Maternal Vitamin D Deficiency: A Risk Factor for Gestational Diabetes Mellitus in North IndiaMadhu Jain1*, Sweety Kapry1, Shuchi Jain1, SK Singh2 and TB Singh3
- *Corresponding Author:
- Madhu Jain
G-11, Lal Bahadur Shastri Nagar Colony
Karaundi, Varanasi, India
E-mail: [email protected]
Received date: January 03, 2015; Accepted date: January 13, 2015; Published date: January 15, 2015
Citation: Jain M, Kapry S, Jain S, Singh SK, Singh TB (2015) Maternal Vitamin D Deficiency: A Risk Factor for Gestational Diabetes Mellitus in North India. Gynecol Obstet (Sunnyvale) 5:264. doi: 10.4172/2161-0932.1000264
Copyright: © 2015 Jain M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use,distribution, and reproduction in any medium, provided the original author and source are credited.
Objective: The aim was to assess maternal vitamin D deficiency in early pregnancy and subsequent risk of developing gestational diabetes mellitus (GDM) in north India.
Methods: Nested case control study was done taking 550 antenatal women. Two maternal blood samples, one at <20 wks and the other at term along with cord blood were taken. Vitamin D was estimated by 25-Hydroxyvitamin D 125 I RIA Kit and categorised according to ACOG (2011) criteria. Patients were categorised into GDM and control groups as per ADA recommendations. Pearson χ2, ANOVA, linear correlation and logistic regression were used for statistical analysis.
Results: High prevalence (72.8%) of vitamin D deficiency was found in early pregnancy. Serum 25(OH) D
concentrations were significantly lower (46% less) in women who subsequently developed GDM compared with controls [mean: 11.93 ± 3.42 ng/ml, 95% CI: 10.7-13.17 ng /ml; vs. mean: 22.26 ± 15.28 ng/ml, 95% CI: 20.0-24.52 ng/ml; p<0.001]. Fasting blood sugar in early gestation negatively correlated with 25 (OH) D level (r=-0.489, p=0.004) and at term gestation (r=-0.435, p<0.013). Women with hypovitaminosis D in early pregnancy were eleven times more likely to have GDM compared to controls (p=0.001; r=11.55). Cord serum 25(OH) D concentrations were also significantly lower among neonates of GDM mothers than of controls (mean, 10.39 ± 2.26 ng/ml, vs. 21.33 ± 14.40; p<0.001). In GDM women, maternal 25 (OH) D concentration at <20 weeks positively correlated with vitamin D concentration at term gestation (r=0.781, p<0.001) and also with cord blood levels (r=0.478, p<0.0001).
Conclusion: Maternal vitamin D deficiency is highly prevalent in early pregnancy and is an independent risk factor for GDM in North India. Further clinical trials are needed to find out whether vitamin D supplementation would prevent or improve glycemic control in women with GDM.