Profound Vitamin D Deficiency in a Diverse Group of Women during Pregnancy Living in a Sun-Rich Environment at Latitude 32°N

Stuart A Hamilton, Rebecca McNeil, Bruce W Hollis, Deborah J Davis, Joyce Winkler, Carolina Cook, Gloria Warner, Betty Bivens, Patrick McShane, Carol L Wagner, Stuart A Hamilton, Rebecca McNeil, Bruce W Hollis, Deborah J Davis, Joyce Winkler, Carolina Cook, Gloria Warner, Betty Bivens, Patrick McShane, Carol L Wagner

Abstract

Objective: Determine prevalence of vitamin D deficiency (VDD) in a diverse group of women presenting for obstetrical care at two community health centers in South Carolina at latitude 32°N.

Methods and design: Any pregnant woman presenting for care at 2 community health centers was eligible to participate. Sociodemographic and clinical history were recorded. A single blood sample was taken to measure circulating 25(OH)D as indicator of vitamin D status [25(OH)D < 20 ng/mL (50 nmol/L deficiency; <32 ng/mL (80 nmol/L) insufficiency]. Total serum calcium, phosphorus, creatinine, and intact parathyroid hormone also were measured.

Results: 559 women, [mean age 25.0 ± 5.4 (range 14-43) years] participated: African American (48%), Hispanic (38%), Caucasian/Other (14%). Mean gestational age was 18.5 ± 8.4 (median 14.6, range 6.4-39.6) weeks' gestation. 48% were VDD; an additional 37% insufficient. Greatest degree was in the African American women (68% deficient; 94% insufficient). In multivariable regression, 25(OH)D retained a significant negative association with PTH (P < .001).

Conclusions: VDD was high in a diverse group of women, greatest in those of darker pigmentation. The negative correlation between 25(OH)D and PTH confirms their corroborative use as biomarkers of VDD. These findings raise the issue of adequacy of current vitamin D recommendations for pregnant women.

Figures

Figure 1
Figure 1
Baseline circulating 25(OH)D levels (ng/mL).
Figure 2
Figure 2
Scatterplot of PTH and 25(OH)D concentrations. The overlaid line modeling the relationship between PTH and 25(OH)D was fit using loess regression (locally weighted smoothed regression).

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