pigmentation and clothing styles (especially among Malay women wearing full-body garments) [ 2 , 6 , 17 , 19 ].…”