title: Prospective audit of vitamin D levels of women presenting for their first antenatal visit at a tertiary centre.
abstract: BACKGROUND
  Vitamin D deficiency in pregnancy is associated with adverse events such as pre-eclampsia, primary caesarean section and vitamin D deficiency of the newborn. Vitamin D screening in pregnancy is not universal.
  
  
  OBJECTIVE
  To evaluate the vitamin D status of pregnant women at our institution and assess the sensitivity of the current risk-based screening guideline.
  
  
  METHODS
  A prospective audit of vitamin D levels of all women presenting for their first antenatal booking visit during 3 four-week periods (in 2009-2010) was conducted at the Women's and Children's Hospital, South Australia. The main outcome measure was 25-hydroxyvitamin D3 levels. Information was also collected on body mass index, self-reported ethnicity and whether or not vitamin D testing was indicated based on the hospital guidelines.
  
  
  RESULTS
  Four hundred and seventy-two women consented to inclusion in the audit. 67.4% (318/472) were 'low-risk' according to the hospital guidelines for vitamin D screening. 46.2% of these women and 78.6% of 'high-risk' women were vitamin D deficient (<60 nmol/L). Mean vitamin D levels were 62.7 ± 22.0 and 43.4 ± 26.3 nmol/L for low- and high-risk women, respectively. 54.9% (147/268) of women who were found to be vitamin D deficient were classified as 'low-risk' giving a sensitivity of 45% for the current risk-based screening guideline.
  
  
  CONCLUSIONS
  Based on current normal ranges for vitamin D, risk-based screening criteria for vitamin D deficiency in pregnancy fails to detect over half of vitamin D deficient women at our institution. Current South Australian guidelines should be amended in favour of universal screening of vitamin D for all pregnant patients at their booking visit.
authors: Obstetrics and Gynaecology, Women's and Children's Hospital, North Adelaide, SA, Australia. kate.delaine@health.sa.gov.au
authors: Kate M
authors: KM
authors: De Laine
authors: Geoff
authors: G
authors: Matthews
authors: Rosalie M
authors: RM
authors: Grivell
mesh_terms: D005260:Female; D006801:Humans; D015994:Incidence; D008485:Medical Audit; D011247:Pregnancy / Q000097:blood; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology*; D012307:Risk Factors; D013021:South Australia / Q000453:epidemiology; D014807:Vitamin D / Q000097:blood; D014808:Vitamin D Deficiency / Q000175:diagnosis / Q000453:epidemiology*
chemical_list: D014807:Vitamin D
keywords: South Australia; pregnancy; vitamin D