Calcium and vitamin D supplementation to pregnant women in urban maternity centre

Abstract

Prevalence of vitamin D deficiency in pregnant women in India is high. There have been case reports from India of neonatal tetany and vitamin D deficiency in breast-fed infants. India initiated the calcium and vitamin D supplementation programmes for pregnant women a decade ago. There is a need to assess compliance with calcium and vitamin D supplementation and impact of supplements on vitamin D levels in pregnant women.Women attending antenatal clinic in an urban maternity centre who fulfilled the eligibility criteria and were willing to participate in the study were enrolled. They were given one month’s supply of supplements, and form for recording compliance and side effects and were followed up every month. Blood samples were drawn at enrolment and after three months of supplementation and plasma vitamin D levels were estimated.Two third of the women had vitamin D level below 20 ng/ml at enrolment There was excellent compliance with supplementation; women who were followed up consumed 94% of the tablets provided. None of the women had clinical signs suggestive of vitamin D deficiency or any major obstetric problems; their offsprings were healthy. A third of the pregnant women continued to have low vitamin D levels after three months supplementation.The current dose of supplements appears to be inadequate to correct the vitamin D levels in deficient individuals. There is a need to undertake studies to find out the optimal dose of vitamin D supplementation which corrects vitamin D deficiency as assessed by maternal vitamin D levels.