The Hidden Link: Vitamin D Deficiency and Its Association with Anemia and Red Blood Cell Health in Pregnancy
Keywords:
Vitamin D deficiency, anemia, pregnancy, red blood cell indices, maternal healthAbstract
Background: Vitamin D deficiency and anemia are common comorbidities in pregnancy, both independently linked with adverse maternal and fetal outcomes. However, the interrelationship between maternal vitamin D status and hematological health, particularly red blood cell indices, remains incompletely understood.
Objective: This study aimed to investigate the association between maternal vitamin D deficiency and anemia, with a specific focus on evaluating the impact of vitamin D status on red cell parameters among pregnant women.
Methods: A cross-sectional analysis was conducted involving 150 anemic and 150 non-anemic pregnant women. Serum vitamin D and comprehensive hematological indices—including hemoglobin, red blood cell (RBC) count, hematocrit, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW), and platelet count—were measured and compared between groups. Correlation analyses explored the relationship between vitamin D and red cell indices.
Results: Anemic women exhibited significantly lower mean vitamin D levels (9.6 ± 5.0 ng/ml) compared to non-anemic women (29.4 ± 6.0 ng/ml; p < 0.001). All major hematological indices (hemoglobin, RBC, hematocrit, MCV, MCH, MCHC) were reduced, while RDW was elevated in the anemic group (all p < 0.001). Vitamin D levels positively correlated with hemoglobin (r = 0.65), RBC (r = 0.62), and red cell indices, and inversely with RDW (r = –0.51; each p < 0.05).
Conclusion: Vitamin D deficiency is strongly associated with anemia and impaired red cell health in pregnancy. Integrating vitamin D screening and supplementation into antenatal care may reduce the burden of gestational anemia and improve maternal outcomes.
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Amrein K, Scherkl M, Hoffmann M, Neuwersch-Sommeregger S, Köstenberger M, Tmava Berisha A, Martucci G, Pilz S, Malle O. Vitamin D deficiency 2.0: an update on the current status worldwide. European journal of clinical nutrition. 2020 Nov;74(11):1498-513.
Palacios C, Gonzalez L. Is vitamin D deficiency a major global public health problem?. The Journal of steroid biochemistry and molecular biology. 2014 Oct 1;144:138-45.
Roth DE, Abrams SA, Aloia J, Bergeron G, Bourassa MW, Brown KH, Calvo MS, Cashman KD, Combs G, De‐Regil LM, Jefferds ME. Global prevalence and disease burden of vitamin D deficiency: a roadmap for action in low‐and middle‐income countries. 2018 Oct.
Agarwal S, Kovilam O, Agrawal DK. Vitamin D and its impact on maternal-fetal outcomes in pregnancy: A critical review. Critical reviews in food science and nutrition. 2018 Mar 24;58(5):755-69.
Larqué E, Morales E, Leis R, Blanco-Carnero JE. Maternal and foetal health implications of vitamin D status during pregnancy. Annals of Nutrition and Metabolism. 2018 Mar 13;72(3):179-92.
Hollis BW, Wagner CL. New insights into the vitamin D requirements during pregnancy. Bone research. 2017 Aug 29;5(1):1-6.
Medrano M, Carrillo-Cruz E, Montero I, Perez-Simon JA. Vitamin D: effect on haematopoiesis and immune system and clinical applications. International journal of molecular sciences. 2018 Sep 8;19(9):2663.
Bikle DD. Vitamin D regulation of immune function. Current osteoporosis reports. 2022 Jun;20(3):186-93.
Azab AE, Albasha MO, Jbireal JM, El Hemady SY. Haematological changes during pregnancy: Insight into anaemia, leukocytosis, and thrombocytopenia. East African Scholars Journal of Medical Sciences. 2020;3(5):185-92.
Icardi A, Paoletti E, De Nicola L, Mazzaferro S, Russo R, Cozzolino M. Renal anaemia and EPO hyporesponsiveness associated with vitamin D deficiency: the potential role of inflammation. Nephrology Dialysis Transplantation. 2013 Jul 1;28(7):1672-9.
Uwaezuoke SN. Vitamin D deficiency and anemia risk in children: a review of emerging evidence. Pediatric health, medicine and therapeutics. 2017 May 10:47-55.
Azizi-Soleiman F, Vafa M, Abiri B, Safavi M. Effects of iron on vitamin D metabolism: a systematic review. International journal of preventive medicine. 2016 Jan 1;7(1):126.
Singh S, Tiwari V, Nigam V, Kulshrestha R,Kulshrestha MR. Anemia profiling in antenatal women at a tertiary carecenter in northern India: An observational study. Indian J ObstetGynecol Res 2024;11(1):53-57.
Gonzalez D. Interpretation of maternal and fetal biomarkers in a population with coexisting nutrient deficiencies and infections. McGill University (Canada); 2019.
Chaber R, Helwich E, Lauterbach R, Mastalerz-Migas A, Matysiak M, Peregud-Pogorzelski J, Styczyński J, Szczepański T, Jackowska T. Diagnosis and treatment of iron deficiency and iron deficiency anemia in children and adolescents: recommendations of the Polish Pediatric Society, the Polish Society of Pediatric Oncology and Hematology, the Polish Society of Neonatology, and the Polish Society of Family Medicine. Nutrients. 2024 Oct 25;16(21):3623.
Mitchell D, Foley J, Kamat A. Nutritional anemias: iron deficiency and megaloblastic anemia. InBenign Hematologic Disorders in Children: A Clinical Guide 2020 Aug 19 (pp. 15-30). Cham: Springer International Publishing.
Sooragonda B, Bhadada SK, Shah VN, Malhotra P, Ahluwalia J, Sachdeva N. Effect of vitamin D replacement on hemoglobin concentration in subjects with concurrent iron-deficiency anemia and vitamin D deficiency: a randomized, single-blinded, placebo-controlled trial. Acta haematologica. 2014 Jul 8;133(1):31-5.
Arabi SM, Ranjbar G, Bahrami LS, Vafa M, Norouzy A. The effect of vitamin D supplementation on hemoglobin concentration: a systematic review and meta-analysis. Nutrition journal. 2020 Feb 3;19(1):11.
Basutkar RS, Tsundue T, Siva H, Rose A, Ponnusankar S. Vitamin D Supplementation in Patients with Iron Deficiency Anaemia: A Systematic Review and a Meta-Analysis. Systematic Reviews in Pharmacy. 2019 Jan 1;10(1).
Li N, Zhao G, Wu W, Zhang M, Liu W, Chen Q, Wang X. The efficacy and safety of vitamin C for iron supplementation in adult patients with iron deficiency anemia: a randomized clinical trial. JAMA network open. 2020 Nov 2;3(11):e2023644-.
Baggerly CA, Cuomo RE, French CB, Garland CF, Gorham ED, Grant WB, Heaney RP, Holick MF, Hollis BW, McDonnell SL, Pittaway M. Sunlight and vitamin D: necessary for public health. Journal of the American College of Nutrition. 2015 Jul 4;34(4):359-65.
Cashman KD, Kiely M. Towards prevention of vitamin D deficiency and beyond: knowledge gaps and research needs in vitamin D nutrition and public health. British journal of nutrition. 2011 Dec;106(11):1617-27.
Paxton GA, Teale GR, Nowson CA, Mason RS, McGrath JJ, Thompson MJ, Siafarikas A, Rodda CP, Munns CF. Vitamin D and health in pregnancy, infants, children and adolescents in Australia and New Zealand: a position statement. Medical Journal of Australia. 2013 Feb;198(3):142-3.
Bardan CR, Ionita I, Iordache M, Lighezan D, Gluhovschi A, Enatescu I, Bernad E. Hepcidin as the Central Regulator in Pregnancy-Associated Iron Deficiency Anemia and Vitamin D Deficiency. Timisoara Med. 2024 Dec;2024(2).
Wojciechowska M, Wisniewski OW, Kolodziejski P, Krauss H. Role of hepcidin in physiology and pathophysiology. Emerging experimental and clinical evidence. Journal of Physiology & Pharmacology. 2021 Feb 1;72(1).
Greenwood AA. The impact of vitamin D status on hepcidin and iron status in premenopausal females living in Auckland, New Zealand: a thesis presented in partial fulfilment of the requirements for the degree of Masters of Science in Nutrition and Dietetics, Massey University, Albany, New Zealand (Doctoral dissertation, Massey University).
-.
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