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Abstract #157060

Anne Merewood, MPH, IBCLC¹, Supriya Mehta, MHS, PhD², Reginald Fonrose, BS³, Xena Grossman, MS, RD³, Jeffrey Mathieu, MS⁴, Tai Chen, PhD⁴, Michael F. Holick, PhD, MD⁵, and Howard Bauchner, MD, MPH⁶. (1) Division of General Pediatrics, Boston Medical Center, 91 E Concord St 4th Fl, Boston, MA 02118, (617) 414-7902, Anne.Merewood@bmc.org, (2) School of Public Health, University of Illinois Chicago, 958 SPHPI, M/C 923, 1603 W Taylor St, Chicago, IL 60612, (3) Boston Medical Center, The Breastfeeding Center, 88 East Newton St, Vose 3, Boston, MA 02118, (4) General Clinical Research Center, Boston University School of Medicine, 715 Albany Street, 85 E Newton St, Boston, MA 02118, (5) Dept of Medicine/Endocrinology, Nutrition and Diabetes, Boston University School of Medicine, 715 Albany Street, M-1013, Boston, MA 02118, (6) Division of General Pediatrics, Boston University School of Medicine, 88 East Newton St, Boston, MA 02118

Background: While conducting a larger study on vitamin D status in newly delivered mothers and their infants, we obtained information on vitamin D status in women with cesarean births. Historically, when access to cesarean birth was limited, rickets was responsible for high rates of maternal death in childbirth. Methods: The study took place in an urban Boston hospital between 2004 and 2006. Blood was drawn pospartum in the hospital. Vitamin D status was measured by 25(OH)D levels: levels <15 ng/ml (<37.4 nmol/L) were considered severely deficient. Results: We obtained blood from 206 women of whom 162 (79%) had vaginal births and 44 (21%) had cesareans. Seven women were excluded due to missing data. Of women delivering vaginally, 16% (25/156) were severely vitamin D deficient; of women having a cesarean, 33% (14/43) were severely deficient. In multivariate logistic regression, controlling for skin color, race, season of birth, use of prenatal vitamins, and time spent outside (exposure to sunlight), women who had a cesarean birth were 2.6 times more likely to have severe vitamin D deficiency than women who had a vaginal delivery (AOR 2.57; 95% CI 1.01-6.57). Conclusion: Severe vitamin D deficiency in our sample was associated with increased likelihood of cesarean birth.

Learning Objectives:

• The learner will be able to discuss factors that influence vitamin D status in new mothers
• The learner will be able to describe elevated rates of cesarean birth in women with low vitamin D status
• The learner will be able to determine which mother/infant pairs should receive preventive therapy for vitamin D deficiency.

Keywords: Vitamins, Birth Outcomes

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.