Abstract

PREVALENCE OF VITAMIN D DEFICIENCY AND THE IMPACT OF ORAL SUPPLEMENTATION IN AN UNSELECTED PREGNANT INDIAN POPULATION

Author(s): Hema Divakar, Rita Singh2, Poorvi Narayanan3, G. V. Divakar4

BACKGROUND There are many previous studies on vitamin D deficiency (VDD), providing evidence of widespread VDD in south Asian populations. It underscores the need for vitamin D supplementation and fortification guidelines in India, especially considering the deleterious health effects of VDD. The objectives of this study were 1. To explore the prevalence of VDD among pregnant women at a multi-specialty hospital in Bengaluru, India 2. To study the impact of daily oral vitamin D supplementation in pregnancy 3. To explore population-based remedies. MATERIALS AND METHODS This single center, open label clinical study was conducted at the Divakars Speciality Hospital, Bengaluru, India. Two hundred pregnant women were enrolled in the study in the 14th week of gestation. Serum vitamin D levels were measured at enrolment (baseline), and again on Day 3 postpartum. The vitamin D levels of the women were classified as follows: serum 25(OH) D levels <20 ng/ml = vitamin D deficiency (VDD); levels >20–<30 ng/ml = vitamin D insufficiency (VDI) and levels >30 ng/ml = vitamin D sufficient (VDS). All participants, regardless of their vitamin D status, were given an oral vitamin D supplementation regimen consisting of 1000 IU/day. RESULTS The mean age of the participants was 29???4 years. The mean serum vitamin D level at baseline was 11???93 ng/mL and on Day 3 postpartum it was 24.42???10.93 ng/mL, a statistically significant change (p < 0.001) at base line 86.3% (n = 173) women were vitamin D deficient (VDD), 12.5% (n = 25) were vitamin D insufficient (VDI), and 1% (n = 2) were vitamin D sufficient (VDS). The corresponding figures at the end of the study were 37% (n= 74) VDD, 32.5% (n = 65) VDI, and 30.5% (n = 61) VDS. Thus 30.3% (n = 60) of the participants had achieved vitamin D sufficiency by the end of the study period. There were no adverse effects reported as a result of taking the vitamin D supplements. CONCLUSION This study confirms previous reports of a high prevalence of VDD in pregnant Indian women. Oral vitamin D supplementation at a dose of 1000 IU/day significantly improved serum 25(OH)D levels in pregnant women, with a significant proportion attaining vitamin D sufficiency status. Further research is required to explore the potential clinical benefits of routine screening for VDD and supplementation as a part of routine prenatal services in India.