High prevalence of vitamin D deficiency among pregnant women and their newborns in northern India.
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.
Sachan
Alok
A
Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Gupta
Renu
R
Das
Vinita
V
Agarwal
Anjoo
A
Awasthi
Pradeep K
PK
Bhatia
Vijayalakshmi
V
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*
D002136:Calcium, Dietary; D014807:Vitamin D; C104450:25-hydroxyvitamin D