Vitamin D levels and antenatal complications in pregnant Nigerian Igbo women

J. B. Brian-D Adinma, J. Ahaneku, E. Adinma, J. Ugboaja, V. Oguaka, N. Adinma-Obiajulu, M. Edet
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Abstract

Background: Serum levels of Vitamin D have been linked to some complications in pregnancy such as diabetes mellitus and premature rupture of membranes (PROM). While some studies suggest inverse relationship between serum Vitamin D levels and poor pregnancy outcomes, others report a J-shaped (curvilinear) or U-shaped relationship. Objective: The objective of the study is to determine the relationship between serum Vitamin D and some selected pregnancy complications among pregnant Nigerian Igbo women. Subjects and Methods: A prospective, cross-sectional study conducted on 256 consecutive consenting antenatal women in Anambra state, Southeastern Nigeria. Maternal blood obtained was assayed for 25 hydroxyvitamin D3 using high-pressure liquid chromatography. A pro forma was used to elicit information with respect to the biosocial characteristics of the subjects. Data obtained were analyzed using SPSS version 23, and the relationship between Vitamin D levels and antenatal complications was determined using Chi-square at P < 0.05 at 95% confidence interval being considered statistically significant. Results: The overall results showed that no participant had hypovitaminosis D. It also showed that there is maximum safe limit for serum Vitamin D beyond which the prevalence of hypertensive disorders/preeclampsia, preterm labor, and PROM rises. However, higher serum Vitamin D appears to be protective against clinical and laboratory-diagnosed malaria and malaria parasitemia. The study showed an inverse relationship between the degree of malaria parasitemia and serum Vitamin D levels. Conclusion: Despite the importance of Vitamin D in both skeletal and extra-skeletal health, there appears to be a safe upper limit. Therefore, Vitamin D supplementation should be reserved for proven cases of hypovitaminosis in pregnancy, especially in our locality where there is abundance of sunshine and low prevalence of hypovitaminosis D.
尼日利亚伊博孕妇的维生素D水平和产前并发症
背景:血清维生素D水平与妊娠期的一些并发症如糖尿病和胎膜早破(PROM)有关。虽然一些研究表明血清维生素D水平与不良妊娠结局呈反比关系,但其他研究报告则呈j型(曲线)或u型关系。目的:研究尼日利亚伊博孕妇血清维生素D水平与某些妊娠并发症的关系。对象和方法:在尼日利亚东南部阿南布拉州对256名连续同意产前的妇女进行前瞻性横断面研究。采用高压液相色谱法测定母体血液中25羟基维生素D3的含量。一个形式被用来引出关于受试者的生物社会特征的信息。获得的数据使用SPSS 23版进行分析,维生素D水平与产前并发症之间的关系采用卡方法确定,P < 0.05, 95%置信区间认为有统计学意义。结果:总体结果显示,没有参与者患有维生素D缺乏症,同时也表明血清维生素D存在最大安全限度,超过该限度,高血压疾病/先兆子痫、早产和胎膜早破的患病率上升。然而,较高的血清维生素D似乎对临床和实验室诊断的疟疾和疟疾寄生虫病有保护作用。该研究显示疟疾寄生虫病的程度与血清维生素D水平呈反比关系。结论:尽管维生素D对骨骼和骨骼外健康都很重要,但似乎存在一个安全上限。因此,维生素D的补充应保留在已证实的妊娠期维生素缺乏症病例中,特别是在我们当地日照充足、维生素缺乏症患病率低的地区。
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