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Hajizadeh, S., Rankin Shary, J., Gayle Reed, S., & Lynn Wagner, C. (2019). The prevalence of hypovitaminosis D and its risk factors in pregnant women and their newborns in the Middle East: A systematic review. International Journal of Reproductive BioMedicine (IJRM), 17(10). https://doi.org/10.18502/ijrm.v17i10.5284
https://doi.org/10.18502/ijrm.v17i10.5284
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- Cited by 4 articles
authors
-
Shayesteh Hajizadeh
Shayesteh Hajizadeh
Department of Pediatrics, Medical University of South Carolina, Charleston, SC
-
Judy Rankin Shary
Judy Rankin Shary
Department of Pediatrics, Medical University of South Carolina, Charleston, SC
-
Susan Gayle Reed
Susan Gayle Reed
Department of Pediatrics, Medical University of South Carolina, Charleston, SC
-
Carol Lynn Wagner
Carol Lynn Wagner
Department of Pediatrics, Medical University of South Carolina, Charleston, SC
Published Date
- Oct 1, 2019
The prevalence of hypovitaminosis D and its risk factors in pregnant women and their newborns in the Middle East: A systematic review
Abstract
Background: Pregnant women and newborns are at risk for vitamin D deficiency (VDD). Also, poor health outcomes for pregnant women with VDD are reported in the published literature.
Objective: The aim of this systematic review was to estimate the prevalence of hypovitaminosis D and the associated risk factors for hypovitaminosis D in Middle Eastern pregnant women and their newborns. Materials and Methods: The international electronic databases PubMed and Scopus for the years 2000-2017 were utilized to identify studies of vitamin D status for pregnant women and newborns in the Middle East. Of the 1,785 reports identified, 1,734 met exclusion criteria and 51 studies were included for this review.
Results: The prevalence of circulating 25-hydroxyvitamin D (25(OH)D) < 50 nmol/L as a marker of vitamin D status in pregnant women and their newborns was between 24.5-98% and 22-100%, respectively. The prevalence of 25(OH) D < 25 nmol/L in pregnant women and their newborns was over a wide range between 16.7-80% and 22- 82%, respectively. Predictors for low maternal and neonatal 25(OH)D concentrations included decreased vitamin D synthesis due to reduced exposure to sunlight and decreased nutritional intake of vitamin D. A predictor of low neonatal 25(OH)D concentrations included maternal vitamin D status and the correlation between vitamin D concentrations in maternal and cord blood.
Conclusion: The high prevalence of VDD in the pregnant women of the Middle East underscores the necessity of implementing national prevention and intervention strategies. A clear policy for clinicians and healthcare workers is needed for screening and maintaining sufficient vitamin D status during pregnancy.
Key words: Vitamin D, Pregnancy, Newborns, Cord blood, Middle East.
References
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[4] Arabi A, El Rassi R, Fuleihan GE-H. Hypovitaminosis D in developing countries—prevalence, risk factors and outcomes. Nat Rev Endocrinol 2010; 6: 550–561.
[5] Hilger J, Friedel A, Herr R, Rausch T, Roos F, Wahl DA, et al. A systematic review of vitamin D status in populations worldwide. Brit J Nutr 2014; 111: 23–45.
[6] Alp H, Tekgündüz KŞ, Akkar MK. Maternal and cord blood vitamin D status in high-altitude pregnancy. J Matern-Fetal Neo M 2016; 29: 571–575.
[7] Aghajafari F, Nagulesapillai T, Ronksley P, Tough S, O’beirne M, Rabi D. Association between maternal serum 25-hydroxyvitamin D level and pregnancy and neonatal outcomes: systematic review and meta-analysis of observational studies. Obstetric Anesthesia Digest 2014; 34: 115–116.
[8] Wei S-Q, Qi H-P, Luo Z-C, Fraser WD. Maternal vitamin D status and adverse pregnancy outcomes: a systematic review and meta-analysis. J Matern-Fetal Neo M 2013; 26: 889–899.
[9] Nassar N, Halligan GH, Roberts CL, Morris JM, Ashton AW. Systematic review of first-trimester vitamin D normative levels and outcomes of pregnancy. Am J Obstet Gynecol 2011; 205: 208.e1–208.e7.
[10] Lau SL, Gunton JE, Athayde NP, Byth K, Cheung NW. Serum 25-hydroxyvitamin D and glycated haemoglobin levels in women with gestational diabetes mellitus. Med J Aust 2011; 194: 334–337.
[11] Soheilykhah S, Mojibian M, Rashidi M, Rahimi-Saghand S, Jafari F. Maternal vitamin D status in gestational diabetes mellitus. Nutrit Clin Pract 2010; 25: 524–527.
[12] Baker AM, Haeri S, Camargo Jr CA, Espinola JA, Stuebe AM. A nested case-control study of midgestation vitamin D deficiency and risk of severe preeclampsia. J Clin Endocr Metab 2010; 95: 5105–5109.
[13] Robinson CJ, Alanis MC, Wagner CL, Hollis BW, Johnson DD. Plasma 25-hydroxyvitamin D levels in early-onset severe preeclampsia. Am J Obstet Gynecol 2010; 203: 366.e1–366.e6.
[14] Azar M, Basu A, Jenkins AJ, Nankervis AJ, Hanssen KF, Scholz H, et al. Serum carotenoids and fat-soluble vitamins in women with type 1 diabetes and preeclampsia. Diabetes Care 2011; 34: 1258–1264.
[15] Wikström Shemer E, Marschall HU. Decreased 1, 25−dihydroxy vitamin D levels in women with intrahepatic cholestasis of pregnancy. Acta Obstet Gyn Scan 2010; 89: 1420–1423.
[16] Dawodu A, Nath R. High prevalence of moderately severe vitamin D deficiency in preterm infants. Pediatr Int 2011; 53: 207–210.
[17] Morley R, Carlin JB, Pasco JA, Wark JD. Maternal 25- hydroxyvitamin D and parathyroid hormone concentrations and offspring birth size. J Clin Endocr Metab 2006; 91: 906–912.
[18] Merewood A, Mehta SD, Chen TC, Bauchner H, Holick MF. Association between vitamin D deficiency and primary cesarean section. J Clin Endocr Metab 2009; 94: 940– 945.
[19] Hensel KJ, Randis TM, Gelber SE, Ratner AJ. Pregnancy specific association of vitamin D deficiency and bacterial vaginosis. Am J Obstet Gynecol 2011; 204: 41.e1–41.e9.
[20] Dror DK. Vitamin D status during pregnancy: maternal, fetal, and postnatal outcomes. Curr Opin Obstet Gynecol 2011; 23: 422–426.
[21] Rethman MP. Pregnancy and periodontal disease. J Am Dent Assoc (1939) 2011; 142: 484.
[22] Boggess KA, Espinola JA, Moss K, Beck J, Offenbacher S, Camargo Jr CA. Vitamin D status and periodontal disease among pregnant women. J Periodontol 2011; 82: 195–200.
[23] Mehta S, Giovannucci E, Mugusi FM, Spiegelman D, Aboud S, Hertzmark E, et al. Vitamin D status of HIV-infected women and its association with HIV disease progression, anemia, and mortality. PLOS ONE 2010; 5: e8770.
[24] Miyake Y, Sasaki S, Tanaka K, Hirota Y. Dairy food, calcium and vitamin D intake in pregnancy, and wheeze and eczema in infants. Eur Respir J 2010; 35: 1228–1234.
[25] Swamy GK, Garrett ME, Miranda ML, Ashley−Koch AE. Maternal vitamin D receptor genetic variation contributes to infant birth weight among black mothers. Am J Med Genet Part A 2011; 155: 1264–1271.
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