الفهرس 
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Abstract
Summary
Maternal vitamin D deficiency is considered an important biomarker which can change the glucocorticoid-related parameters in placenta. Maternal vitamin D deficiency induces the placental and fetal glucocorticoid exposure thus leads to the adverse outcome of fetal growth restriction eventually.
Although there is growing evidence that vitamin D deficiency and insufficiency are associated with negative infant outcomes, evidence for the correlation of hypovitaminosis D with the potential neonatal risk pairs is limited.
So this study was conducted to assess the relation between maternal vitamin D level during pregnancy and neonatal outcomes in order to contribute to the infant and maternal health.
This study included 222 pregnant women attending primary health care units for routine antenatal visit at 28th week of pregnancy. The study participants were distributed into two groups; pregnant women with vitamin D deficiency (n=111) and healthy controls pregnant women with normal vitamin D level (n=111). Both groups were followed up till two months after delivery.
In the current study age, gravidity, parity, smoking, educational level and husband working status showed insignificant differences between groups asp>0.05. Working women percentage was significantly higher among women with normal vitamin D level (80.2%) than women with vitamin D deficiency (18%) with p value <0.001.
According to institute of medicine classification, weight gain was significantly higher among pregnant women with vitamin D deficiency than normal group (p<0.001). BMI showed statistical insignificant difference between groups at first, while it showed significant difference in third trimester. Systolic and diastolic B.P had insignificant differences between both study groups (p=0.080 and 0.273, respectively).
Vitamin D supplementation intake was significantly higher among pregnant women with normal vitamin D (p<0.001)women with vitamin D deficiency had significantly lower intake of milk, milk product, and other products with high vitamin D content with p values<0.05. Also, overall vitamin D intake per week was significantly lower among women with vitamin D deficiency (973.1±403.6) than women with normal vitamin D level (p<0.001).
Among pregnant women with abnormal vitamin D level, 44.1% had vitamin D insufficiency and 55.9% had vitamin D deficiency. Vitamin D level was significantly lower among pregnant women with vitamin D deficiency (16.8±6.7) than normal group (37.3±3.2) (p<0.001).
Mode of delivery, gestational age, baby gender, and perinatal death showed insignificant difference between study groups (p=0.451, 0.079, 0.328, and 0.099, respectively). Birth weight was significantly lower among women with vitamin D deficiency (2.5±0.3) than other groups with p value 0.034. Only one case of perinatal death in women with normal vitamin D level and 3(.8%) cases in women with vitamin D deficiency with statistical insignificant difference (p=0.099). Low birth weight infant was higher among women with vitamin D deficiency group (59.7%) than other groups with statistical significant difference (p=0.041).
Neonatal respiratory infection showed significant increase among groups with low vitamin D level (p<0.001), while neonatal death and serious infection showed statistical insignificant differences between groups (p>0.05). Also women with vitamin D deficiency had neonates with NICU admission (4.8%) with statistical significant difference (p=0.031).
There was statistical direct strong correlation between maternal vitamin D level and birth weight (p<0.001 and r=0.725), while perinatal mortality and NICU admission had indirect weak correlations with maternal vitamin D level (p=0.015, 0.006 and r=-0.0163,-0.186 respectively). Respiratory infections had indirect weak correlations with maternal vitamin D level (p=0.015, 0.006 and r=-0.0163,-0.186 respectively). Mode of delivery, baby gender and serious infection showed insignificant correlations with maternal vitamin D level. There was statistical direct weak correlation between maternal vitamin D level and birth weight (p=0.011 and r=0.320), while respiratory, mode of delivery, and baby gender showed insignificant correlations with maternal vitamin D level.
Vitamin D deficiency in the mother has been linked to offspring’s birth weight, and immunity. Vitamin D is crucial for illness prevention and health outcomes for both the mother and her kids.
So we recommend raising awareness about its relevance during pregnancy among pregnant women through health education sessions in PHCUs or in mass media.