Prevalence and association with birth outcomes of low vitamin D levels among pregnant women living with HIV

Abstract

Objectives: To evaluate the prevalence of low vitamin D levels among well treated pregnant women living with HIV (WLWH) on combination antiretroviral therapy in Denmark, to identify risk factors of low vitamin D levels, and to assess the association between vitamin D status and birth outcomes.Design: Nationwide cohort study.Methods: All WLWH in Denmark giving birth from 2000 to 2018 with a vitamin D measurement during pregnancy were identified. Risk factors for low vitamin D (deficiency or insufficiency) were assessed using log-binomial regression models, both univariate and adjusted for maternal and HIV factors. The association between vitamin D status and birth outcomes was assessed using linear regression models for continuous outcomes and log-binomial models for binary outcomes.Results: Among 208 WLWH, the prevalence of vitamin D deficiency was 13%, insufficiency 34%, and sufficiency 53%. Being of African origin (RR 2.68, P ¼ 0.01), Asian origin (RR 3.38, P ¼ < 0.01), or having HIV RNA levels more than 50 copies/ml (RR 1.43, P ¼ 0.04) was associated with an increased risk of low vitamin D level. WLWH with vitamin D deficiency had an increased risk of preterm birth (RR 2.66, P ¼ 0.03) and giving birth to small for gestational age (SGA) children (RR 6.83, P ¼ 0.02) compared with WLWH with sufficient vitamin D level. Conclusion:Low vitamin D level was prevalent among well treated pregnant WLWH in Denmark, especially among women of African or Asian origin, and women with detectable viral loads. Vitamin D deficiency was associated with an increased risk of preterm birth and SGA.

Prevalence and risk factors of vitamin D deficiency among living with HIV adults receiving antiretroviral treatment in tropical area: Cross-sectional study

“…Among the female population in our study, 65.3% (132:202) were VDD, which was five times greater than a study of HIV-infected pregnant women in Denmark (65.3%:13%) [ 29 ]. The cause of VDD may be due to factors common to VDD in today's culture that are different from those in the past, such as lifestyle habits that tend to avoid sunlight.…”