Prevalence of Vitamin D Deficiency in Burka-clad Pregnant Women in a 450-Bedded Maternity Hospital of Delhi

Abstract

Aim To assess the prevalence of vitamin D deficiency in burka-clad pregnant women and to study feto-maternal outcome in these women. Methods 200 pregnant burka-clad women of 18-40-year age group irrespective of the period of gestation were recruited from the ANC OPD/ward of Kasturba hospital, and their vitamin D levels were estimated. Patients were categorized into vitamin D deficient, vitamin D inadequate, and vitamin D adequate according to The Endocrine Society Guidelines. The association of vitamin D deficiency with dietary/environmental factors was taken note of. Associations with preeclampsia, gestational diabetes mellitus (GDM), low birth weight (LBW), prematurity, APGAR score, and NICU admission were also studied. Results 78 patients (39.0 %) were vitamin D inadequate; 75 patients (37.5 %) were vitamin D deficient; and 47(23.5 %) were vitamin D adequate. Mean value of vitamin D level was 23.25 ng/ml ± 18.49 (SD). Fifteen patients (7.5 %) developed preeclampsia, and all 15 were vitamin D deficient; 13 (6.5 %) developed GDM; and only 5 (2.5 %) of them were vitamin D deficient. 19 patients (9.5 %) delivered LBW babies; mothers of 15 (7.5 %) of them were vitamin D deficient. 12 patients (6.0 %) 123 delivered premature babies, and mothers of 4 (2 %) were vitamin D deficient; 12 babies had APGAR score \7 at 5 min; mothers of 4 (2.0 %) were vitamin D deficient. Babies of 12 patients (6 %) were admitted in NICU, and of these 12 babies, mothers of 5 (2.5 %) were vitamin D deficient. Conclusion The prevalence of vitamin D deficiency was high among burka-clad pregnant women, and it is associated with adverse maternal and fetal outcomes. Routine screening of vitamin D levels is recommended in burkaclad women to improve the feto-maternal outcome.

Associations of Maternal Vitamin D Deficiency with Pregnancy and Neonatal Complications in Developing Countries: A Systematic Review

“…Overall the 13 studies represented data from seven different countries within Asia [ 24 , 26 , 34 , 35 , 36 ], the Middle East [ 25 , 37 , 38 , 39 , 40 ] and Africa [ 6 , 27 ]. Two studies were conducted in India [ 24 , 34 ], three in China [ 26 , 35 , 36 ], three in Turkey [ 37 , 38 , 41 ], two in Iran [ 25 , 40 ] and one in each of Pakistan [ 42 ], Kenya [ 6 ] and Nigeria [ 27 ].…”

“…Overall the 13 studies represented data from seven different countries within Asia [ 24 , 26 , 34 , 35 , 36 ], the Middle East [ 25 , 37 , 38 , 39 , 40 ] and Africa [ 6 , 27 ]. Two studies were conducted in India [ 24 , 34 ], three in China [ 26 , 35 , 36 ], three in Turkey [ 37 , 38 , 41 ], two in Iran [ 25 , 40 ] and one in each of Pakistan [ 42 ], Kenya [ 6 ] and Nigeria [ 27 ]. Seven studies were conducted in the inpatient setting within large maternity hospitals [ 6 , 24 , 25 , 26 , 27 , 38 , 39 ] and four studies involved women who were recruited as outpatients, attending antenatal clinic bookings [ 34 , 37 , 40 , 41 ].…”

“…Two studies were conducted in India [ 24 , 34 ], three in China [ 26 , 35 , 36 ], three in Turkey [ 37 , 38 , 41 ], two in Iran [ 25 , 40 ] and one in each of Pakistan [ 42 ], Kenya [ 6 ] and Nigeria [ 27 ]. Seven studies were conducted in the inpatient setting within large maternity hospitals [ 6 , 24 , 25 , 26 , 27 , 38 , 39 ] and four studies involved women who were recruited as outpatients, attending antenatal clinic bookings [ 34 , 37 , 40 , 41 ]. One study included women recruited through both of these settings [ 36 ] and the study conducted by Chen et al assessed a sub sample of a large population-based birth cohort study in China [ 35 ].…”

“…Five different methods across studies were used to measure serum 25OHD levels. Six studies used enzyme-linked immunosorbent assay (ELISA) methods [ 6 , 24 , 25 , 26 , 38 , 41 ]. Each study showed one or more positive association between VDD and maternal and/or neonatal health outcomes.…”

“…For women in developing countries specifically, although there has been recent research which has reported on the prevalence of VDD in such populations and in some cases on pregnancy complications [ 24 , 25 , 26 , 27 ], there has been no published systematic review assessing associations of maternal VDD with maternal and/or neonatal outcomes. In order to assist women to achieve optimal vitamin D levels during pregnancy via culturally suitable strategies, it is necessary to first investigate the impact of deficiency on health outcomes in “high risk” populations throughout the developing world.…”