To estimate serum 25-hydroxy vitamin D (25OHD) levels
in newly pregnant women and to evaluate its relation to development of
gestational diabetes mellitus (GDM) and maternal and fetal outcome.
Patients & Methods: The study included 328 pregnant women, and at
6th week gestational age (GA), women's clinical and obstetric data were
collected and blood samples were obtained for estimation of baseline
blood glucose (BG) and serum 25OHD levels. Studied women were
divided into two equal groups: Group A included pregnant women
received supplemental vitamin D3 in a daily dose of 1000 IU oral
capsule starting since 6th week GA till delivery. Group B included
pregnant women who completed their pregnancy without vitamin D
supplementation. All women underwent the 75g Oral Glucose
Tolerance Test (75-OGTT) at the 20th, 28th and 36th week for detection
of GDM. All women were followed up till delivery and maternal and
neonatal outcome.
Results: Serum 25OHD levels were sufficient, insufficient and deficient
in 42, 142 and 144 women, respectively. Forty-three women (13.1%)
developed GDM and 62 women (18.9%) had emergency and 23 women
had elective CS. Moreover, 48 neonates (14.6%) required NICU
admission; 15 for respiratory-aid, 22 for phototherapy and 11 neonates
for management of sepsis, but 4 neonates died. Women of group A
showed significantly lower frequency of GDM with significantly lower
BG levels, significantly lower frequency of CS especially emergency
CS and significantly lower frequency of NICU admission.
Conclusion: Low serum 25OHD levels are a widespread problem
among pregnant women and are associated with higher frequency of
GDM, CS delivery especially emergency ones and NICU admission
rate. Supplemental vitamin D therapy did well for reducing the
frequencies of these events. Supplemental daily dose of 1000 IU
appears appropriate and convenient as it was taken in the form of oral
capsules. |
