VITAMIN D DEFICIENCY IN PREGNANCY AND ITS RELATIONSHIP WITH MATERNAL-FETAL OUTCOMES IN WOMEN LIVING IN THE TROPICS

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: MON 238-262-Vitamin D Action, Deficiency & Disorders
Bench to Bedside
Monday, June 17, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board MON-248
Cynthia Salgado, Juliana Maia, Manoel Aderson Soares Filho*, Paula Arag„o, Luiz Henrique Griz, Cristiane Farias and Francisco Farias Bandeira
Division of Endocrinology and Diabetes, and Obstetrics, Agamenon Magalh„es Hospital, University of Pernambuco Medical School, Recife-PE, Brazil
INTRODUCTION:

Vitamin D deficiency in pregnancy has been reported as variable as 5 to 50% and its association with pregnancy-related outcomes is still controversial. Measurement of maternal serum 25OHD at the end of pregnancy is closely related to cord blood levels.

OBJECTIVE

The aim of this study was to evaluate de prevalence of vitamin D deficiency during pregnancy and its relationship with maternal-fetal outcomes.

METHODS

Maternal-fetal clinical and laboratory parameters were analyzed in 165 consecutive pregnant women (mean age 27,30 ±6,32yr). Blood samples were collected at the end of pregnancy and vitamin D deficiency was defined according to two cut points for serum 25OHD concentrations (<20 and <30 ng/ml).

RESULTS

40% had skin phototype between I-III, 65% had a cesarean section as a method of delivery and 72% at term. Gestational diabetes, hypertension and pre-eclampsia occurred in 16.4%, 31.5% and 20.6%, respectively. Mean serum 25OHD was 27.5 ±7.5ng/ml, 67% had levels <30ng/ml and 17% <20ng/ml. Offspring data showed 80% adequate for gestational age, head circumference 34.1 ±2.1 cm, arm circumference 9.8 ±1.7cm, weight 3.0 ±0.7Kg, length 47.4 ±3.5cm and 95% had Apgar score >5.

Women with 25OHD >30ng/ml (in comparison with those with <20ng/ml) had significant higher serum albumin concentrations (3.4 ±0.4 vs 3.2 ±0.4g/dl; p=0.03); lower total hemoglobin (11.23 ±1.2 vs 12.1 ±1.6g/dl; p=0.005); lower BMI at the end of pregnancy (29.3 ±5.5 vs 32.3±5.7Kg/m2; p=0.03); and their neonate had lower arm circumference (9.5 ±1.9 vs 10.3 ±1.1cm; p=0.03). There were no differences in mean sun index between the 2 groups (3.2 ±4.1 vs 3.5 ±4.3; p=0.3).

More patients with skin phototypes between I-III had 25OHD <20ng/ml (21% vs 14% in those between IV-VI) but without statistical significance (p=0.8). There was no difference using cut point of 25OHD <30ng/ml between patients with skin phototypes I–III and IV-VI (66.2% vs 68%, p= 0.8). There was also no significant difference in the rate of pre-term birth, gestational diabetes and pre-eclampsia between the two groups.

CONCLUSION

We found a high prevalence of vitamin D deficiency in late pregnancy in women living in a tropical area, which was unrelated to sun index and skin pigmentation. Vitamin D sufficiency was associated with better nutritional status and hemodynamic adaptation during pregnancy and to less neonate adiposity. We found no association between vitamin D deficiency and pre-term birth, gestation diabetes or pre-eclampsia.

Nothing to Disclose: CS, JM, MAS, PA, LHG, CF, FFB

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm