ASSOCIATION OF VITAMIN-D INSUFFICIENCY DURING PREGNANCY WITH MATERNAL & PEINATAL MORBIDITY AND MOTALITY

Objective: To determine the association of Vitamin-D insufficiency during pregnancy with maternal & perinatal morbidity and mortality. Study Design: Prospective cohort study. Place and Duration of Study: This study was conducted at Obstetrics and Gynaecology Department, PNS Shifa Karachi, from Dec 2017 to Dec 2018. Methodology: A total of 585 pregnant females who fulfilled the inclusion criteria were booked at or before 20 weeks of gestation. Serum vitamin–D3 levels [25(OH)D], Doppler studies and serial measurements of blood pressures were done and the patients were observed for intrauterine growth restriction (IUGR), low birth weight (LBW), development of pregnancy induced hypertension (PIH) and outcomes of pregnancy like still birth and neonatal intensive care unit (NICU) admissions. Results: A total of 585 patients were enrolled in the study out of which 394 (67.4%) were found to be vitamin–D deficient. Sixty seven babies (11.5%) had IUGR [31=vitamin-D deficient mothers, 36=non-deficient mothers] (RR=0.660). Increased Doppler indices were seen in 108 (18.5%) of the babies [87=Vitamin-D deficient mothers, 21=non-deficient mothers] (RR=1.25). A total of 128 babies (22%) were low birth weight (LBW) [93=vitamin D deficient mothers, 35=non-deficient mothers] (RR=1.103). Two (0.34%) still births were seen in vitamin-D deficient patients (RR=1.48). 14% babies required neonatal intensive care [53=vitamin-D deficient mothers, 28=non-deficient mothers] (RR=0.967). Eighty three (14.2%) cases of maternal hypertension [54=vitamin-D deficient mothers, 29=non-deficient mothers] (RR=0.961). Conclusion: Increased doppler indices, low birth weight and still birth had statistically significant association with vitamin D deficiency.