Association between Vitamin D Deficiency and Primary Cesarean Section
ABSTRACT At the turn of the 20th century, women commonly died in childbirth due to rachitic pelvis. Although rickets virtually disappeared with the discovery of the hormone vitamin D, recent reports suggest vitamin D deficiency is widespread in industrialized nations. Poor muscular performance is an established symptom of vitamin D deficiency. The current U.S. cesarean birth rate is at an all-time high of 30.2%. We analyzed the relationship between maternal serum 25-hydroxyvitamin D [25(OH)D] status, and prevalence of primary cesarean section.
Between 2005 and 2007, we measured maternal and infant serum 25(OH)D at birth and abstracted demographic and medical data from the maternal medical record at an urban teaching hospital (Boston, MA) with 2500 births per year. We enrolled 253 women, of whom 43 (17%) had a primary cesarean.
There was an inverse association with having a cesarean section and serum 25(OH)D levels. We found that 28% of women with serum 25(OH)D less than 37.5 nmol/liter had a cesarean section, compared with only 14% of women with 25(OH)D 37.5nmol/liter or greater (P = 0.012). In multivariable logistic regression analysis controlling for race, age, education level, insurance status, and alcohol use, women with 25(OH)D less than 37.5 nmol/liter were almost 4 times as likely to have a cesarean than women with 25(OH)D 37.5 nmol/liter or greater (adjusted odds ratio 3.84; 95% confidence interval 1.71 to 8.62).
Vitamin D deficiency was associated with increased odds of primary cesarean section.
Full-textDOI: · Available from: Supriya D Mehta, May 30, 2015
SourceAvailable from: Mojgan Mirghafourvand[Show abstract] [Hide abstract]
ABSTRACT: Evidence suggests a high prevalence of calcium and vitamin D deficiencies exists in both pregnant women and babies. Adequate intake of micronutrients has great importance especially during pregnancy and lactation period. Thus, the present study aimed at assessing the effect of vitamin D and calcium-vitamin D on pregnancy and birth outcomes (including duration of pregnancy, type of delivery and infant anthropometric indicators). A randomized, controlled, clinical, triple-blind trial conducted on 126 pregnant women referring to Tabriz health centers in 2013-14. Subjects were allocated into three groups using block randomization. Interventional groups received vitamin D, calcium-vitamin D and placebo pills daily for 60 days. ANCOVA and Chi-square tests were used for data analysis. By controlling BMI before and during pregnancy, there were no significant differences between the group in average neonatal weight, height and head circumference, duration of pregnancy, type of delivery and gestational age at the time of delivery. The results show that calcium-vitamin D and vitamin D have no effect on duration of pregnancy, type of delivery and infant anthropometric indicators.03/2015; 4(1):35-44. DOI:10.5681/jcs.2015.004
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ABSTRACT: Adequate vitamin D intake and its status are important not only for bone health and CaP metabolism, but for optimal function of many organs. Pregnant and breastfeeding women are in a group of increased risk of vitamin D deficiency. Vitamin D deficiency during pregnancy has negative impact not only on women's health but also on their offspring's health. Vitamin D deficiency during pregnancy may increase risk of gestational diabetes, preeclampsia, bacterial vaginosis, cesarean section and bone demineralization in pregnant women. Fetal vitamin D deficiency may lead to many negative clinical outcomes, including neonatal hypocalcaemia, hereditary rickets, decreased bone mineralization, disorders of enamel development, diabetes mellitus type 1, atopy and acute lower respiratory tract infections. Experimental studies underline role of vitamin D in fetal brain development. Vitamin D supplementation in dose of 800-1000 IU/d in case of lack of vitamin D endogenous synthesis and/or low consumption from diet is necessary during pregnancy and lactation to keep optimal vitamin D status of mother and offspring. Measurement of 25(OH)D concentration is a useful tool in management of vitamin D supplementation according to its safety and efficacy (individualized therapy).
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ABSTRACT: The present study was designed to assess the effects of Ca+vitamin D supplementation on pregnancy outcomes in women with gestational diabetes mellitus (GDM). A randomized, double-blind, placebo-controlled trial was conducted among sixty women with GDM. Participants were divided into two groups to receive Ca+vitamin D supplements or placebo. Individuals in the Ca+vitamin D group (n 30) received 1000 mg Ca/d and two pearls containing 1250 µg (50 000 IU) of cholecalciferol (vitamin D3) during the intervention (one at study baseline and another at day 21 of the intervention); those in the placebo group (n 30) received two placebos of vitamin D at the mentioned times and placebos of Ca every day for 6 weeks. Pregnancy outcomes were determined. A urban community setting in Arak, Iran. Sixty women with GDM and their newborns, living in Arak, Iran were enrolled. Women treated with Ca+vitamin D had a significant decrease in caesarean section rate (23·3 % v. 63·3 %, P=0·002) and maternal hospitalization (0 v. 13·3 %, P=0·03) compared with those receiving placebo. In addition, newborns of GDM women randomized to Ca+vitamin D had no case of macrosomia, while the prevalence of macrosomia among those randomized to placebo was 13·3 % (P=0·03). Lower rates of hyperbilirubinaemia (20·0 % v. 56·7 %, P=0·03) and hospitalization (20·0 % v. 56·7 %, P=0·03) were also seen in the supplemented group of newborns than in the placebo group. Ca+vitamin D supplementation for 6 weeks among pregnant women with GDM led to decreased caesarean section rate and maternal hospitalization, and decreased macrosomia, hyperbilirubinaemia and hospitalization in newborns.Public Health Nutrition 03/2015; DOI:10.1017/S1368980015000609 · 2.48 Impact Factor