Characteristics of pregnancy and delivery in women with vitamin D deficiency
DOI:
https://doi.org/10.14739/2310-1210.2020.4.208347Keywords:
vitamin D, pregnancy, parturition, complicationsAbstract
Vitamin D deficiency is recognized as a public health problem in many countries around the world, with special attention being paid to pregnant women. In the last decade, studies have been conducted to link vitamin D deficiency during pregnancy with a wide range of obstetric and perinatal complications, namely preeclampsia, gestational diabetes, bacterial vaginosis, fetal growth retardation syndrome, low birth weight, impaired fetal formation and bone loss.
Purpose. To study the characteristics of pregnancy and childbirth in women with vitamin D deficiency.
Materials and methods. The article presents the study results of the pregnancy and childbirth characteristics in women with vitamin D deficiency. In total, 100 pregnant women of reproductive age were examined and two groups were formed: the main group – 50 pregnant women with vitamin D deficiency and the control group – 50 somatically healthy pregnant women with a normal level of 25(OH)D. Three peripheral blood sampling were performed to determine the serum level of 25(OH)D: at 10–12, 20–22 and 30–32 weeks of gestation.
Results. As a result of our study, the most common complications of vitamin D deficiency were: risk of pregnancy termination, which was observed in 28 (56.0 %) women of the main group and in 6 (12.0 %) women of the control group, P < 0, 05. The threat of preterm birth was observed in 19 (38.0 %) women of the main group and 7 (14.0 %) women of the control group, P < 0.05. Mild preeclampsia was diagnosed in 18 (36.0 %) women of the main group and in 4 (8.0 %) women of the control group, P < 0.05; moderate preeclampsia was diagnosed in 9 (18.0 %) women of the main group and in none of the control women; severe preeclampsia – in 2 (4.0 %) women of the main group, which was not characteristic of the control group. Based on the glucose tolerance test in women of the main group, the diagnosis of gestational diabetes (GD) was established in 16 (32.0 %) pregnant women in the second trimester and in 7 (14.0 %) in the third trimester. In this study, it was found that GD was accompanied by first degree obesity in 7 (14.0 %) women of the main group. Bacterial vaginosis at 10–12 weeks was diagnosed in 18 pregnant women: in 15 (30.0 %) women of the main group and in 3 (6.0 %) of the control group, – P < 0.05; at 20–22 weeks in – 28 pregnant women: in 21 (42.0 %) women of the main group and in 7 (14.0 %) of the control group, P < 0.05; at 30–32 weeks it was diagnosed in 37 pregnant women: in 26 (52.0 %) women of the main group and in 11 (22.0 %) of the control group, – P < 0.05. Asymmetric fetal intrauterine growth restriction of the 1st degree was found in 6 (12.0 %), the 2nd degree – in 4 (8.0 %) pregnant women of the main group and no case in the control group women was reported.
Conclusions. The established multiple actions of vitamin D and a number of obstetrical and perinatal complications, namely gestational diabetes, early and late spontaneous abortions, preterm birth, bacterial vaginosis associated with vitamin D deficiency, underline the urgency of this problem. The findings indicate that screening of pregnant women for serum vitamin D content with the following timely supplementation during pregnancy will help to reduce the incidence of obstetrical and perinatal complications.
References
Radzinsky, V. E., & Fuks A. M. (Eds.). (2016). Akusherstvo [Obstetrics]. GEOTAR-Media. [in Russian].
Maltseva, L. I., Vasilyeva, E. N., & Denisova, T. G. (2016) Vitamin D i preeklampsiya [Vitamin D and preeclampsia]. Rossiiskii vestnik akushera-ginekologa, 16(1), 79-83. https://doi.org/10.17116/rosakush201616179-83 [in Russian].
Ministry of Health of Ukraine. (2011, July 15). Pro orhanizatsiiu ambulatornoi akushersko-hinekolohichnoi dopomohy v Ukraini [About the organization of outpatient obstetric and gynecological care in Ukraine (No. 417)]. https://zakon.rada.gov.ua/rada/show/v0417282-11?lang=uk#Text
Povoroznyuk, V. V., & Balatska, N. I. (2013). Defitsyt vitaminu D u naselennia Ukrainy ta chynnyky ryzyku yoho rozvytku [Deficiency of vitamin d among ukrainian population: risk-factors of development]. Reproduktivnaya endokrinologiya, (5), 7-13. [in Ukrainian].
Semin, S. G., Volkova L. V., Moiseev, A. B., & Nikitina, N. V. (2012). Perspektivy izucheniya biologicheskoi roli vitamina D [Prospects for studying the biological role of vitamin D]. Pediatriya. Zhurnal im. G. N. Speranskogo, 91(2), 122-131. [in Russian].
Spirichev, V. B., & Gromova, O. A. (2012). Vitamin D i ego sinergisty [Vitamin D and its synergists]. Zemskii vrach, (2), 33-38. [in Russian].
Baker, A. M., Haeri, S., Camargo, C. A., Jr, Espinola, J. A., & Stuebe, A. M. (2010). A nested case-control study of midgestation vitamin D deficiency and risk of severe preeclampsia. The Journal of clinical endocrinology and metabolism, 95(11), 5105-5109. https://doi.org/10.1210/jc.2010-0996
De-Regil, L. M., Palacios, C., Lombardo, L. K., & Peña-Rosas, J. P. (2016). Vitamin D supplementation for women during pregnancy. Cochrane Database of Systematic Reviews, (1), Article CD008873. https://doi.org/10.1002/14651858.CD008873.pub3
Ghaly, S., & Lawrance, I. (2014). The role of vitamin D in gastrointestinal inflammation. Expert review of gastroenterology & hepatology, 8(8), 909-923. https://doi.org/10.1586/17474124.2014.925796
Holick, M. F., Binkley, N. C., Bischoff-Ferrari, H. A., Gordon, C. M., Hanley, D. A., Heaney, R. P., Murad, M. H., Weaver, C. M., & Endocrine Society. (2011). Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. The Journal of clinical endocrinology and metabolism, 96(7), 1911-1930. https://doi.org/10.1210/jc.2011-0385
Hollis, B. W., Johnson, D., Hulsey, T. C., Ebeling, M., & Wagner, C. L. (2011). Vitamin D supplementation during pregnancy: double-blind, randomized clinical trial of safety and effectiveness. Journal of Bone and Mineral Research, 26(10), 2341-2357. https://doi.org/10.1002/jbmr.463
Lanham-New, S. A., Buttriss, J. L., Miles, L. M., Ashwell, M., Berry, J. L., Boucher, B. J., Cashman, K. D., Cooper, C., Darling, A. L., Francis, R. M., Fraser, W. D., de Groot, C. P., Hyppönen, E., Kiely, M., Lamberg-Allardt, C., Macdonald, H. M., Martineau, A. R., Masud, T., Mavroeidi, A., Nowson, C., … Williams, C. M. (2011). Proceedings of the Rank Forum on Vitamin D. British Journal of Nutrition, 105(1), 144-156. https://doi.org/10.1017/S0007114510002576
Lau, S. L., Gunton, J. E., Athayde, N. P., Byth, K., & Cheung, N. W. (2011). Serum 25-hydroxyvitamin D and glycated haemoglobin levels in women with gestational diabetes mellitus. Medical journal of Australia, 194(7), 334-337.
Liu, N. Q., Kaplan, A. T., Lagishetty, V., Ouyang, Y. B., Ouyang, Y., Simmons, C. F., Equils, O., & Hewison, M. (2011). Vitamin D and the regulation of placental inflammation. Journal of immunology, 186(10), 5968-5974. https://doi.org/10.4049/jimmunol.1003332
Taheri, M., Baheiraei, A., Foroushani, A. R., Nikmanesh, B., & Modarres, M. (2015). Treatment of vitamin D deficiency is an effective method in the elimination of asymptomatic bacterial vaginosis: A placebo-controlled randomized clinical trial. Indian journal of medical research, 141(6), 799-806. https://doi.org/10.4103/0971-5916.160707
Mirzakhani, H., Litonjua, A. A., McElrath, T. F., O'Connor, G., Lee-Parritz, A., Iverson, R., Macones, G., Strunk, R. C., Bacharier, L. B., Zeiger, R., Hollis, B. W., Handy, D. E., Sharma, A., Laranjo, N., Carey, V., Qiu, W., Santolini, M., Liu, S., Chhabra, D., Enquobahrie, D. A., … Weiss, S. T. (2016). Early pregnancy vitamin D status and risk of preeclampsia. The Journal of clinical investigation, 126(12), 4702-4715. https://doi.org/10.1172/JCI89031
Mithal, A., & Kalra, S. (2014). Vitamin D supplementation in pregnancy. Indian journal of endocrinology and metabolism, 18(5), 593-596. https://doi.org/10.4103/2230-8210.139204
Płudowski, P., Karczmarewicz, E., Bayer, M., Carter, G., Chlebna-Sokół, D., Czech-Kowalska, J., Dębski, R., Decsi, T., Dobrzańska, A., Franek, E., Głuszko, P., Grant, W. B., Holick, M. F., Yankovskaya, L., Konstantynowicz, J., Książyk, J. B., Księżopolska-Orłowska, K., Lewiński, A., Litwin, M., Lohner, S., … Żmijewski, M. A. (2013). Practical guidelines for the supplementation of vitamin D and the treatment of deficits in Central Europe – recommended vitamin D intakes in the general population and groups at risk of vitamin D deficiency. Endokrynologia Polska, 64(4), 319-327. https://doi.org/10.5603/ep.2013.0012
Sheth, J. J., Shah, A., Sheth, F. J., Trivedi, S., Lele, M., Shah, N., Thakor, P., & Vaidya, R. (2015). Does vitamin D play a significant role in type 2 diabetes? BMC endocrine disorders, 15, Article 5. https://doi.org/10.1186/s12902-015-0003-8
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