25-hydroxy Vitamin D serum level in pregnant women with 8-12 gestational weeks in Semnan city and its association with Fasting Blood Sugar and Body Mass Index

Document Type : Original Article

Authors

1 Associate professor, Department of Obstetrics and Gynecology, Abnormal Uterin Bleeding Research Center, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran.

2 Gynecologist, Student Research Committee, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran.

3 Assistant professor, Department of Social Medicine, Social Determinants of Health Research Center, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran.

Abstract

Introduction: Vitamin D has significant and multilateral effects on pregnancy. Vitamin D deficiency in pregnancy leads to different maternal and fetal complications. This study was performed with aim to determine the prevalence of serum vitamin D deficiency in pregnant women with 8-12 gestational weeks and its relation with Fasting Blood Sugar (FBS) and Body Mass Index (BMI) in Semnan city.
Methods: This cross sectional study was performed on 180 pregnant women referred to Semnan Amiralmomenin hospital in 2014. After recording the demographic information (age, parity, gravidity, BMI), serum level of FBS and 25-OH vitamin D was measured. FBS> 92mg/dl was considered abnormal. Serum vitamin D < 32 ng/ml was considered as vitamin D deficiency and < 10ng/ml as severe deficiency of vitamin D. Analysis of data was performed by SPSS software (version 16), and T-test, Pearson correlation coefficients and Kolmogorov-Smirnov. PResults: In this study, mean serum levels of vitamin D was 25.88± 18.0 ng/ml. Vitamin D deficiency was observed in 128 women (71.1%), so that, 30 cases (16.7%) had severe deficiency. FBS was abnormal in 21 (11.7%) that among them, 10 (47.6%) had severe deficiency of vitamin D. BMI was 25kg/m² in 99 (55%). Although no significant relation was found between serum vitamin D level and BMI, but a significant direct correlation was seen between serum vitamin D level and FBS (P=0.02, r=0.17).
Conclusion: Regarding to high prevalence of vitamin D deficiency in Semnan pregnant women, and considering the effects of vitamin D on maternal and fetal health, adequate management for this deficiency in this period should be conceded as a necessity.

Keywords


  1. Zarean E, Jamal AS. Vitamin D and pregnancy. Iran J Obstet Gynecol Infertil 2011; 6(3):13-20. (Persian).
  2. Barrett H, McElduff A. Vitamin D and pregnancy: An old problem revisited. Best Pract Res Clin Endocrinol Metab 2010; 24(4):527-39.
  3. Thomson K, Morley R, Grover SR. Zacharin MR. Postnatal evaluation of vitamin D and bone health in women who were vitamin D-deficient in pregnancy and in their infants. Med J Aust 2004; 181(9):486-8.
  4. Prentice A. Micronutrients and the bone mineral content of the mother, fetus and newborn. J Nutr 2003; 133(5 Suppl 2):1693S-9S.
  5. Valaii N, Basyrmahta F, Farsar AR. Deficiency of vitamin D in apparently healthy pregnant women and their infants and its variations in a longitudinal study. Pejouhandeh J 2002; 7(3):255-62. (Persian).
  6. Althaus J. Vitamin D and pregnancy: 9 things you need to know. OBG Management 2011; 23(8):30-8.
  7. Mulligan ML, Felton SK, Riek AE, Bernal-Mizrachi C. Implication of vitamin D deficiency in pregnancy and lactation. Am J Obstet Gynecol 2010; 202(5):429e1-e9.
  8. Saedinea A, Larijani B, Jalalinea S, Farzadfar F, Keshtkar F, Rezae A, et al. Evaloation of prevalence deficiency of vitamin D in Iranian population the province during 1990-2010. Iran J Diabetes Metab 2013; 12(6):574-84. (Persian).
  9. Bassir M, Laborie S, Lapillonne A, Claris O, Chappuis MC, Salle BL. Vitamin D deficiency in Iranian mothers and their neonates: a pilot study. Acta Pediatr 2001; 90(5):577-9.
  10. Specker B. Vitamin D requirements during pregnancy. Am J Clin Nutr 2004; 80(6 Suppl):1740S-7S.
  11. Nowson CA, Margerison C. Vitamin D intake and vitamin D status of Australians. Med J Aust 2002; 177(3):149-52.
  12. Aghajafari F, Nagulesapillai T, Ronksley PE, Tough SC, O’Beirne M, Rabi DM. Association between maternal serum 25-hydroxyvitamin D level and pregnancy and neonatal outcomes: systematic review and meta-analysis of observational studies. BMJ 2013; 346:f1169.
  13. Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune disease, cancer and cardiovascular disease. Am J Clin Nutr 2004; 80(6 Suppl):1678S-88S.
  14. Congdon P, Horsman A, Kirby PA, Dibble J, Bashir T. Mineral content of the forearms of babies born to Asian and white mothers. Br Med J 1983; 286(6373):1233-5.
  15. Marya AK, Rathee S, Dua V, Sangwan K. Effect of vitamin D supplementation during pregnancy on fetal growth. Indian J Med Res 1998; 88:488-92.
  16. Luxwolda MF, Kuipertic RS, Kema Ip, van der Veer E, Dijck-Brouwer DA, Muskiet FA. Vitamin D status indicators in indigenous populations in East Africa. Eur J Nutr 2013; 52(3):1115-25.
  17. Catalano PM, Tyzbir ED, Roman NM, Amini SB, Sims EA. Longitudinal changes in insulin release and insulin resistance in nonobese pregnant women. Am J Obstet Gynecol 1991; 165(6 pt 1):1667-72.
  18. Pittas AG, Lau J, Hu FB, Dawson-Hughes B. The role of vitamin D and calcium in type 2 diadetes: a systematic review and meta-analysis. J Clin Endocrinol Metab 2007; 92(6):2017-29.
  19. Pittas AG, Dawson-Hughes B, Li T, Van Dam RM, Willett WC, Manson JE, et al. Vitamin D and calcium intake in relation to type 2 diabetes in women. Diabetes Care 2006; 29(3):650-6.
  20. Boucher BJ, Mannan N, Noonan K, Hales CN, Evans SJ. Glucose intolerance and impairment of insulin secretion in relation to vitamin D deficiency in east London Asians. Diabetologia 1995; 38(10):1239-45.
  21. Mimouni F, Tsang RC, Hertzberg VS, Neumann V, Ellis K. Parathyroid hormone and calcitriol change in normal and insulin-dependent diabetic pregnancies. Obstet Gynecol 1989; 74(1):49-54.
  22. Vandevijvere S, Amsalkhir S, Van Oyen H, Moreno-Reyes R. High prevalence of vitamin D deficiency in pregnant women: a national cross-sectional survey. PLoS One 2012; 7(8):e43868.
  23. Ergur AT, Belberoglu M, Atasay B, Siklar Z, Bilir P, Arsan S, et al. Vitamin D deficiency in Turkish mothers and their neonates and in women of reproductive age. J Clin Res Pediatr Endocrinol 2009; 1(6):266-9.
  24. Salek M, Hashemipour M, Aminorroaya A, Gheiratmand A, Kelishadi R, Ardestani PM, et al. Vitamin D deficiency among pregnant women and their newborns in Isfahan, Iran. Exp Clin Endocrinol Diabetes 2008; 116(6):352-6.
  25. Kazemi A, Sharifi F, Jafari N, Mousavinasab N. High prevalence of vitamin D deficiency among pregnant women and their newborns in an Iranian population. J Womens Health 2009; 18(6):835-9.
  26. Hatami G, Ahmadi S, Motamed N, Eghbali SS, Amirani S. 25-OH Vitamin D serum level in pregnant women in Bushehr-2012. Iran South Med J 2014; 16(6):410-8. (Persian).
  27. Baradaran A, Behradmanesh S, Nasri H. Association of body mass index and serum vitamin D level in healthy Iranian adolescents. Endokrynol Pol 2012; 63(1):29-33.
  28. Lagonova Z, Porpjnicu AC, Lindberg F, Hexeberg S, Moan J. The dependency of vitamin D status on body mass index, gender, age and season. Anticancer Res 2009; 29(9):3713-20.
  29. Bodnar LM, Catov JM, Roberts JM, Simhan HN. Prepregnancy obecity predict poor vitamin D status in mothers and their neonates. J Nutr 2007; 137(11):2437-42.
  30. Hurskainen AR, Virtanen JK, Tuomainen TP, Nurmi T, Voutilainen S. Association of serum 25-hydroxyvitamin D with type 2 diabetes and markers of insulin resistance in a general older population in finland. Diabetes Metab Res Rev 2012; 28(5):418-23.
  31. Pittas AG, Nelson J, Mitri J, Hillmann W, Garganta C, Nathan DM, et al. Plasma 25-hydroxyvitamin D and progression to diabetes in patients at risk for diabetes: an ancillary analysis in the Diabetes Prevention Program. Diabetes Care 2012; 35(3):565-73.
  32. Kostoglou-Athanassiou I, Athanassiou P, Gkountouvas A, Kaldrymides P. Vitamin D and glycemic control in diabetes mellitus type 2. Ther Adv Endocrinol Metab 2013; 4(4):122-8.
  33. Soliman AT, Aref MK, Rogol AD. Arginine-induced insulin and growth hormone secretion in children with nutritional rickets. J Pediatr Gastroenterol Nutr 1987; 6(4):589-92.
  34. Nyomda BL, Auwerx J, Bormans V, Peeters TL, Pelemans W, Reynaert J, et al. Pancreatic secretion in man with subclinical vitamin D deficiency. Diabetologia 1986; 29(1):34-8.
  35. Scragg R, Holdaway I, Singh V, Meltcalf P, Baker J, Dryson E. Serum 25-hydroxyvitamin D3 levels decreased in impaired glucose tolerance and diabetes mellitus. Diabetes Res Clin Pract 1995; 27(3):181-8.
  36. Tandon VR, Sharma S, Mahajan S, Raina K, Mahajan A, Khajuria V, et al. Prevalence of vitamin D deficiency among Indian menopausal women and its correlation with diabetes: A first Indian cross sectional data. J Midlife Health 2014; 5(3):121-5.
  37. Dutta D, Maisnam I, Shrivastava A, Shinha A, Ghosh S, Mukhopadhyay P, et al. Serum vitamin-D predicts insulin resistance in individuals with prediabetes. Indian J Med Res 2013; 138(6):853-60.
  38. EL Lithy A, Abdella RM, El-Faissal YM, Sayed AM, Samie RM. The relationship between low maternal serum vitamin D levels and glycemic control in gestational diabetes assessed by HbA1c levels: an observational cross-sectional study. BMC Pregnancy Childbirth 2014; 14:362.