The Use of Vitamin D Supplement in Prevention of Preterm Labor

Abstract

In modern obstetrics, preterm labor remain a major problem . Infection during pregnancy is the commonest cause. Since that vitamin D has been shown to act as an anti-inflammatory& immune modulator in the placenta so it could be used for preterm labor prevention. In pregnant ladies ,higher levels of vitamin D were considerably associated with a lower risk of infection, preterm labor & preterm birth. Vitamin D supplementation during pregnancy has long been a matter of concern, but updated researches showed that even a high dose supplementation in healthy pregnant ladies was safe & effective. The aim of the study 1.Determine the relationship between maternal 25-hydroxyvitamin D & the risk of spontaneous preterm birth before 37 completed weeks.2.Determine whether 4000 IU/day of vitamin D supplement prevent preterm birth in those with threatened preterm labor (premature uterine contraction)& those with early preterm labor(in the latent phase) . the study was carried : 1. at Babylon Teaching hospital for Maternity& pediatric in the obstetrical word. 2.out patient clinic. A randomized clinical trial was done on (109) patients from 1st of June 2014 to 1st of Jan 2015. Their gestational age was of (24-<37completed weeks), Blood samples were taken from all of them for measurement of vitamin D level. Those patients then divided into 2 groups: 1. study group consist of 69 pregnant women who were presented with either threatened preterm labor or early preterm labor ( at the latent phase) were given a supplement of vitamin D (4000IU) daily till term & follow them for their progress of labor& 2. Control group of 40 pregnant women at the same gestational age of the study group but without preterm labor.(just assess vitamin D level). There was a significant association between low vitamin D level & preterm labor as preterm labor was inversely associated with pre delivery level. The study found that (61.1%) of patients with threatened preterm labor & (75.8%) of patients with early preterm labor are presented with low vitamin D level , while (62.5%) of control group presented with sufficient vitamin D level. There was (36.4%) reduction in proportion of early preterm labor as well as (83.3%) reduction in proportion of threatened preterm labor(premature uterine contraction) after vitamin D supplementation.Conclusion: vitamin D supplement has a role in prevention of preterm labor especially in those with low pre delivery serum level & those with threatened preterm labor.