SEVERE VITAMIN D DEFICIENCY AMONG PREGNANT WOMEN AND THEIR NEWBORNS IN SIDI BEL ABBES REGION, ALGERIA

Background: Vitamin D deficiency is common in pregnant women and newborn infants. Adequate vitamin D concentrations during pregnancy are necessary to ensure appropriate maternal responses to the calcium demands of the fetus and neonatal handling of calcium.

There are few data from Algeria on serum 25(OH) D concentration and the prevalence of vitamin D deficiency in pregnant women and their newborn. This study was undertaken to determine the prevalence of maternal and fetal hypovitaminosis D in SBA region of Algeria and to study their correlations with the levels of calcium, serum 25(OH)D, albumin, alkaline phosphatase (ALP) and plasma parathyroid hormone (PTH).

Methods: Maternal serum and cord blood levels of calcium, 25-hydroxyvitamin D [25(OH)D], ALP, PTH were studied in 100 mother-neonate pairs at term.

Results: About 86% of patients have serum 25(OH)D <3 ng/ml, and 78% of newborn have serum 25(OH)D <3 ng/ml. The mean level of maternal PTH was 92.13±45.29 pmol/L, and that of cord blood PTH was 13.61±11.82 pmol/L. The intake of calcium was low in Algerian women (796,30±366,35 mg Ca/d ). The mean level of maternal serum calcium was 84.64±4.04 mg/L, and that of cord blood calcium was 96.26±9.90 mg/L. Maternal serum calcium was correlated with cord blood calcium (r=0.16, p= 0.69). The mean level of maternal serum albumin was 30.84±3.26 g/l. The mean birth weight of the newborn was 3434.±437.81g (2600-4500 g).

Women deficient in vitamin D had infants with vitamin D deficiency respectively (4.33±4.36 ng/ml; 4.31±4.81 ng/ml.).

Maternal vitamin D status during pregnancy has been shown to be associated with neonatal vitamin D. Maternal serum 25(OH)D correlated positively with cord blood 25(OH)D (r=0.78, p<0.01) and negatively with PTH (r=-0.24, p< 0.001). A positive linear relationship was found between gestity and maternal calcium (r=- 0.32, p=0.02).

Conclusion: There is a high prevalence and severe of vitamin D deficiency in pregnant women and neonates in SBA, Algeria. The newborn serum 25(OH)D concentrations rely on maternal vitamin D status. Poor maternal vitamin D status may adversely affect neonatal vitamin D status. Supplementation is needed to improve maternal and neonatal vitamin D and calcium nutrition.