Objective To evaluate maternal vitamin D levels in term normotensive and preeclamptic patients in labor and to assess additional factors such as maternal and cord blood levels of calcium, phosphorus, parathormone, and alkaline phosphatase and associated factors such as BMI, birth weight, and mode of delivery. Method This was a case control study carried out in Department of Obstetrics and Gynaecology, ESIC-PGIMSR, New Delhi, India from August 2012-April 2014.A total of 100 patients were divided into two equal groups (control and study groups of 50 each). Control group had women with singleton uncomplicated, term normotensive pregnant women in labor while the study group composed of term preeclamptic women in labor. Blood samples were drawn for vitamin D, serum calcium, serum phosphorus, serum alkaline phosphatase, and serum parathormone levels during first stage of labor, and subsequently, their levels were evaluated in cord blood also. 123Results All the enrolled patients had vitamin D deficiency pointing toward a universal prevalence of this micronutrient deficiency in antenatal patients. We found more incidence of severe vitamin D deficiency (90 %) in preeclamptic patients as compared to normotensive patients (62 %). Also preeclamptic group had lower median vitamin D levels (3.9 ng/ml) when compared to normotensive group (9 ng/ml). Similarly, all the neonates were found to be vitamin D deficient as assessed by their cord blood levels. Neonates born to preeclamptic mothers had lower median cord blood vitamin D levels (4.4 ng/ml) when compared to those born to normotensive mothers (7.25 ng/ml). The mean maternal calcium levels followed trends observed in vitamin D levels with preeclamptic patients having consistently lower calcium levels (mean value of 8.50 ± 0.80 mg/dl) when compared to normotensive patients (mean value of 8.89 ± 0.56 mg/dl). Preeclamptic group was found to have more number of patients (58 %) with higher BMI when compared to normotensive group (32 % of patients). A slightly more incidence (36 %) of low birth weight babies is being born to preeclamptic mothers as compared to normotensive mothers (34 %). Significantly a more number of patients (36 %) with vitamin D levels below 15 ng/ml underwent cesarean section when compared to only 9 % of patients having vitamin D level above this level. Conclusion Preeclampsia is indeed associated with lower vitamin D levels, and its pathophysiology involves vitamin D and calcium metabolism.

INTRODUCTION: Obesity is associated with alteration in the vitamin D levels and has been related to vitamin D status. Lower vitamin D levels in higher BMI individuals may be secondary to an alteration in tissue distribution resulting from an increase in adipose mass. Therefore women with higher BMI need higher vitamin D supplementation as compared to women with BMI within normal range.  MATERIAL AND METHOD: This was a case control study carried out in Department of Obstetrics and Gynaecology, ESIC-PGIMSR, New Delhi from August 2012-April 2014. A total of 100 patients were divided into two equal groups (control and study groups of 50 each). Control group had women with singleton uncomplicated term normotensive pregnant women in labour while the study group comprised of term preeclamptic women in labour.In all the patients their BMI was analysed .Blood samples for vitamin D, serum calcium, serum phosphorus, serum parathormone, serum alkaline phosphatase levels were drawn and subsequently their levels were evaluated in cord blood; correlation studied between vitamin D & BMI. RESULTS: The mean BMI was relatively higher in the study group (26.34 ± 4.12)kg/m2 than in the control group ( 24.24 ± 3.13)kg/m2. Thus in our study a prevalence of higher BMI was seen in patients of preeclampsia. When all the 100 women are being considered, median vitamin D levels were found to be higher (6.6ng/ml) in normal BMI patients (n=55) as compared to levels (5.6ng/ml) in patients with higher BMI(n=45).  CONCLUSION: Vitamin D levels are related to maternal body mass index. Individuals with higher percentage body fat may require higher vitamin D intake to attain optimal 25(OH) D levels, compared with lean individuals and thereby may prevent pregnancy complications like Pre eclampsia.