How effective is public health policy in Scotland on vitamin D deficiency during pregnancy?

• Main Authors: Ruth Campbell (Author), Christopher Curran (Author), Jonathan Hayward (Author), Jon Godwin (Author), Susan Johnston (Author), Julie Armstrong (Author), Andrew Collier (Author)
• Format: Book
• Published: Cambridge University Press, 2023-12-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.1017/S1368980023002227; 1368-9800; 1475-2727
• Keywords: Vitamin D; Supplementation; Pregnancy; Deficiency; Public aspects of medicine; RA1-1270; Nutritional diseases. Deficiency diseases; RC620-627
• Source: Public Health Nutrition, Vol 26, Pp 3311-3319 (2023)

Abstract Objective: To evaluate the uptake of universal vitamin D supplementation during pregnancy, its effectiveness in preventing vitamin D deficiency and the factors associated with these. Design: The regional public health organisation in Ayrshire, Scotland has a policy of universal provision of vitamin D supplements (10 µg/d) to all pregnant women for the duration of their pregnancy. Pregnant women in this area were recruited at their 12-week antenatal appointment. Blood samples were collected at the 12-week and 34-week appointments. To account for the seasonal variation, women were recruited in two cohorts: summer and winter. Telephone interviews were conducted at 34 weeks to assess the uptake of vitamin D supplements during pregnancy. Other variables were obtained from medical records. Setting: The study was conducted in the NHS Ayrshire and Arran Health Board in Scotland. Participants: 612 pregnant women (aged 15-44 years) living in Ayrshire (latitude 55°), Scotland. Results: Sixty-six percentage took supplementation as recommended. Consumption of supplementation was significantly associated with a higher median serum 25-hydroxyvitamin D concentrations at 34 weeks. Despite this at 34 weeks, 33 % of the summer cohort had insufficient or deficient vitamin D status, while 15 % of the winter cohort had insufficient or deficient status. In multivariable analysis, only adherence and season were independent predictors of vitamin D status. Conclusions: While supplementation improved and maintained vitamin D status during pregnancy, it was not adequate to ensure all those insufficient at 12 weeks achieved sufficient status at the end of pregnancy.