title: Impact of vitamin D deficiency on maternal and birth outcomes in the Saudi population: a cross-sectional study.
abstract: Low serum vitamin D [25(OH)D] has been associated with different health problems worldwide. However, its causal role in several diseases remains unclear. We aimed to correlate vitamin D status with maternal and neonatal outcomes in pregnant females.
  
  
  
  One thousand pregnant women were recruited during early labour from the labour ward of King Khaled University Hospital, Riyadh, Saudi Arabia. Detailed medical data of all participants were collected from their records. Delivery events and birth outcomes were also documented. Serum 25(OH)D levels were measured using an enzyme-linked immunosorbent assay. A receiver operating characteristic (ROC) curve was constructed to evaluate the ability of vitamin D levels to predict complicated pregnancies. Regression analysis was used to test the correlation between serum 25(OH)D levels and different variables.
  
  
  
  Most of the participants were Saudis (89.9 %) and housewives (85.1 %) and 86.4 % of them had vitamin D deficiency (mean: 30.46 ± 19.6 nmol/L). Gestational diabetes mellitus (GDM) was the commonest complication detected (11.1 %) while the history of miscarriage was elevated (24.5 %). There was no association between GDM and low 25(OH)D. Yet, there was a significant negative correlation between serum 25(OH)D levels and fasting blood glucose among females older than 35 years (r = -0.2, p = 0.03). Hypertensive disorders of pregnancy and pre-existing hypertension were less than 1.5 % of frequency. Nevertheless, they were only recorded in women with insufficient and deficient vitamin D. ROC curve revealed that 25(OH)D levels were not able to discriminate between normal and adverse pregnancy outcomes (AUROC curve: 0.51; 95 % confidence interval (CI): 0.44-0.58; p = 0.8).
  
  
  
  Hypovitaminosis D, a highly prevalent health problem among pregnant females in Riyadh, has no relation to adverse pregnancy outcomes except for a higher prevalence of miscarriage in women with low 25(OH)D.
authors.affiliation: Obstetrics and Gynecology Department, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia.|College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Ghadeer K
authors.initials: GK
authors.lastname: Al-Shaikh
authors.affiliation: College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia. gehan_amer@med.suez.edu.eg.|Department of Medical Biochemistry, Faculty of Medicine, Suez Canal University, Round Road, Ismailia, 41511, Egypt. gehan_amer@med.suez.edu.eg.
authors.forename: Gehan H
authors.initials: GH
authors.lastname: Ibrahim
authors.affiliation: College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia.|Department of Biostatistics, High Institute of Public Health, Alexandria University, Alexandria, Egypt.
authors.forename: Amel A
authors.initials: AA
authors.lastname: Fayed
authors.affiliation: Obstetrics and Gynecology Department, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Hazem
authors.initials: H
authors.lastname: Al-Mandeel
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001786:Blood Glucose / Q000032:analysis; D003430:Cross-Sectional Studies; D016640:Diabetes, Gestational / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D004797:Enzyme-Linked Immunosorbent Assay; D005215:Fasting / Q000097:blood; D005260:Female; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood* / Q000453:epidemiology / Q000209:etiology; D011256:Pregnancy Outcome; D015995:Prevalence; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: Adverse pregnancy outcome; Gestational diabetes; Hypovitaminosis D; Pregnancy; Vitamin D