Vitamin D Postpartum Concentrations: Relationship with Nutritional Condition and Morbidities during Pregnancy

Abstract

Objective To evaluate postpartum vitamin D deficiency/insufficiency and to relate it to pregestational BMI, gestational weight gain, and sociodemographic variables. Methods This is a cross-sectional study with 225 full-term pregnant women. Data collected are as follows: maternal health, socioeconomic status, pregestational body mass index (BMI), and gestational weight gain. Laboratory evaluation included vitamin D [25(OH)D], calcium, phosphorus, magnesium, and alkaline phosphatase. Results The mean age of women was 25.6±6.6 years. Dark skin color, low education, and work in the urban region were predominant. Regular sun exposure, photoprotection, and vitamin D supplementation were reported by 144 (64.0%), 44 (19.6%), and 5 (2.2%) women, respectively. The mean plasma concentrations of 25(OH)D were 26.0±6.8 ng/mL. Levels compatible with deficiency (<20 ng/mL) and insufficiency (20-30 ng/mL) were observed in 43 (19.1%) and 124 (55.1%) women, respectively. The increase of 1 ng/mL in 25(OH)D concentrations was associated with an increase of 0.16 mg/dL (95%CI 0.19 to 2.02; p=0.018) for calcium. There were no associations with 25(OH)D concentrations with pregestational BMI and with gestational weight gain. Conclusions The high frequency of postpartum vitamin D deficiency/insufficiency in women with a full-term pregnancy in a region with a large and permanent sun exposure reminds us of the need for intervention policies aimed at preventing vitamin D deficiency during pregnancy.

Deficiency and Insufficiency of Vitamin D in Women of Childbearing Age: A Systematic Review and Meta-analysis

“…The studies were conducted between 1995 and 2017 (six studies did not report inclusion period), in cities in the Southeast ( n = 18), South ( n = 7), Northeast ( n = 5), and Center-west ( n = 2) Brazilian regions, with women selected mainly from outpatient care ( n = 20). Araújo et al, 32 Queiroz, 33 Queiroz et al, 34 de Oliveira et al, 35 and dos Santos et al 36 used a random probabilistic sampling, while Martins et al 37 used convenience sampling ( Chart 1 ). 3 17 18 19 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68…”

“…Araújo et al, 32 Queiroz, 33 Queiroz et al, 34 de Oliveira et al, 35 and dos Santos et al 36 used a random probabilistic sampling, while Martins et al 37 used convenience sampling ( Chart 1 ). 3 17 18 19 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68…”

“…The main characteristics of the participants are described in Chart 2 . 3 17 18 19 32 33 34 35 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 …”

“…For instance, when considered vitamin D deficiency in postpartum women (48%, 95% CI 44-52%, I 2 99%), Martins et al 37 identified prevalence of 19%, whereas Prado et al 3 described it as 85%. While Martins et al 37 included 79% of dark-skin women (variable associated with deficiency), 64% using supplement (variable associated with sufficiency), and during spring and summer (variable associated with sufficiency); Prado et al 3 included 52% of white women (variable associated with sufficiency), 97% using supplement (variable associated with sufficiency), and throughout the year. Moreover, it was not possible to conduct a robust subgroup analysis to explore the heterogeneity, as well as to identify possible associated factors to deficiency or insufficiency of vitamin D, since most studies did not report the characteristics of the participants, nor population subgroup analysis using common categories.…”

Prevalence of vitamin D and calcium deficiencies and their health impacts on women of childbearing age: a protocol for systematic review and meta-analysis

“…Vitamin D deficiency is considered a significant public health problem and affects approximately one billion people worldwide 6 7. However, there are significant data gaps in measuring this problem magnitude in many countries 8.…”