{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T19:03:33Z","timestamp":1778267013526,"version":"3.51.4"},"reference-count":16,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T00:00:00Z","timestamp":1737504000000},"content-version":"unspecified","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,1,9]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>There is a dearth of published data on the vitamin D status of the Ugandan population; the objective of the study was to determine the prevalence of vitamin D deficiency among pregnant women in Uganda and its associations with maternal characteristics and adverse foetal-maternal outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study design and setting<\/jats:title><jats:p>We conducted a cross-sectional study on pregnant women admitted to a tertiary referral hospital in Kampala, Uganda for delivery during the study period from July to December 2023.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>The study was conducted on 351 pregnant women aged \u226518 years who consented to participate in the study, who had a single intrauterine pregnancy and a gestational age greater than 26 weeks, and who delivered at St. Francis Hospital, Nsambya. We excluded pregnant women admitted to the hospital longer than 1\u2009week before delivery; pregnant women with self-reported pre-existing kidney diseases, liver diseases, or gut or malabsorption disorders and pregnant women with severe pregnancy-unrelated comorbidities requiring intensive care unit admission before delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>Maternal venous blood was collected at admission, and serum 25-hydroxy-vitamin D (25(OH)D) was measured by an electrochemiluminescence binding assay.<\/jats:p><\/jats:sec><jats:sec><jats:title>Primary and secondary outcome measures<\/jats:title><jats:p>Maternal sociodemographic characteristics and obstetric-medical factors, and adverse maternal and foetal outcomes were captured by using a data collection form. The data were analysed by logistic regression analysis at the univariate, bivariate and multivariate levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The prevalence of vitamin D deficiency, defined as a serum 25(OH)D concentration less than 20\u2009ng\/mL, was 40.2%. This was seen more among the Muslims (OR 2.4, 95%\u2009CI 1.33 to 4.43, p value 0.004), members of the Banyankore tribe (OR 2.1, 95%\u2009CI 1.02 to 4.36, p value 0.043) and primigravidae (OR 0.6 for women with parity of 1\u20134 compared with primigravidity, 95%\u2009CI 0.36 to 0.94, p value 0.028). Among adverse maternal outcomes, vitamin D deficiency was associated with hypertensive disorders in pregnancy (OR 2.4, 95%\u2009CI 1.16 to 4.10, p value &lt;0.001), in particular gestational hypertension (OR 2.2, 95%\u2009CI 1.21 to 4.94, p value 0.014), and pre-eclampsia\/eclampsia\/haemolysis, elevated liver enzymes and low platelets syndrome (OR 2.9, 95%\u2009CI 1.45 to 6.08, p value 0.003), with increased preterm birth (OR of 4.0, 95%\u2009CI 1.78 to 10.84, p value&lt;0.001) and with delivery of babies with low birth weight (OR 4.2, 95%\u2009CI 2.63 to 13.62, p value 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The study found a high prevalence (40.2%) of vitamin D deficiency among pregnant women delivering at St. Francis Hospital, Nsambya. Additionally, vitamin D deficiency was linked with adverse maternal and foetal outcomes such as hypertensive disorders in pregnancy, preterm birth and low birth weight.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2024-089504","type":"journal-article","created":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T03:41:53Z","timestamp":1737603713000},"page":"e089504","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Prevalence of vitamin D deficiency and its association with adverse obstetric outcomes among pregnant women in Uganda: a cross-sectional study"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7111-7324","authenticated-orcid":false,"given":"Cristina","family":"Reverzani","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Zaake","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faridah","family":"Nansubuga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herman","family":"Ssempewo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonard","family":"Manirakiza","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Kayiira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gilbert","family":"Tumwine","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,1,22]]},"reference":[{"key":"2025031814182105000_15.1.e089504.1","doi-asserted-by":"crossref","DOI":"10.1186\/s12884-017-1408-3","article-title":"The role of vitamin D in pre-eclampsia: a systematic review","volume":"17","author":"Purswani","year":"2017","journal-title":"BMC Pregnancy Childbirth"},{"key":"2025031814182105000_15.1.e089504.2","doi-asserted-by":"crossref","first-page":"e134","DOI":"10.1016\/S2214-109X(19)30457-7","article-title":"Prevalence of vitamin D deficiency in Africa: a systematic review and meta-analysis","volume":"8","author":"Mogire","year":"2020","journal-title":"Lancet Glob Health"},{"key":"2025031814182105000_15.1.e089504.3","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/136.4.1126"},{"key":"2025031814182105000_15.1.e089504.4","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.metabol.2017.10.001","article-title":"Understanding vitamin D metabolism in pregnancy: From physiology to pathophysiology and clinical outcomes","volume":"86","author":"Karras","year":"2018","journal-title":"Metab Clin Exp"},{"key":"2025031814182105000_15.1.e089504.5","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1080\/10408398.2016.1220915","article-title":"Vitamin D and its impact on maternal-fetal outcomes in pregnancy: A critical review","volume":"58","author":"Agarwal","year":"2018","journal-title":"Crit Rev Food Sci Nutr"},{"key":"2025031814182105000_15.1.e089504.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra070553"},{"key":"2025031814182105000_15.1.e089504.7","article-title":"Vitamin D supplementation for women during pregnancy","volume":"7","author":"Palacios","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"2025031814182105000_15.1.e089504.8","unstructured":"Royal College of Obstetricians and Gynaecologists . Vitamin D in pregnancy, scientific impact paper no.43. 2014. Available: https:\/\/www.maternofetal.net\/wp-content\/uploads\/2020\/08\/vitamin_d_sip43_june14.pdf [Accessed 26 May 2024]."},{"key":"2025031814182105000_15.1.e089504.9","unstructured":"Fingar KR , Mabry-Hernandez I , Ngo-Metzger Q , et al . Delivery hospitalizations involving preeclampsia and eclampsia, 2005\u20132014. In: Healthcare cost and utilization project (HCUP) statistical briefs. 2017."},{"key":"2025031814182105000_15.1.e089504.10","doi-asserted-by":"crossref","DOI":"10.1093\/cdn\/nzaa075","article-title":"Anemia and Micronutrient Status during Pregnancy, and Their Associations with Obstetric and Infant Outcomes among HIV-Infected Ugandan Women Receiving Antiretroviral Therapy","volume":"4","author":"Finkelstein","year":"2020","journal-title":"Curr Dev Nutr"},{"key":"2025031814182105000_15.1.e089504.11","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1016\/j.cmi.2014.12.010","article-title":"The impact of vitamin D on the innate immune response to uropathogenic Escherichia coli during pregnancy","volume":"21","author":"Ramos","year":"2015","journal-title":"Clin Microbiol Infect"},{"key":"2025031814182105000_15.1.e089504.12","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-0385"},{"key":"2025031814182105000_15.1.e089504.13","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12210"},{"key":"2025031814182105000_15.1.e089504.14","doi-asserted-by":"crossref","DOI":"10.3390\/nu14051074","article-title":"Vitamin D Deficiency and Its Associated Factors among Female Migrants in the United Arab Emirates","volume":"14","author":"Anouti","year":"2022","journal-title":"Nutrients"},{"key":"2025031814182105000_15.1.e089504.15","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(14)70227-X"},{"key":"2025031814182105000_15.1.e089504.16","unstructured":"MOH Knowledge Management Portal . National annual maternal and perinatal death report fy 2022\/2023. library.health.go.ug; 2024."}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2024-089504","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T21:31:29Z","timestamp":1742333489000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2024-089504"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":16,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,22]]},"published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1136\/bmjopen-2024-089504"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2024-089504","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]}}}