Vitamin D Deficiency in Turkish Mothers and Their Neonates and in Women of Reproductive Age

Abstract

Objective: Materno-fetal vitamin D deficiency (VDD) may occur in the early neonatal period. We aimed to evaluate the vitamin D (vitD) status and risk factors for VDD in healthy newborns and their mothers, and also in fertile women. Methods: Serum 25 hydroxyvitamin D3 (25(OH)D), calcium (Ca), phosphorus (P) and alkaline phosphatase (ALP) levels were measured in 70 mothers (study group) and their newborns, and in umbilical cord samples. 104 nonpregnant fertile women comprised the control group. Demographic factors such as education and clothing habits of the mother, number of pregnancies and month of delivery were recorded. A serum 25(OH)D level below 11 ng/ml was accepted as severe, 11-25 ng/ml as moderate VDD, and a value over 25ng/ml as normal. Results: Severe VDD was found in 27% of the mothers, and moderate deficiency in 54.3%. Severe VDD was detected in 64.3% of the neonates, and moderate deficiency in 32.9%. Only 18.6% of the mothers and 2.9 % of the neonates had normal vitD levels. In thecontrol group, severe VDD was observed in 26.9%, and moderatedeficiency in 45.2 %. Only 27.8 % of the controls had normal vitD levels. In the control group, the 25(OH)D levels of the women dressed in modern clothes were significantly higher than those of the women wearing traditional clothes. This difference was not observed in the study group because 75% of these 70 mothers wore modern clothes. Mothers giving birth during the summer months and their neonates had significantly higher serum 25(OH)D levels than those of the mothers giving birth during the winter months and their neonates. Conclusion: The study has shown that in Turkey VDD is an important problem in women of reproductive age, in mothers and their neonates. The 25(OH)D levels obtained from the cord may serve as a guide in the determination of the high risk groups.Conflict of interest:None declared.

Incidence of maternal vitamin D deficiency in a region of Ankara, Turkey: a preliminary study

“…25(OH)D 3 transfers to the baby during pregnancy through the placenta and, thus, the vitamin D level of the umbilical cord blood of the baby indicates 80%-100% of the maternal vitamin D level (22). Similarly, Ergür et al suggested that 25(OH)D 3 levels in the umbilical cord blood were a good predictor of the vitamin D level in the newborn, and hence it could be a feasible method to use in newborns that are thought to be in the risk group for vitamin D deficiency, as it is a noninvasive test (14). Similarly, the identification of a strong positive correlation between maternal and umbilical cord blood vitamin D levels was found to be compatible with the literature findings.…”

“…In the study by Andiran et al performed in 2002 in Ankara, the rate of vitamin D deficiency (<10 ng/ mL) was found to be 46% and 80% in mothers and their babies, respectively (20). In another study from Ankara in 2009, vitamin D deficiency was classified as severe and intermediate; cases with a vitamin D level of less than 11 ng/mL were defined as severe and levels between 11 and 25 ng/mL were defined as intermediate vitamin D deficiency (14). Vitamin D deficiency was seen in 81.4% of mothers, with 27% and 54.3% of them having severe and intermediate types of deficiency, respectively; 64.3% of newborns had severe vitamin D deficiency and 32.9% had intermediate vitamin D deficiency, with a total incidence of 97.2% (14).…”

“…The primary source of vitamin D for a newborn baby is the vitamin D that passes transplacentally to the baby from the mother in the intrauterine period (14). In a baby with maternal vitamin D deficiency, findings of vitamin D deficiency (neonatal hypocalcemia and congenital rickets) may appear immediately after birth since the breast milk is also a poor source of vitamin D (15).…”

“…In another study from Ankara in 2009, vitamin D deficiency was classified as severe and intermediate; cases with a vitamin D level of less than 11 ng/mL were defined as severe and levels between 11 and 25 ng/mL were defined as intermediate vitamin D deficiency (14). Vitamin D deficiency was seen in 81.4% of mothers, with 27% and 54.3% of them having severe and intermediate types of deficiency, respectively; 64.3% of newborns had severe vitamin D deficiency and 32.9% had intermediate vitamin D deficiency, with a total incidence of 97.2% (14). In a study by Pehlivan et al performed in Kocaeli in 2003, vitamin D levels were found to be <16 ng/mL in 95% of the mothers and <10 ng/mL in 80% of the mothers (12).…”

Vitamin D deficiency is a problem for adult out-patients? A university hospital sample in Istanbul, Turkey

“…Interestingly, supporting the significantly lower 25(OH)D levels in our elderly but not younger female patients when compared with males, the age-related fall in vitamin D level was previously reported not to be the same in both genders and suggested to occur at a younger age in women than men (5,21) . While strong seasonal variation in serum 25(OH)D with a marked downward shift during the winter months has been reported consistently (22) , identification of vitamin D deficiency even in the summer months in our countrywhich has, in most of its geographic regions, sufficient sunshine to maintain adequate vitamin D status by dermal synthesis (23)(24)(25) -seems worth noting. In this vein, similar to studies indicating lower levels of vitamin D in females that mainly reflect lifestyle and dress style (5,26,27) , most Turkish women of reproductive age were documented to lack benefit from this source because of their clothing habits (28) .…”