Assessment on Vitamin D Dietary Intake, Knowledge, and Practice among Pregnant Mothers in Malaysia

Despite the year-round availability of plenty of sunlight, vitamin D insufficiency (VDD) was common in Malaysia, especially among pregnant mothers. In addition to the scarcity of food sources of vitamin D and high levels of sun avoidance habits especially among women, this might hinder vitamin D synthesis in the body [1]. Pregnancy complications such maternal osteomalacia, gestational hyperglycemia, and preeclampsia have all been strongly linked to VDD in pregnant women [2]. Therefore, the purpose of this cross-sectional study was to evaluate vitamin D consumption, knowledge (K) and practise (P) among Malaysian pregnant mothers.   A total of 200 participants (median age: 29.5 + 8.8 years old), consisting of pregnant mothers in between 12 to 40 weeks of gestational ages were recruited within this study. Information on socio-demographic was obtained using self-administered questionnaires. Vitamin D intakes were estimated using Food Frequency Questionnaire (FFQ) [3], while knowledge and practice questionnaires were measured using adapted validated questionnaires [2,4].     Out of the 200 pregnant mothers consented to participate in this study, 128 specified they were in their second trimester and the remaining 72 were in their third trimester. Majority of participants were Malay (93%) followed by Chinese (4%), Indian (2%) and others (1%) and most of them obtained university/college education (80.5%) with moderate monthly income (RM 4,851 - RM 10,970) participated in this study. The mean dietary intake of vitamin D among pregnant mothers was 10.41 + 4.52 µg/day. The reported major highest food group contributing to the daily mean intake of vitamin D among respondents were fish and fish products with a mean + SD of 3.61 + 5.09, followed by milk and milk products (3.32 + 4.56), eggs (1.33 + 0.80), others (0.98 + 1.64), beverages (0.51 + 0.91), cereal and cereal products (0.37 + 0.89), and meat and meat products (0.28 + 0.52).   Nearly half of the participants (56%) had good knowledge regarding vitamin D, hence coming to terms with the fact that pregnant mothers generally had a good knowledge level towards vitamin D with the average knowledge score of 75.2%. Despite having a good knowledge, this study found only 3.5% of the participants exhibited good practice towards vitamin D. It is noted that pregnant mothers generally had a moderate practice level towards vitamin D with the average score of 56.4%.   This present study found that majority of Malaysian pregnant women has not achieved their vitamin D requirement during pregnancy, precisely, 161 out of 200 representing 80.5% respondents did not fulfil the RNI 2017 recommendation. Although with good level of knowledge, Malaysian pregnant mothers exhibited a moderate practice level. Considering the importance of vitamin D function during pregnancy, details investigation on vitamin D level among pregnant women should be investigated to raise the awareness of the importance of vitamin D, especially to the pregnant mothers.