Maternal Vitamin D Deficiency and Insufficiency - Prevelance and Effective Factors

Yıl 2018, Cilt: 4 Sayı: 3, 20 - 25, 27.12.2018

Deha Denizhan Keskin

https://doi.org/10.19127/mbsjohs.474947

Öz

Objective: We aimed to reveal the prevalences of vitamin D
deficiency and severe deficiency in pregnant women who applied for routine
examination in our study.

Material and
Methods: Between January 2015 and January 2018, 635 healthy
pregnant women who applied to our clinic for the first trimester routine
pregnancy examination were included in the study. The age, place of residence,
season in which the material was taken, 25 - OH vitamin D levels were reached.
Vitamin D level under 10 ng/ml was accepted as severe deficiency, 10 - 30 ng/ml
insufficiency and 30 - 100 ng/ml normal.

Results: Vitamin
D deficiency was detected in 58.1 % and severe deficiency was found in 36.9 %,
while vitamin D levels were normal in only 5 % of the patients. Vitamin D
levels were significantly lower in the 35 years old group (95.8 % - 90.9 %) (p =
0.03). There was no statistical correlation between the place of residence and
vitamin D (94.6 % - 95.7 %) (p = 0.529). We found abnormal vitamin D results in
winter and autumn season (98 % - 99.4 % versus 89.4 % - 93.3 %) (p = 0,000).

Conclusion: We observed that vitamin D deficiency and severe
deficiency, which have serious maternal and neonatal effects, are quite common
in our society (95 %). We are in the belief that how much decrease in negative
maternal and perinatal outcomes have been observed with the ‘Vitamin D
Supplement Programme in Pregnancy’ hold by T.C. Ministry of Health, via using
1200 IU vitamin D perday from 12 week of pregnancy until postpartum 6th month,
by cross-sectional studies and if the first 6 year results are in positive
direction, deficiency must be replaced according to age, season, and the
geographic region with more effective methods.

Anahtar Kelimeler

Vitamin D, pregnancy, prevalence

Kaynakça

• 1. Iyidir ÖT, Altınova AE. Vitamin D and Diabetes Mellitus. Turkish Journal of Endocrinolgy and Metobolism 2012;16:89-94.2. Barrett H, McElduff A. Vitamin D and pregnancy: An old problem revisited. Best Practice & Research Clinical Endocrinology & Metabolism 2010;24:527-39.3. Fidan F, Alkan BM, Tosun A. Pandemic Era: Vitamin D Deficiency and Insufficiency. Turkisch Journal of Osteoporosis 2014;20:71-4.4. Bikle DD. What’s new in vitamin-D: 2006-2007. Current Opinion in Rheumatology 2007;19:383-8.5. Meer IM, Middelkoop BJC, Boeke AJP, Lips P. Prevalence of vitamin D deficiency among Turkish, Moroccan, Indian and sub-Sahara African populations in Europe and their countries of origin: an overview. Osteoporosis International 2011;22:1009-21. 6. Mallah EM, Hamad MF, Elmanaseer MA, Qinna NA, Idkaidek NM, Arafat TA, MAtalka TZ. Plasma concentrations of 25-hydroxyvitamin D among Jordanians: Effect of biological and habitual factors on vitamin D status. BMC Clinical Pathology 2011;11:8:1-6.7. Kovacs CS, Kronenberg HM. Maternal-fetal calcium and bone metabolism during pregnancy, puerperium and lactation. Endocrine Reviews 1997;18:832-72.8. Kovacs CS, Kronenberg HM. Skeletal physiology: pregnancy and lactation. In: Favus MJ (ed). Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism (6th ed). Washington, DC: American Society for Bone and Mineral Research 2006:63-70.9. Kent GN, Price RI, Gutteridge DH, Rosman KJ, Smith M, Allen JR, Hickling CJ, Blakemanet SL. The efficiency of intestinal calcium absorption is increased in late pregnancy but not in established lactation. Calcified Tissue International 1991;48:293-5.10. Pludowski P, Holick MF, Pilz S, Wagner CL, Hollis BW, Grant WB, Shoenfeld Y, Lerchbaum E, Llewellyn DJ, Kienreich K, Soni M. Vitamin D effects on musculoskeletal health, immunity, autoimmunity, cardiovascular disease, cancer, fertility, pregnancy, dementia and mortality-a review of recent evidence. Autoimmunity Reviews 2013;12:976-89.11. Kiely M, Hemmingway A, O’Callaghan KM. Vitamin D in pregnancy: current perspectives and future directions. Therapeutic Advances in Musculoskeletal Disease 2017;9(6) 145-154.12. Ferrari D, Lombardi G, Banfi G. Concerning the vitamin D reference range: pre-analytical and analytical variability of vitamin D measurement. The journal of Croatian Society of Medical Biochemistry and Laboratory Medicine 2017;27(3):1-14.13. Holick MF. Vitamin D deficiency. The New England Journal of Medicine. 2007;357(3): 266-281.14. Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: An Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology and Metabolism 2011;96(7):1911-1930.15. Institute of Medicine. Dietary reference intakes for calcium and vitamin D. Washington, DC: National Academies Press, 2011.16. Scientific Advisory Committee on Nutrition. Vitamin D and health. London: The Stationary Office, 2016.17. Nordic Council of Ministers. Nordic nutrition recommendations: integrating nutrition and physical activity, 2012.18. Republic of Turkey Ministry of Health. Vitamin D support program in pregnants, May 2011.19. Rajneeta S, Susan MBM, Carlos AC, Cameron CG. Global summary of maternal and newborn vitamin D status-a systematic review. Maternal and Child Nutrition 2016;12:647-68.20. Daphna K. Vitamin D status during pregnancy: maternal, fetal, and postnatal outcomes. Current Opinion in Obstetrics and Gynecology 2011;23:422-6.21. Mithal A,Wahl DA, Bonjour JP, Burckhardt P, Dawson-Hughes B, Eisman J, El-Hajj G, Josse RG, Lips P, Morales-Torres J. Global vitamin D status and determinants of hypovitaminosis D. Osteoporosis International 2009;20:1807-20.22. Holick MF. Vitamin D and bone health. The Journal of Nutrition 1996;126:1159-64.23. Çidem M, Kara S, Sarı H, Özkaya M, Karacan İ. Prevalence and risk factors of vitamin D deficiency in patients with widespread musculoskeletal pain. Journal of Clinical and Experimental Investigations 2013;4(4):488-91.24. Wacker M, Holick MF. Sunlight and Vitamin D: A global perspective for health. Dermato-Endocrinology 2013;5:51-108.25. Yuan-Hua C, Lin F, Jia-Hu H, Hua W, Cheng Z, Fang-Biao T, De-Xiang X. Influent factors of gestational vitamin D deficiency and its relation to an increased risk of preterm delivery in Chinese population Scientific Reports 2018;8:3608:1-8.26. Dror DK, Allen LH. Vitamin D inadequacy in pregnancy: biology, outcomes and interventions. Nutrition Reviews 2010;68:465-77.27. Weinert LS, Silveiro SP. Maternal–Fetal Impact of Vitamin D Deficiency: A Critical Review. Matern Child Health Journal 2015;19:94-101.28. Milman N, Paszkowski T, Cetin I, Castelo-Branco C. Supplementation during pregnancy: beliefs and science. Gynecology and Endocrinology 2016;32(7):509-516.29. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology Metabolism 2011;96:1911-30.30. ACOG Committee on Obstetric Practice. Committee Opinion Number 495: Vitamin D: screening and supplementation during pregnancy. Obstetics and Gynecology 2011;118:197-8.31. Amegah AK, Klevor KK, Wagner CL. Maternal vitamin D insufficiency and risk of adverse pregnancy and birth outcomes: A systematic review and meta-analysis of longitudinal studies. PLOS ONE https://doi.org/10.1371/journal.pone.0173605 March 17,2017.32. Ruddersa SA, Camargo CA. Sunlight, vitamin D and food allergy Current Opinion in Allergy and Clinical Immunology 2015;15:350-7.