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Comparative Study of Vitamin D Status and Fetomaternal Outcome in Preeclampsia/Eclampsia and Normal Pregnant Women at Term

Radha Rastogi, Professor and Unit Head, Department of Obstetrics and Gynaecology, RNT Medical College, Udaipur, Rajasthan 313001, India , Choudhary Nidhi1 , Rastogi Radha2 , Joshi Priyanka3

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Indian Journal of Obstetrics and Gynecology 6(5):p 478-485, Sep-Oct 2018. | DOI: DOI: http://dx.doi.org/10.21088/ijog.2321.1636.6518.7

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Abstract

Objective: To evaluate maternal vitamin D levels in term normotensive and pre-eclamptic/ eclamptic patients and to assess associated factors such as BMI, birth weight, and mode of delivery and fetomaternal outcome. Method: This was a prospective case control study  arried out in Department of Obstetrics and Gynaecology, R.N.T. Medical College Udaipur from July 2017 to December 2017. 100 patients were divided into control and study groups of 50 each. Control group had normotensive term pregnant women while the study group had  pre-eclamptic and eclamptic women. Results: We found more incidence of vitamin D deficiency (96%) in study group as compared to controls (82%). Vitamin D levels were lower in the study group  (7.81±4.88ng/ml) compared to control group (12.94±6.72ng/ml) (P<0.001). Group with BMI >24.9 had the lowest vitamin D level (5.50±2.91ng/ml) (p<0.01). Mean Thyroid Stimulating Hormone (TSH) in study group was 4.71±1.51µIU/ml and in control was  3.0±1.11µIU/ml (p value<0.001). Incidence of hypothyroidism was 36% in study group and 12% in controls (p<0.05). The mean Vitamin D Levels in the two groups (TSH ï‚³4.5mIU/ml and TSH <4.5mIU/ml) were 5.60±3.08 ng/ml and 11.88±7.84ng/ml respectively (p<0.001). Study group had a SB rate of 20% vs 2% in controls and 12% neonatal mortality in NICU vs 8% in controls. Maternal vitamin D  levels in patients with still borns was 5.71±2.22ng/ml in comparison to 10.95±7.71ng/ml in those with Live birth (p<0.001). Mean birth weight for study group was 2.04±0.60kg and control group was 2.63±0.37kg (p<0.01). Maternal Vitamin D level for neonates weighing >2.5kg was 12.76±3.91 ng/ml (p<0.01). Low BMI patients (<18.5) had a mean neonatal birth weight of 1.89±0.47kg. For Maternal BMI >24.9, the mean neonatal birth weight was 2.47±0.85kg (p<0.05). Conclusion : Low Maternal Vitamin D is associated with an increased risk of preeclampsia and poorer feto-maternal outcome. This could be a modiûable risk factor with important public- health implications. 

Keywords: Vitamin D; Pre-Eclampsia; Eclampsia; Thyroid Stimulating Hormone (TSH).  

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DOI: DOI: http://dx.doi.org/10.21088/ijog.2321.1636.6518.7

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