PLASMA VITAMIN D STATUS AND ASSOCIATED FACTORS AMONG PREGNANT WOMEN OF PESHAWAR, KHYBER PAKHTUNKHAWA, PAKISTAN: A PILOT STUDY
Article Sidebar
Main Article Content
Abstract
OBJECTIVES: To assess plasma vitamin D status and its association with dietary intake and body mass index (BMI) in primary gravida women.
METHODS: This cross-sectional study was carried out in the Department of Gynecology, Lady Reading Hospital (LRH) and Institute of Basic Medical Sciences, Khyber Medical University, Peshawar from January to March 2016. Primary gravida women (n=88) in their first trimester attending antenatal clinic at LRH were included. Socio-demographic and anthropometric measures were recorded using standard methods. Nutritional intake was assessed using 24-hours dietary recall. Blood samples were collected to assess plasma vitamin D status through ELISA.
RESULTS: Median plasma 25-OH vitamin D levels were 41.71 ηg/mL (IQR=17.29). Only 8 (9.09%) women had vitamin D deficiency (<15 ηg/mL), 10 (11.36%) had insufficiency (15-30 ηg/mL) and 70 (79.54%) had adequate (>30 ηg/mL) levels of plasma vitamin D. Dietary intake of vitamin A and thiamine were significantly different between the three groups (sufficient/insufficient/deficient). No significant correlation was found between plasma vitamin D and anthropometric and dietary variables. Only socioeconomic status (p=0.03) was significantly associated with plasma vitamin D status.
CONCLUSION: In our study, plasma vitamin D status was not significantly associated with dietary intake and BMI in primary gravida women. However, due to relatively small sample size, results may be taken with caution and large-scale study is recommended to establish the relationship of plasma vitamin D status with dietary intake and BMI in antenatal women.
Article Details
Work published in KMUJ is licensed under a
Creative Commons Attribution 4.0 License
Authors are permitted and encouraged to post their work online
(e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
References
Nobile S, Tenace MA, Pappa HM. The Role of Vitamin D in the Pathogenesis of Inflammatory Bowel Disease. Gastrointest Disord 2019;1(1):231-40. DOI: 10.3390/gidisord1010018.
Gangula PR, Dong YL, Al-Hendy A, Richard-Davis G, Montgomery-Rice V, Haddad G, et al. Protective cardiovascular and renal actions of vitamin D and estrogen. Front Biosci (Scholar edition) 2013;5:134-48. DOI: 10.2741/s362.
Deluca HF, Cantorna MT. Vitamin D: its role and uses in immunology. FASEB J 2001;15(14):2579-85. DOI: 10.1096/fj.01-0433rev.
Tang BM, Eslick GD, Nowson C, Smith C, Bensoussan A. Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis. Lancet 2007;370(9588):657-66. DOI: 10.1016/S0140-6736(07)61342-7.
Feldman D, Krishnan AV, Swami S, Giovannucci E, Feldman BJ. The role of vitamin D in reducing cancer risk and progression. Nat Rev Cancer 2014;14(5):342. DOI: 10.1038/nrc3691
Pleskacova A, Bartakova V, Pacal L, Kuricova K. Vitamin D Status in Women with Gestational Diabetes Mellitus during Pregnancy and Postpartum. Biomed Res Int 2015;2015:260624. DOI: 10.1155/2015/260624.
Holick MF. Resurrection of vitamin D deficiency and rickets. J Clin Invest 2006;116(8):2062-72. DOI: 10.1172/JCI29449
Bailey RL, West Jr KP, Black RE. The Epidemiology of Global Micronutrient Deficiencies. Ann Nutr Metab 2015;66(Suppl. 2):22-33. DOI: 10.1159/000371618
Elmadfa I, Meyer AL. Vitamins for the first 1000 days: preparing for life. Int J Vitam Nutr Res 2012;82(5):342-7. DOI: 10.1024/0300-9831/a000129
Trumbo P, Yates AA, Schlicker S, Poos M. Dietary reference intakes: vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. J Am Diet Assoc 2001;101(3):294-301. DOI: 10.1016/S0002-8223(01)00078-5
Khan H, Ansari M, Waheed U, Farooq N. Prevalence of vitamin D deficiency in general population of Islamabad, Pakistan. Ann Pak Inst Med Sci 2013;9(1):45-7.
Pfotenhauer KM, Shubrook JH. Vitamin D Deficiency, Its Role in Health and Disease, and Current Supplementation Recommendations. J Am Osteopath Assoc 2017;117(5):301-5. DOI: 10.7556/jaoa.2017.055.
Cashman KD, Sheehy T, O’Neill CM. Is vitamin D deficiency a public health concern for low middle income countries? A systematic literature review. Eur J Nutr 2019;58(1):433-53. DOI: 10.1007/s00394-018-1607-3.
Krishnaveni GV, Veena SR, Winder NR, Hill JC, Noonan K, Boucher BJ, et al. Maternal vitamin D status during pregnancy and body composition and cardiovascular risk markers in Indian children: the Mysore Parthenon Study1–4. Am J Clin Nutr 2011;93(3):628-35. DOI: 10.3945/ajcn.110.003921.
Zaman S, Hawlader M, Biswas A, Hasan M, Jahan M, Ahsan G. High Prevalence of Vitamin D Deficiency among Bangladeshi Children: An Emerging Public Health Problem. Health 2017;09:1680-8. DOI: 10.4236/health.2017.912123
World Health Organization (WHO), Food and Agriculture Organization (FAO). National Nutrition and Food Security Survey, Afghanistan. 2013. [Cited on: January 15, 2019]. Available from URL: http://www.fao.org/3/a-at617e.pdf
Bhutta Za, Soofi SB, Zaidi SSH, Habib A, Hussain I. Pakistan National Nutrition Survey, 2011. Department of Paediatrics and Child Health, The Agha Khan University, Pakistan. 2011 [Cited on: January 15, 2019]. Available from URL: https://ecommons.aku.edu/cgi/viewcontent.cgi?article=1262&context=pakistan_fhs_mc_women_childhealth_paediatr
Riaz H, Finlayson AE, Bashir S, Hussain S, Mahmood S, Malik F, et al. Prevalence of Vitamin D deficiency in Pakistan and implications for the future. Expert Rev Clin Pharmacol 2016;9(2):329-38. DOI: 10.1586/17512433.2016.1122519.
Iqbal R, Jafri L, Haroon A, Habib Khan A. Illuminating the dark side--vitamin D status in different localities of Karachi. J Coll Physicians Surg Pak 2013;23(8):604-6. DOI: 08.2013/JCPSP.604606.
Lundqvist A, Sandström H, Stenlund H, Johansson I, Hultdin J. Vitamin D Status during Pregnancy: A Longitudinal Study in Swedish Women from Early Pregnancy to Seven Months Postpartum. PLoS One 2016;11(3):e0150385. DOI: 10.1371/journal.pone.0150385.
Aji AS, Erwinda E, Yusrawati Y, Malik SG, Lipoeto NI. Vitamin D deficiency status and its related risk factors during early pregnancy: a cross-sectional study of pregnant Minangkabau women, Indonesia. BMC Pregnancy Childbirth 2019;19(1):183. DOI: 10.1186/s12884-019-2341-4.
Mulligan ML, Felton SK, Riek AE, Bernal-Mizrachi C. Implications of vitamin D deficiency in pregnancy and lactation. American journal of obstetrics and gynecology. Am J Obstet Gynecol 2010;202(5):e4291-e4299. DOI: 10.1016/j.ajog.2009.09.002.
Lyu LC, Hsu YN, Chen HF, Lo CC, Lin CL. Comparisons of four dietary assessment methods during pregnancy in Taiwanese women. Taiwan J Obstet Gynecol 2014;53(2):162-9. DOI: 10.1016/j.tjog.2014.04.007.
Lomonte C, Antonelli M, Vernaglione L, Cazzato F, Casucci F, Chimienti D, et al. Are low plasma levels of 25-(OH)vitamin D a major risk factor for hyperparathyroidism independent of calcitriol in renal transplant patients? J Nephrol 2005;18(1):96-101.
Dawodu A, Wagner CL. Prevention of vitamin D deficiency in mothers and infants worldwide - a paradigm shift. Paediatrics and international child health. Paediatr Int Child Health 2012;32(1):3-13. DOI: 10.1179/1465328111Y.0000000024
Khalessi N, Kalani M, Araghi M, Farahani Z. The Relationship between Maternal Vitamin D Deficiency and Low Birth Weight Neonates. J Family Reprod Health 2015;9(3):113-7.
Sharma N, Nath C, Mohammad J. Vitamin D status in pregnant women visiting a tertiary care center of North Eastern India. J Family Med Prim Care 2019;8(2):356-60. DOI: 10.4103/jfmpc.jfmpc_404_18.
Sohail S, Rashid S. Serum 25 hydroxy vitamin-D level is the best predictor of vitamin-D deficiency during pregnancy. Professional Med J 2013(1):78-81.
Sharif S, Farasat T, Shoaib H, Saqib M, Fazal S. Vitamin D levels among pregnant and lactating women. J Coll Physicians Surg Pak 2013;23(12):862-5. DOI: 12.2013/JCPSP.862865.
Roomi MA, Farooq A, Ullah E, Lone KP. Hypovitaminosis D and its association with lifestyle factors. Pak J Med Sci 2015;31(5):1236-40. DOI: 10.12669/pjms.315.7196
Duchaine CS, Diorio C. Association between intake of sugar-sweetened beverages and circulating 25-hydroxyvitamin D concentration among premenopausal women. Nutrients 2014;6(8):2987-99. DOI: 10.3390/nu6082987
Mahmood K, Akhtar ST, Talib A, Haider I. Vitamin D status in a population of healthy adults in Pakistan. Pak J Med Sci 2009;25(4):545-50.