Impact of maternal hypovitaminosis D on birth and neonatal outcome – a prospective cohort study

T.B. Gowtham, S. Venkatesh, S. Palanisamy, S. Rathod
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引用次数: 2

Abstract

Abstract Objective Vitamin D deficiency in pregnant women is of special concern as mother is the only source of vitamin D for the developing fetus, and maternal hypovitaminosis D has been implicated in a number of maternal and neonatal adverse outcomes. The objective of this study was to assess the association of maternal circulating 25-hydroxy vitamin D3 [25(OH)D] concentration with cord blood 25(OH)D and adverse birth and neonatal outcomes. Methods This prospective cohort study was conducted in Mahatma Gandhi Medical College and Research Institute (MGMCRI) from January 2020 to December 2020. 121 babies born to mothers with singleton pregnancy tested for serum 25(OH)D level on admission for safe confinement were included in the study and cord blood of the babies were sampled for 25(OH)D. Based on the maternal 25(OH)D level, babies were categorized as those born to mothers with sufficient vitamin D level and those born to mothers with hypovitaminosis D (deficient/insufficient) and primary and secondary outcome was compared between two groups. Results Maternal and cord blood hypovitaminosis D was observed in 65% of mothers and 68.6% of babies, respectively. Maternal vitamin D level was the single most significant predictor of cord blood vitamin D level with five-fold increased risk of cord blood hypovitaminosis D in babies born to mothers with hypovitaminosis D. Birthweight (t = −2.219, p = .028) and preterm birth (aOR = 4.417, 95% CI: 1.03–18.9) was significantly associated with maternal hypovitaminosis D and a trend toward increased risk of LBW (aOR − 2.1, 95%CI: 0.6–7.3), SGA babies (aOR − 1.5, 95% CI: 0.5–4.7), perinatal depression (aOR − 1.5, 95% CI: 0.4–5.8) and neonatal hyperbilirubinemia (aOR = 2.68, 95%CI: 0.942–7.6) was observed. Conclusions Hypovitaminosis D in pregnant women is a significant health issue affecting both the mother and her baby. Safest dose for supplementation during pregnancy to prevent adverse perinatal outcome needs to be evaluated.
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母亲维生素D缺乏症对出生和新生儿结局的影响——一项前瞻性队列研究
孕妇维生素D缺乏症是一个特别值得关注的问题,因为母亲是发育中的胎儿维生素D的唯一来源,而母亲维生素D缺乏症与许多孕产妇和新生儿的不良结局有关。本研究的目的是评估母亲循环25-羟基维生素D3 [25(OH)D]浓度与脐带血25(OH)D和不良出生和新生儿结局的关系。方法本前瞻性队列研究于2020年1月至2020年12月在圣雄甘地医学院和研究所(MGMCRI)进行。121名单胎妊娠母亲所生的婴儿在安全分娩入院时进行血清25(OH)D水平检测,并采集婴儿脐带血25(OH)D。根据母亲的25(OH)D水平,将婴儿分为维生素D水平充足的母亲所生的婴儿和维生素D缺乏(缺乏/不足)母亲所生的婴儿,并比较两组的主要和次要结局。结果母体和脐带血维生素D缺乏症发生率分别为65%和68.6%。孕妇维生素D水平是最重要的预测脐带血的维生素D水平与5倍的风险增加脐带血维生素缺乏D与维生素缺乏母亲出生的婴儿出生体重(t =−2.219,p = .028)和早产(优势比= 4.417,95% CI: 1.03—-18.9)明显与母体维生素缺乏有关D和趋势的风险增加激光焊(aOR−2.1,95%置信区间CI: 0.6 - -7.3), SGA婴儿(aOR−1.5,95%置信区间CI:0.5 ~ 4.7)、围产期抑郁(aOR = 1.5, 95%CI: 0.4 ~ 5.8)和新生儿高胆红素血症(aOR = 2.68, 95%CI: 0.942 ~ 7.6)。结论孕妇维生素D缺乏症是影响母婴健康的重大问题。需要评估在怀孕期间补充以防止不良围产期结局的最安全剂量。
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