Maternal Vitamin D Status and Delivery by Cesarean

Abstract

We examined the association of vitamin D deficiency to risk of cesarean delivery using prospective data in a cohort of 1153 low income and minority gravidae. Circulating maternal 25-hydroxyvitamin D and intact parathyroid hormone were measured at entry to care 13.73 ± 5.6 weeks (mean ± SD). Intake of vitamin D and calcium was assessed at three time points during pregnancy. Using recent Institute of Medicine guidelines, 10.8% of the gravidae were at risk of vitamin D deficiency, and 23.8% at risk of insufficiency. Maternal 25-hydroxyvitamin D was related positively to vitamin D and calcium intakes and negatively to circulating concentrations of parathyroid hormone. Risk for cesarean delivery was increased significantly for vitamin D deficient women; there was no increased risk for gravidae at risk of insufficiency. When specific indications were examined, vitamin D deficiency was linked to a 2-fold increased risk of cesarean for prolonged labor. Results were the similar when prior guidelines for vitamin D deficiency (25(OH)D < 37.5nmol/L) and insufficiency (37.5–80 nmol/L) were utilized.

Vitamin D status in the first-trimester: effects of Vitamin D deficiency on pregnancy outcomes

“…Furthermore, the current study was focused primarily on the first trimester of pregnancy and we cannot rule out the possibility that differences in 25(OH)D concentrations become apparent only in the third trimester. A recent study with a large size of population revealed no association between the first trimester vitamin D status and the mode of delivery 28. Our findings are in contrast to those of two other studies, Merewood et al 9 found almost four-fold increase in the rate of primary caesarean section in women with 25(OH)D levels below 15 ng/ mL at the time of the delivery, and Scholl et al 29 reported increased risk for caesarean delivery for women with 25(OH)D levels below 12 ng/ mL.…”

Effect of vitamin D supplementation during pregnancy on maternal and neonatal outcomes: a systematic review and meta-analysis of randomized controlled trials

“…Low circulating blood 25(OH)D levels have been reported to be associated with an increased rate of cesarean section (49,50). On the contrary, first-trimester maternal vitamin D levels were similar in women who subsequently have a vaginal delivery vs. those who deliver by elective or emergency cesarean section (51).…”

The impact of vitamin D: From a fetus to an infant

“…The incidence of bacterial vaginosis during pregnancy is important because it is associated with adverse outcomes, such as premature rupture of the membranes, premature delivery and the incidence of postpartum endometritis. In addition, a higher level of parturition by Caesarean section has also been reported in pregnant women with VD deficiency, although some other studies indicate that the method of delivery is independent of maternal VD status (36).…”