Low vitamin D levels may increase risk of urinary incontinence in pregnancy: Study

The main function of the pelvic floor is to support pelvic organs and so maintain continence. Weakness of pelvic floor muscles is associated with urinary incontinence (UI), which is the most frequently reported symptoms. vitamin D has an essential role in regulation of calcium and bone homeostasis.Parathyroid hormone (PTH) interacts with vitamin D in this regulation, and serum levels of PTH reflect vitamin D status. During pregnancy, physiological changes such as increased intra‐abdominal pressure and pregnancy‐related hormonal changes may lead to reduced strength and reduced supportive and sphincter functions of the pelvic floor muscles.

Previously, numerous studies have found that vitamin D affects muscle strength and function, and low serum levels of vitamin D are associated with reduced muscle mass, strength and performance as well as increased risk of falls in the elderly.

Vitamin D status is assessed by measuring the level of circulating 25‐hydroxvitamin D (25(OH)D).Vitamin D insufficiency has emerged as a risk factor for PFDs. A positive correlation between antepartum vitamin D levels and postpartum pelvic floor muscle strength and endurance has been observed.

With this knowledge,Researchers undertook the study to assess the association between levels of vitamin D and urinary incontinence (UI) in pregnancy.

The study was designed as a cross‐sectional study. It was a Secondary analysis of a randomised controlled trial.

A total of 851 healthy, pregnant women >18 years in gestational weeks 18–22 with a singleton live fetus.Data on UI were collected from a questionnaire at inclusion and serum analysis of 25‐hydroxy vitamin D (25(OH)D) was performed. Univariable and multivariable logistic regression analyses were applied to study associations between exposure and outcomes.

Main outcome measures assessed was Prevalence of self‐reported UI, stress (SUI) and urge (UUI) or mixed UI.

On data analysis, the following facts emerged.

• In total, 230/851 (27%) of the participants were vitamin D insufficient (25(OH)D <50 nmol/l) and 42% reported to have any UI.
• Women with 25(OH)D <50 nmol/l were more likely to report any UI (P = 0.03) and SUI (P < 0.01) compared with women with 25(OH)D ≥50 nmol/l.
• In a univariable logistic regression analysis, serum levels of 25(OH)D <50 nmol/l was associated with increased risk of any UI (odds ratio [OR] 1.5 with 95% CI 1.0–2.1), SUI only (OR 1.7, 95% CI 1.2–2.4), but not mixed UI or UUI only (OR 0.8, 95% CI 0.5–1.5).
• In a multivariable logistic regression model, serum levels of 25(OH)D <50 nmol/l were associated with a higher risk of experiencing SUI only (OR 1.5, 95% CI 1.1–2.2).

Considering that serum 25(OH)D <50 nmol/l was associated with increased risk of any UI and SUI in the present study, our findings support the hypothesis that vitamin D plays a role in the function of the pelvic floor muscles during pregnancy. Whether vitamin D deficiency (25(OH)D <30 nmol/l) is associated with an even higher risk of UI could not be assessed because of the small number of women in this category."wrote the team.

For the full article follow the link: https://doi.org/10.1111/1471-0528.16398

Primary source: Obstetrics & Gynaecology