EVALUATION OF VITAMIN D STATUS IN ANTENATAL PATIENTS ATTENDING OPD AT A TERTIARY CARE CENTRE

• MANPREET KAUR,*  
• Reena sood,  
• Sangeeta Pahwa

Abstract

Introduction: Vitamin D deficiency during pregnancy is a worldwide epidemic. Studies have reported a prevalence that ranges from 18-84%, depending on country of residence, season and local clothing customs. Furthermore studies have shown that pregnancy alone is a risk factor for vitamin D deficiency particularly among women living at high altitudes. The main risk factors of vitamin D deficiency are those that inhibit the body’s production of vitamin D in the skin, including dark pigmentation, too little exposure to sunlight, clothing that limits exposure of skin to sunlight, the season of the year, environmental pollution, use of sunscreen and ageing. Vitamin D deficiency in pregnancy is associated with increased risk of pre eclampsia, gestational diabetes mellitus, preterm birth, small for gestational age infants, impaired fetal skeletal formation, bone mineral content (BMC) and bone mineral density (BMD). Aim and objectives: Aim: Aim of the study is to assess vitamin D levels in antenatal patients in first trimester attending OPD at a tertiary care centre. Objectives: 1. To estimate Vitamin D levels in antenatal patients in first trimester. 2. To find association of vitamin D levels with socioeconomic status, education status & Hb levels. Material and Methods: It was a cross-sectional study that was conducted in department of Obstetrics and Gynaecology at Sri Guru Ram Das Institute of Medical Sciences and Research, Sri Amritsar. All participants meeting inclusion criteria were enrolled for the study from antenatal OPD. A written informed consent was taken from all participants. Detailed history was recorded including complete demographic details, dietary history, past medical history. The serum vitamin D levels were done using VITROS 5600 integrated system. Vitamin D levels will be categorized according to figure 1. Serum calcium and serum phosphorus levels alongwith hemoglobin levels were measured in all study participants. Results: A high prevalence of vitamin D deficiency was observed in our study population where only 18.8% had adequate levels of vitamin D while 81.2% of the participants had vitamin D deficiency ( 69% were insufficient and 12.2% were severe deficient), and none of the participants was having vitamin D toxicity. The deficiency was equally high in all age groups of study participants irrespective of their area of residence. The mean serum calcium in severe deficient and adequate group was 7.97+0.61 and 9.22 +0.63 respectively (p=0.001). Similarly mean serum phosphorus levels in severe deficient and adequate group is 3.03+0.79 and 3.60+0.63 respectively (p=0.001). Maternal education, socioeconomic status, obesity, serum calcium and serum phosphorus levels were found to be significantly associated with severe vitamin D deficiency. Conclusion: Vitamin D deficiency is highly prevalent among our pregnant women who participated in our study, which raises concern about the health consequences for the mother and the offspring.

Keywords

Pregnancy, Vitamin D, Prevalence, Calcium.