Vitamin D deficiency during pregnancy and its associated factors among third trimester Malaysian pregnant women

• Main Authors: Woon, Fui Chee, Chin, Yit Siew, Ismail, Intan Hakimah, Batterham, Marijka, Abdul Latiff, Amir Hamzah, Gan, Wan Ying, Appannah, Geeta, Mohammed Hussien, Siti Huzaifah, Edi, Muliana, Tan, Meng Lee, Chan, Yoke Mun
• Format: Article
• Language: English
• Published: Public Library of Science 2019
• Online Access: http://psasir.upm.edu.my/id/eprint/82730/1/Vitamin%20D%20deficiency%20.pdf; http://psasir.upm.edu.my/id/eprint/82730/; https://pubmed.ncbi.nlm.nih.gov/31233513/

Background: Despite perennial sunshine, vitamin D deficiency is prevalent among Malaysians especially pregnant women. This study determines the vitamin D status and its associated factors among third trimester pregnant women attending government health clinics in Selangor and Kuala Lumpur, Malaysia. Methods: Information on socio-demographic characteristics, obstetrical history, and sun exposure were obtained through face-to-face interviews. Vitamin D intake was assessed using a semi-quantitative food frequency questionnaire (FFQ). Serum 25-hydroxyvitamin D concentration was measured and classified as deficient (< 30 nmol/L), insufficient (30-50 nmol/L), and sufficient (≥ 50 nmol/L). Results: Of the 535 pregnant women recruited, 42.6% were vitamin D deficient. They consumed an average of 8.7 ± 6.7 μg of vitamin D daily. A total of 80.4% of the vitamin D were obtained from the food sources, while 19.6% were from dietary supplements. Fish and fish products showed the highest contribution to vitamin D intake (35.8%). The multivariable generalized linear mixed models, with clinic as a random effect, indicates that higher intake of vitamin D is associated with lower odds of vitamin D deficiency among pregnant women (OR = 0.96; 95% CI = 0.93-0.99). The odds of having vitamin D deficiency was reduced by 87% in non-Malays (OR = 0.14; 95% CI = 0.05-0.41) compared to Malays. No associations were found between age, educational level, monthly household income, work status, gravidity, parity, pre-pregnancy body mass index, total hours of sun exposure, total percentage of body surface area, and sun exposure index per day with vitamin D deficiency. Conclusion: Vitamin D deficiency is prevalent among Malaysian pregnant women. Considering the possible adverse obstetric and fetal outcomes of vitamin D deficiency during pregnancy, future nutrition education should emphasise on vitamin D-fortified foods consumption among pregnant women by taking into consideration ethnic differences.