Volume 8, Issue 4, July 2020, Page: 56-60
Vitamin D Supplementation for Pregnant Women in Bulgaria
Anna-Maria Borissovа, Clinic of Endocrinology, University Hospital Sofiamed, Sofia, Bulgaria; Medical Faculty, Sofia University Saint Kliment Ohridski, Sofia, Bulgaria
Boyana Trifonova, Clinic of Endocrinology, University Hospital Sofiamed, Sofia, Bulgaria; Medical Faculty, Sofia University Saint Kliment Ohridski, Sofia, Bulgaria
Lilia Dakovska, Clinic of Endocrinology, University Hospital Sofiamed, Sofia, Bulgaria
Eugenia Mihailova, Clinic of Endocrinology, University Hospital Sofiamed, Sofia, Bulgaria
Mircho Vukov, Clinic of Endocrinology, University Hospital Sofiamed, Sofia, Bulgaria
Received: Jun. 30, 2020;       Accepted: Jul. 22, 2020;       Published: Aug. 18, 2020
DOI: 10.11648/j.ejpm.20200804.14      View  116      Downloads  43
The aim: of our study was to evaluate the levels of 25-hydroxy vitamin D [25 (OH) D] in pregnant Bulgarian women with and without vitamin D supplementation. Material and methods: We investigated 547 pregnant Bulgarian women, mean age 30±5 years, median 30 (18-47). All pregnant women filled in a specially designed standard questionnaire. The cohort consisted of 547 unselected pregnant women, 278/547 (50.82%) taking vitamins at the time of the investigation, as a monotherapy or in combination with other medications. We introduced four category level of vitamin D: Severe deficiency: < 10 ng / ml; Moderate deficiency: 10 - 20 ng / ml; Insufficiency: 20 - 30 ng / ml; Sufficiency: > 30 ng / ml. The peripheral levels of 25(OH)D were investigated using a standard Electro Chemyluminescence Immuno Assay (Competition principle) in a central laboratory on the day of the sampling. Results: For the whole group (547 pregnant women), the mean 25(OH)D level was 25.86±9.46 ng / ml; median 24.51 (7.96 - 70.00), corresponding to mild insufficiency. Sufficient vitamin D (≥ 30 ng / ml) had a significantly higher percentage of pregnant women supplemented with vitamin D compared to the non-supplementеd group - 87 (31.29%) versus 61 (22.68%), P < 0.05. At the same time, vitamin D deficiency (< 20 ng/ml) was significantly higher in pregnant women without supplementation with vitamin D - 86 (31.98%) versus those with supplementation - 61 (21.94%), P < 0.01. In conclusion: the levels of vitamin D among pregnant Bulgarian women are within the span of mild insufficiency, probably due to the intake of combined vitamin supplements by approximately half of the studied women during the pregnancy.
Vitamin D, Pregnancy, Vitamin Supplementation
To cite this article
Anna-Maria Borissovа, Boyana Trifonova, Lilia Dakovska, Eugenia Mihailova, Mircho Vukov, Vitamin D Supplementation for Pregnant Women in Bulgaria, European Journal of Preventive Medicine. Vol. 8, No. 4, 2020, pp. 56-60. doi: 10.11648/j.ejpm.20200804.14
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Danese E, Pucci M, Montagnana M, Lippi G. (2020). Vitamin D deficiency and pregnancy disorders. J Lab Precis Med; 5: 5 | http://dx.doi.org/10.21037/jlpm.2019.11.03).
Saraf R, Morton S. M, Camargo, C. A. Jr, Grant C. C. (2016). Global summary of maternal and newborn vitamin D status—A systematic review. Matern. Child Nutr. 12, 647–668.
Kiely M. E, Wagner C. L, Roth D. E. (2020). Vitamin D in pregnancy: Where we are and where we should go. The Journal of Steroid Biochemistry and Molecular Biology. Volume 201, 105669.
Lambert PW, Stern PH, Avioli RC, Brackett NC, Turner RT, Greene A. (1982). Evidence for extrarenal production of 1a, 25-dihydroxyvitamin D in man. J Clin Invest. 69: 722–725. doi: 10.1172/JCI110501.
Zehnder D, Bland R, Williams MC, McNinch RW, Howie AJ, Stewart PM, et al. (2001). Extrarenal expression of 25-hydroxyvitamin D3-1a-hydroxylase. J Clin Endocrinol Metab. 86: 888–894. doi: 10.1210/jc.86.2.888.
Tamblyn JA, Hewison M, Wagner CL, Bulmer JN, Kilby MD. (2015). Immunological role of vitamin D at the maternal–fetal interface. J Endocrinol. 224: R114–117.
Guideline: Vitamin D supplementation in pregnant women. Geneva: World Health Organization (2012). http://www.who.int/nutrition/publications/micronutrients/guidelines/vit_d_supp_pregnant_women/en/.
Gallo S, McDermid JM, Al-Nimr RI, Hakeem R, Moreschi JM, Pari-Keener M, Stahnke, B, Papoutsakis C, Handu D, Cheng FW. (2020). Vitamin D Supplementation during Pregnancy: An Evidence Analysis Center Systematic Review and Meta-Analysis. J Acad Nutr Diet. May; 120 (5): 898-924.
Brustad N, Garland J, Thorsen J, Sevelsted A, Krakauer M, Vinding RK, Stokholm J, Bønnelykke K, Bisgaard H, Chawes BL. (2020). Effect of High-Dose vs Standard-Dose Vitamin D Supplementation in Pregnancy on Bone Mineralization in Offspring Until Age 6 Years: A Prespecified Secondary Analysis of a Double-Blinded, Randomized Clinical Trial. JAMA Pediatr. Feb 24; 174 (5): 1-9.
World Medical Association. Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects. JAMA. 2013; 310 (20): 2191-2194. doi: 10.1001/jama.2013.28105.
Bischoff-Ferrari, HA (2012). Vitamin D–why does it matter ? -defining vitamin D deficiency and its prevalence. Scand J Clin Lab Investig, 72 (Suppl 243): 3-6.
Rosen, CJ., Abrams, SA., Aloia, JF., Brannon, PM., Clinton, SK., Durazo-Arvizu, RA., Gallagher, JC., Gallo, RL., Jones, G., Kovacs, CS., Manson, JE., Mayne, ST., Ross, AC., Shapses, SA., Taylor, CL. (2012). IOM committee members respond to Endocrine Society vitamin D guideline. J Clin Endocrinol Metab 97 (4): 1146-1152.
Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM. (2011). Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab; 96 (7): 1911-1930.
Dawson-Hughes, B. Vitamin D deficiency in adults: Definition, clinical manifestations and treatment. Up To Date Review 6 January 2017. Access date 13 February 2017. Available from: https://www.uptodate.com/contents/vitamin-ddeficiency-in-adults-definition-clinical-manifestations-and-treatment.
Mackillop, M. (2019). Vitamin D Supplementation in Pregnancy. Oxford University Hospitals, NHS Foundation Trust. https://www.oxfordshireccg.nhs.uk/professional.
Dovnik, A., Mujezinovic, F., Treiber, M., Pecovnik, Balon B., Gorenjak, M., Maver, U., Takac, I. (2017). Determinants of maternal vitamin D concentrations in Slovenia. Wiener klinische Wochenschrift, vol. 129, 21–28.
Pilz S, Zittermann A, Obeid R, Hahn A, Pludowski P, Trummer C, Lerchbaum E, Pérez-López F. R, Karras S. N, März W. (2018). The Role of Vitamin D in Fertility and during Pregnancy and Lactation: A Review of Clinical Data. Int. J. Environ. Res. Public Health 15, 2241.
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