Prospective audit of vitamin D levels of women presenting for their first antenatal visit at a tertiary centre
Date
2013
Authors
De Laine, K.
Matthews, G.
Grivell, R.
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Journal article
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Australian and New Zealand Journal of Obstetrics and Gynaecology, 2013; 53(4):353-357
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Kate M. De Laine, Geoff Matthews and Rosalie M. Grivell
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Abstract
<h4>Background</h4>Vitamin D deficiency in pregnancy is associated with adverse events such as pre-eclampsia, primary caesarean section and vitamin D deficiency of the newborn. Vitamin D screening in pregnancy is not universal.<h4>Aims</h4>To evaluate the vitamin D status of pregnant women at our institution and assess the sensitivity of the current risk-based screening guideline.<h4>Methods</h4>A prospective audit of vitamin D levels of all women presenting for their first antenatal booking visit during 3 four-week periods (in 2009-2010) was conducted at the Women's and Children's Hospital, South Australia. The main outcome measure was 25-hydroxyvitamin D3 levels. Information was also collected on body mass index, self-reported ethnicity and whether or not vitamin D testing was indicated based on the hospital guidelines.<h4>Results</h4>Four hundred and seventy-two women consented to inclusion in the audit. 67.4% (318/472) were 'low-risk' according to the hospital guidelines for vitamin D screening. 46.2% of these women and 78.6% of 'high-risk' women were vitamin D deficient (<60 nmol/L). Mean vitamin D levels were 62.7 ± 22.0 and 43.4 ± 26.3 nmol/L for low- and high-risk women, respectively. 54.9% (147/268) of women who were found to be vitamin D deficient were classified as 'low-risk' giving a sensitivity of 45% for the current risk-based screening guideline.<h4>Conclusions</h4>Based on current normal ranges for vitamin D, risk-based screening criteria for vitamin D deficiency in pregnancy fails to detect over half of vitamin D deficient women at our institution. Current South Australian guidelines should be amended in favour of universal screening of vitamin D for all pregnant patients at their booking visit.
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© 2013 The Authors