title: High prevalence of vitamin D deficiency among pregnant women and their newborns in northern India.
abstract: BACKGROUND
  Vitamin D deficiency is prevalent in India, a finding that is unexpected in a tropical country with abundant sunshine. Vitamin D deficiency during pregnancy has important implications for the newborn and infant. There are few data from India about the prevalence of hypovitaminosis D in pregnancy and in the newborn.
  
  
  OBJECTIVE
  Our aim was to determine the prevalence of osteomalacia and hypovitaminosis D in pregnancy and in cord blood and to correlate maternal 25-hydroxyvitamin D [25(OH)D] status with sun exposure, daily calcium intake (dietary plus supplemental), and intact parathyroid hormone (PTH) concentrations.
  
  
  METHODS
  Serum calcium, inorganic phosphorus, 25(OH)D, heat-labile alkaline phosphatase, and PTH were studied in 207 urban and rural pregnant subjects at term. Alkaline phosphatase and 25(OH)D were measured in the cord blood of 117 newborns.
  
  
  RESULTS
  Mean maternal serum 25(OH)D was 14 +/- 9.3 ng/mL, and cord blood 25(OH)D was 8.4 +/- 5.7 ng/mL. PTH rose above the normal range when 25(OH)D was <22.5 ng/mL. Eighty-four percent of women (84.3% of urban and 83.6% of rural women) had 25(OH)D values below that cutoff. Fourteen percent of the subjects had elevated alkaline phosphatase (17% of urban and 7% of rural subjects). Calcium intake was uniformly low, although higher in urban (842 +/- 459 mg/d) than in rural (549 +/- 404 mg/d) subjects (P < 0.001). Maternal serum 25(OH)D correlated positively with cord blood 25(OH)D (r = 0.79, P < 0.001) and negatively with PTH (r = -0.35, P < 0.001).
  
  
  CONCLUSIONS
  We observed a high prevalence of physiologically significant hypovitaminosis D among pregnant women and their newborns, the magnitude of which warrants public health intervention.
authors.affiliation: Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
authors.forename: Alok
authors.initials: A
authors.lastname: Sachan
authors.forename: Renu
authors.initials: R
authors.lastname: Gupta
authors.forename: Vinita
authors.initials: V
authors.lastname: Das
authors.forename: Anjoo
authors.initials: A
authors.lastname: Agarwal
authors.forename: Pradeep K
authors.initials: PK
authors.lastname: Awasthi
authors.forename: Vijayalakshmi
authors.initials: V
authors.lastname: Bhatia
mesh_terms: D000328:Adult; D002136:Calcium, Dietary / Q000008:administration & dosage; D005260:Female; D005312:Fetal Blood / Q000378:metabolism*; D006801:Humans; D007194:India / Q000453:epidemiology; D007231:Infant, Newborn; D010018:Osteomalacia / Q000097:blood / Q000453:epidemiology*; D011247:Pregnancy; D015995:Prevalence; D012423:Rural Health; D013472:Sunlight; D014504:Urban Health; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000453:epidemiology*
chemical_list: D002136:Calcium, Dietary; D014807:Vitamin D; C104450:25-hydroxyvitamin D