Obstet Gynecol Sci.  2023 Sep;66(5):395-406. 10.5468/ogs.22251.

High prevalence of hypovitaminosis D3 among pregnant women in central Iran: correlation with newborn vitamin D3 levels and negative association with gestational age

• Dorreh F
• Ahmadi R
• Absalan A
• Akhondzadeh A
• Najdi N
• Ghaffari K

• KMID: 2545886
• DOI: http://doi.org/10.5468/ogs.22251

Abstract

Objective
Hypovitaminosis D3 is a significant concern among pregnant women and their newborns because vitamin D3 (Vit-D3) plays a crucial role in embryonic growth, development, and health. This study aimed to evaluate the Vit-D3 status of a group of pregnant Iranian women and its association with newborn Vit-D3 levels, medical and clinical indices after delivery.
Methods
A total of 206 pregnant women and their newborns were assessed for Vit-D3 levels and their correlation with gestational age. Mean±standard deviation (SD) or the orders (non-parametric tests) of variables were compared, and correlation estimations were performed to elucidate any differences or associations between groups, with a confidence interval of at least 0.95.
Results
The mean±SD of mothers’ age and gestational age were 29.65±6.18 years and 35.59±1.6 weeks, respectively. Neonatal Vit-D3 levels were associated with maternal age. Using a 30 ng/mL cutoff point for serum Vit-D3 levels, 83.5% of pregnant women and 84.7% of newborns had hypovitaminosis D3. The average Vit-D3 levels of mothers and newborns at delivery time were 23.5±8.07 ng/mL and 20.76±9.14 ng/mL, respectively. Newborn Vit-D3 levels were positively correlated with maternal Vit-D3 serum levels (R=0.744; P<0.001) and gestational age (R=0.161; P=0.022). In newborns, head circumference was inversely correlated with bilirubin level (R=-0.302; P<0.001) but directly associated with weight (R=0.640; P<0.001).
Conclusion
Hypovitaminosis D3 remains a significant challenge for pregnant Iranian women. Maternal Vit-D3 levels provide for the newborn’s needs, particularly in the late stages of pregnancy. Therefore, Vit-D3 supplementation and regular monitoring are essential for pregnant women and their newborns.

Keyword

Vitamin D; Pregnancy; Newborn; Umbilical cord; Apgar score

Figure

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  Fig. 1 Comparison of mean±standard of maternal (A) and neonatal (B) Vit-D3 levels between urban and rural inhabitants. Inhabitation area did not impact the levels of maternal or neonatal Vit-D3. Mothers with higher levels of Vit-D3 gave birth to neonates with higher mean values of Vit-D3 (C), which is a significant finding. The mean values of maternal Vit-D3 levels did not differ significantly between mothers bearing sons or daughters (D). Vit-D3, vitamin D3.

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  Fig. 3 Comparison of mean±standard of neonatal Vit-D3 between newborns delivered naturally or by cesarean section. The mean value of Vit-D3 in umbilical cord blood samples did not differ significantly between newborns delivered naturally or by cesarean section. Vit-D3, vitamin D3.

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  Fig. 2 Comparison of mean±standard of newborn weight (A) and height (B) among mothers with Vit-D3 levels <20 ng/mL, 20–30 ng/mL, and >30 ng/mL. Insignificant results suggest that maternal Vit-D3 levels are not a significant factor in newborn weight or height. Inhabitation area did not affect the levels of maternal or neonatal Vit-D3. Mothers with higher levels of Vit-D3 gave birth to neonates with higher mean values of Vit-D3 (C), which is a significant finding. The mean values of maternal Vit-D3 levels did not differ significantly between mothers bearing sons or daughters (D). Vit-D3, vitamin D3.

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  Fig. 4 Major factors affecting fetal Vit-D3 levels in our study. Maternal Vit-D3 levels and gestational age have a direct impact on neonatal Vit-D3 levels. Therefore, we recommend Vit-D3 supplementation during pregnancy through nutritional regimens and sunlight exposure. Additionally, cesarean section should be postponed to a suitable time, as maternal Vit-D3 supplementation of the newborn occurs more effectively in the later stages of pregnancy. Vit-D3, vitamin D3;1,25(OH), 1,25-dihydroxyvitamin D.

Reference

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