Gynecology & Obstetrics
Open Access
ISSN: 2161-0932
ISSN: 2161-0932
Madhu Jain, Sweety Kapry, Shuchi Jain, SK Singh and TB Singh
Objective: The aim was to assess maternal vitamin D deficiency in early pregnancy and subsequent risk of developing gestational diabetes mellitus (GDM) in north India.
Methods: Nested case control study was done taking 550 antenatal women. Two maternal blood samples, one at <20 wks and the other at term along with cord blood were taken. Vitamin D was estimated by 25-Hydroxyvitamin D 125 I RIA Kit and categorised according to ACOG (2011) criteria. Patients were categorised into GDM and control groups as per ADA recommendations. Pearson χ2, ANOVA, linear correlation and logistic regression were used for statistical analysis.
Results: High prevalence (72.8%) of vitamin D deficiency was found in early pregnancy. Serum 25(OH) D concentrations were significantly lower (46% less) in women who subsequently developed GDM compared with controls [mean: 11.93 ± 3.42 ng/ml, 95% CI: 10.7-13.17 ng /ml; vs. mean: 22.26 ± 15.28 ng/ml, 95% CI: 20.0-24.52 ng/ml; p<0.001]. Fasting blood sugar in early gestation negatively correlated with 25 (OH) D level (r=-0.489, p=0.004) and at term gestation (r=-0.435, p<0.013). Women with hypovitaminosis D in early pregnancy were eleven times more likely to have GDM compared to controls (p=0.001; r=11.55). Cord serum 25(OH) D concentrations were also significantly lower among neonates of GDM mothers than of controls (mean, 10.39 ± 2.26 ng/ml, vs. 21.33 ± 14.40; p<0.001). In GDM women, maternal 25 (OH) D concentration at <20 weeks positively correlated with vitamin D concentration at term gestation (r=0.781, p<0.001) and also with cord blood levels (r=0.478, p<0.0001).
Conclusion: Maternal vitamin D deficiency is highly prevalent in early pregnancy and is an independent risk factor for GDM in North India. Further clinical trials are needed to find out whether vitamin D supplementation would prevent or improve glycemic control in women with GDM.