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Background: Hypovitaminosis D has been associated with adverse pregnancy outcomes like infertility, gestational diabetes mellitus (GDM), preeclampsia, increased rate of caesarean section, bacterial vaginosis, neonatal hypocalcaemia, foetal growth restriction (FGR), neonatal seizures. Recently, poor vitamin D status was proposed as a contributor to increased GDM risk. There is a need to clinically quantify the impact of vitamin D supplementation on women at higher risk of developing GDM.
Objective: To establish the role of vitamin D supplementation in preventing development of gestational diabetes mellitus in high risk antenatal women.
Materials and methods: In a randomised, double-blind, interventional study, 178 antenatal women with biochemically diagnosed vitamin D deficiency having at least one risk factor for GDM with gestational age 13-24 weeks were randomised into intervention group (86 participants) and control group (92 participants). Women in the intervention group were given vitamin D supplementation, in the form of oral cholecalciferol sachet 60,000 IU per week till 26th week. Women in both intervention and control groups continued to receive iron, calcium and vitamin B, C supplement from second trimester till delivery. Oral Glucose Tolerance Test (OGTT) between 26th -28th weeks was carried out and GDM was determined.
Results: Among 86 patients in intervention group, 13.95% developed GDM while 86.05% did not develop GDM. On the other hand, 32.61% patients in control group developed GDM, while 67.39% did not develop GDM. The difference observed in development of GDM after supplementation with vitamin D was statistically significant (p< 0.001).
Conclusions: It was found that vitamin D supplementation for high-risk pregnant women in the second trimester is useful in preventing development of gestational diabetes mellitus. Investigations to diagnose vitamin D deficiency in pregnant patients and timely supplementation during pregnancy can significantly improve the fetomaternal outcome. Vitamin D could become a new generation drug which is safe, cheap, simple and easily available with additional pleiotropic effects in prevention of GDM.
Keywords: Gestational diabetes mellitus; Vitamin D supplementation; Cholecalciferol