Hipovitaminose D e fatores de risco em gestantes usuárias da rede básica de saúde de Aracaju

Abstract

Introduction: Pregnant women are among the risk groups for hypovitaminosis D, due to the high demand needed to maintain their reserves, and ensure bone mineralization, fetal growth and development. Vitamin D deficiency has been associated with complications such as preeclampsia, premature birth and low birth weight. Objective: To evaluate hypovitaminosis D and its risk factors in pregnant women using the public health system in Aracaju. Methods: This is a cross-sectional and analytical study with adult pregnant women. Two questionnaires were applied through interviews, one containing socioeconomic data, previous and current obstetrics, smoking and alcohol consumption, and the other with questions about skin type, sun exposure and use of vitamin D supplements. a weekly sun exposure recall as proposed by Hanwell et al. (2010). Dietary intake of vitamin D was assessed by applying a 24-hour Food Recall, one being applied at the first contact, and another in 40% of the sample on the day of blood collection. The nutritional status of vitamin D was assessed by the serum dosage of 25(OH)D, in addition to that of parathormone and ionized calcium. A logistic regression model for vitamin D deficiency was developed, considering the season of the year as control variables, considering the date of blood collection, gestational age, education, pre-gestational BMI, skin color, dietary intake of vitamin D and sun exposure score. In the statistical analyses, the significance level of 5% was used. Results: 110 pregnant women were evaluated, vitamin D deficiency was 59.09%, with a mean concentration of 25(OH)D of 29.24(±8.02) ng/mL. In the univariate analysis, vitamin D deficiency was associated with the seasons of the year (p=0.045), ionized calcium (p=0.020), alcohol consumption (p=0.030), pre-gestational weight (p=0.014) and gestational weight (p=0.021), pre-gestational (p=0.016) and gestational (p=0.023) BMI. However, in the multivariate logistic regression model, hypovitaminosis D maintained an association with education below 9 years of study (OR=0.30, 95%CI=0.11-0.80), with pre-pregnancy BMI (OR=0 .89, 95%CI=0.80-0.98), and with a sun exposure score (OR=0.92, 95%CI=0.86-0.98). Conclusion: Pregnant women who use the public health network in Aracaju had a high prevalence of vitamin D deficiency, especially among those with higher education, no prepregnancy excess weight and less exposure to the sun. Thus, it emphasizes the importance of guidance on sun exposure to prevent and control hypovitaminosis D, as well as damage to maternal and child health.