A Case Control Study to Evaluate the Association between Primary Cesarean Section for Dystocia and Vitamin D Deficiency

Abstract

This small case control study did not show a significant association between vitamin D deficiency and primary cesarean section.

Vitamin D and its impact on maternal-fetal outcomes in pregnancy: A critical review

“…In a multiethnic Asian cohort study conducted by GUSTO study group (Loy et al, 2015), it was found that low vitamin D levels were associated with increased risk of emergency C-sections in Chinese and Indian women, and not in Malay women and overall there was no significant association. No association between vitamin D deficiency and risk of C-section was reported in other recent studies (Sebastian et al, 2015; Gernand et al, 2015). The inconsistency in the findings might be due to the difference in defining C-section in terms of indication, primary or secondary, emergency or elective (Gernand et al, 2015).…”

“…Vitamin D regulates the contractile proteins of uterine myometrial cells (Loy et al, 2015). Vitamin D deficiency, therefore, may decrease the strength of the contractile muscles, causing prolonged labor or obstructed labor, indicating the need for C-section (Sebastian et al, 2015). Vitamin D deficiency has also been postulated to cause malformation of pelvis, which is yet another indication for C-section (Gernand et al, 2015).…”

“…Few studies have analyzed the association between vitamin D levels and cesarean sections. Recently, five observational studies were conducted with mixed outcomes (Loy et al, 2015; Sebastian et al, 2015; Gernand et al, 2015; Rodriguez et al, 2015). In a prospective cohort study conducted in Spain in 2,382 mother child pairs, Rodriguez et al (2015) reported that adequate vitamin D (25 OHD ≥ 30ng/ml) decreased the risk of C-section by obstructed labor (RR=0.60, 95% CI 0.37, 0.97).…”

Maternal Vitamin D Status among Different Ethnic Groups and Its Potential Contribution to Adverse Pregnancy and Child Outcomes

“…The indication of C-section can be related to vitamin D deficiency, but there is a mixture of results regarding this association. For example, prospective cohort studies suggested there was an inverse association with having a cesarean section and serum 25(OH)D levels [88][89][90], whereas others did not support this relationship [76,87,91]. Regarding ethnicity, in a cohort multi-ethnic Asian study, vitamin D deficiency was related to a higher risk of C-sections in Chinese and Indian women compared to Malay women [86].…”

“…Uterine muscle and skeletal muscle cells have VDR, which is a regulator of the contractile proteins of uterine myometrial cells [86]. Therefore, the strength of the contractile muscles is decreased with vitamin D deficiency as well as malformation of the pelvis, which are indications for C-section [87]. The indication of C-section can be related to vitamin D deficiency, but there is a mixture of results regarding this association.…”