الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
reterm birth (PTB) is the birth of a baby before 37 complete weeks of gestation. Every year, 15 million neonates worldwide are born preterm. PTB, as the largest cause of neonatal deaths worldwide, puts surviving children at risk for cerebral palsy, behavioral problems, bronchopulmonary dysplasia, retinopathy of prematurity, hearing impairments, increased hospital admissions and academic underachievement.
Despite its discovery 100 years ago, vitamin D (VD) has emerged as one of the most controversial nutrients and prohormones of the 21st century. In the past few years, a growing interest in VD has been observed in the biomedical literature due to evidences demonstrating a relevant relationship not only between regulation of calcium and phosphorus homeostasis, but also multiple disease states and low VD status in the population. Recent findings suggested a significant implication of VD in different physiologic processes, such as vascular health, immune function, metabolism, and placental function. Findings from observational studies show higher rates of preeclampsia, gestational diabetes, preterm birth, and bacterial vaginosis in women with low VD levels.
The aim of the current study was to assess the association between vitamin D status and preterm labor.
The current study was conducted at Ain Shams University Maternity Hospital and Dar Ismael Maternity Hospital; Health Ministry during the period between July and December 2018.
The selected patients fulfilled the following criteria:
o All women with singleton pregnancy in their (20-28w) gestation.
o Pregnant females with no gross anomalies in their routine antenatal ultrasound (either maternal or fetal anomalies).
And we excluded from the study:
o Pregnant women with US gross anomalies that may cause preterm labor (either maternal or fetal anomalies).
o Women with history of preterm labor.
o Women with documented first trimester aneuploidy scan (has documented report from specialized center).
o Women with incompetent cervix and or cerculage (in this pregnancy or a previous one).
The study included a number of pregnant women with singleton pregnancy between 20-28w, were followed up for any sign or symptom of PTL, women completed 37w considered controls, others deliver before 37w are cases.
Finding matched controls from the large cohort group. A blood sample was collected from cases and controls and frozen till reaching our target of PTBs then serum 25(OH) VD was assayed by ELISA.
The Primary outcome was: To assess the association between vitamin D status and preterm labor.
Secondary outcomes were: To measure the prevalence of VDD in women with PTL and to measure levels of 25(OH) VD and divide them into four groups; severe deficient, deficient, insufficient and sufficient.
There was a statistically insignificant difference between preterm and term group as regard their age, BMI, Parity, smoking status, GDM and preeclampsia P value >0.05, as we chose matched controls to decrease cofounders.
There was a highly statistically significant lower levels of serum 25(OH) VD in the preterm group as compared to the full term group (13.34±7.71ng/ml vs. 32.91±18.98ng/ml) respectively, P<0.01 and prevalence of vitamin D severe deficiency and deficiency in preterm was 87.5% vs. 22.5% in full term group.
Vitamin D was significantly associated with Preterm Labor.