Supplementation of vitamin D in pregnancy and its correlation with feto-maternal outcome

Context Vitamin D deficiency is widely prevalent throughout the world. Pregnant women, neonates and infants form most vulnerable groups for vitamin D deficiency. Objective (1) To find prevalence of vitamin D deficiency in pregnant women. (2) To evaluate the effect of supplementation with cholecalciferol in improving vitamin D levels in pregnant women and evaluate its correlation with feto-maternal outcome. Design Randomized control trial from years 2010 to 2012. Setting Tertiary care centre, Delhi, India. Participants One-hundred and eighty pregnant women. Study population divided randomly into two groups: group A: nonintervention (60 women) and group B: intervention (120 women). Intervention The intervention group received supplementation of vitamin D in dosages depending upon 25(OH)-D levels. Main outcome measures Risk of maternal complications such as preterm labour, pre-eclampsia and gestational diabetes associated with vitamin D deficiency and risk of low birthweight and poor Apgar score in infants of mothers with vitamin D deficiency. Results Adjusted serum 25(OH)-D concentration was lower in group A as compared to group B (mean 46.11 +/- 74.21 nmol/l vs 80.51 +/- 53 nmol/l). Forty-four percent patients in group A and 20.3% patients in group B developed preterm labour/preeclampsia/gestational diabetes. Newborns of mothers in group A had lower cord blood levels of 25(OH)-D levels as compared to group B (mean 43.11 +/- 81.32 nmol/l vs 56.8 +/- 47.52 nmol/l). They also had lower birthweight of mean 2.4 +/- 0.38 kg as compared to group B 2.6 +/- 0.33 kg. Conclusions Vitamin D supplementation reduces risk of maternal comorbidities and helps improve neonatal outcomes.