Late Pregnancy Vitamin D Deficiency is Associated with Doubled Odds of Birth Asphyxia and Emergency Caesarean Section:A Prospective Cohort Study

Augustin, Hanna, Mulcahy, Sinead, Schoenmakers, Inez, Bullarbo, Maria, Glantz, Anna, Winkvist, Anna and Bärebring, Linnea (2020) Late Pregnancy Vitamin D Deficiency is Associated with Doubled Odds of Birth Asphyxia and Emergency Caesarean Section:A Prospective Cohort Study. Maternal and Child Health Journal, 24. 1412–1418. ISSN 1092-7875

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Abstract

Objectives: The aim of this prospective cohort study was to investigate the associations between maternal vitamin D status in late pregnancy and emergency caesarean section (EMCS) and birth asphyxia, in a population based sample of women in Sweden. Methods: Pregnant women were recruited at the antenatal care in Sweden and 1832 women were included after exclusion of miscarriages, terminated pregnancies and missing data on vitamin D status. Mode of delivery was retrieved from medical records. EMCS was defined as caesarean section after onset of labour. Birth asphyxia was defined as either 5 min Apgar score < 7 or arterial umbilical cord pH < 7.1. Serum was sampled in the third trimester of pregnancy (T3) and 25-hydroxyvitamin D (25OHD) was analysed by liquid chromatography tandem mass spectrometry. Vitamin D deficiency was defined as 25OHD < 30 nmol/L, and associations were studied using logistic regression analysis and expressed as adjusted odds ratios (AOR). Results: In total, 141 (7.7%) women had an EMCS and 58 (3.2%) children were born with birth asphyxia. Vitamin D deficiency was only associated with higher odds of EMCS in women without epidural anaesthesia (AOR = 2.01, p = 0.044). Vitamin D deficiency was also associated with higher odds of birth asphyxia (AOR = 2.22, p = 0.044). Conclusions for Practice: In this Swedish prospective population-based cohort study, vitamin D deficiency in late pregnancy was associated with doubled odds of birth asphyxia and with EMCS in deliveries not aided by epidural anaesthesia. Prevention of vitamin D deficiency among pregnant women may reduce the incidence of EMCS and birth asphyxia. The mechanism behind the findings require further investigation.

Item Type: Article
Uncontrolled Keywords: 25-hydroxyvitamin d,apgar score,birth asphyxia,caesarean section,fetal distress,epidemiology,pediatrics, perinatology, and child health,obstetrics and gynaecology,public health, environmental and occupational health ,/dk/atira/pure/subjectarea/asjc/2700/2713
Faculty \ School:
Faculty of Medicine and Health Sciences > Norwich Medical School
Related URLs:
Depositing User: LivePure Connector
Date Deposited: 04 Sep 2020 23:58
Last Modified: 16 Oct 2020 23:55
URI: https://ueaeprints.uea.ac.uk/id/eprint/76784
DOI: 10.1007/s10995-020-02999-z

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