title: Risk factors for antenatal hypovitaminosis D in an urban district in Malaysia.
abstract: Pregnant women form one of the high risk groups facing hypovitaminosis D. Low level of vitamin D will affect directly or indirectly both mother and fetus. Screening vitamin D in the first trimester of pregnancy is important to determine the necessary preventive action. Therefore, this study was aimed to determine the prevalence of hypovitaminosis D and its risk factors among pregnant women in the first trimester.
  
  
  
  A cross sectional study was carried out among first trimester pregnant women during their first antenatal visit. Samples were taken from different ethnicities in an urban district in Malaysia. A total of 396 respondents (99 % response rate) aged 18-40 years completed self-administered and guided questionnaire (characteristics and risk factors), validated semi-quantitative food frequency questionnaire for vitamin D in Malaysia (FFQ vitamin D/My), anthropometric measures (weight and height), blood test for serum 25(OH)D, skin measurement using Mexameter (MX 18) and Fitzpatrick Skin Type Chart Measurement (FSTCM). Data were analyzed to determine the association between risk factors and hypovitaminosis D.
  
  
  
  The prevalence of hypovitaminosis D (serum 25(OH)D < 50 nmol/L) was 90.4 % (358). The mean age of respondents was 28.06 ± 4.09 years old. The independent predictors of hypovitaminosis D were Malay ethnicity (OR 33.68; 95 % CI: 12.81, 88.56), Indian ethnicity (OR 16.86; 95 % CI: 3.78,75.20), secondary education (OR 12.12; 95 % CI: 2.71, 54.16) and tertiary education (OR 14.38; 95 % Cl: 3.31, 62.45).
  
  
  
  Awareness should be raised among Malay and Indian pregnant women with secondary and tertiary education who consumed vitamin D (especially milk) poorly in order to prevent adverse health outcomes. Further studies need to be conducted among health care workers to determine their level of knowledge related to vitamin D, as they are front liner in detecting the hypovitaminosis D.
authors.affiliation: Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000, Cheras, Kuala Lumpur, Malaysia.|Petaling District Health Office, Wisma SAHOCA, No 1, Jalan SS 6/3A Kelana Jaya, 47301, Petaling Jaya, Selangor, Malaysia.
authors.forename: Noriklil Bukhary Ismail
authors.initials: NBI
authors.lastname: Bukhary
authors.affiliation: Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000, Cheras, Kuala Lumpur, Malaysia. zms@ppukm.ukm.edu.my.
authors.forename: Zaleha Md
authors.initials: ZM
authors.lastname: Isa
authors.affiliation: Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000, Cheras, Kuala Lumpur, Malaysia.
authors.forename: Khadijah
authors.initials: K
authors.lastname: Shamsuddin
authors.affiliation: School of Health Sciences, Faculty of Medicine and Health, International Medical University, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.
authors.forename: Khor Geok
authors.initials: KG
authors.lastname: Lin
authors.affiliation: Faculty of Medicine, Department of Obstetrics and Gynecology, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000, Cheras, Kuala Lumpur, Malaysia.
authors.forename: Zaleha Abdullah
authors.initials: ZA
authors.lastname: Mahdy
authors.affiliation: Petaling District Health Office, Wisma SAHOCA, No 1, Jalan SS 6/3A Kelana Jaya, 47301, Petaling Jaya, Selangor, Malaysia.
authors.forename: Haslinda
authors.initials: H
authors.lastname: Hassan
authors.affiliation: Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000, Cheras, Kuala Lumpur, Malaysia.
authors.forename: Noor Sharifatul Hana
authors.initials: NSH
authors.lastname: Yeop
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D004034:Diet Surveys; D004522:Educational Status; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007194:India / Q000208:ethnology; D008296:Malaysia / Q000453:epidemiology / Q000208:ethnology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology*; D011264:Pregnancy Trimesters / Q000097:blood*; D011295:Prenatal Care; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data*; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology*; D055815:Young Adult
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: Ethnic; Hypovitaminosis D; Malaysia; Pregnant women; Prevalence; Risk factors; Skin type