Maternal vitamin D deficiency at time of delivery not associated with postpartum hemorrhage

A recent retrospective translational study investigated the potential relationship between vitamin D deficiency and postpartum hemorrhage which is a major cause for maternal morbidity and mortality worldwide. The key findings were published in the Acta Obstetricia et Gynecologica Scandinavica.

The study by Anna Sörsjö Stevenazzi and team included a total of 1367 women and focused on the serum concentration of 25-hydroxylated vitamin D at the time of delivery. While the vitamin D deficiency has been implicated in various health issues, including the complications during pregnancy, but, this study found no evidence to suggest a direct association between vitamin D levels and postpartum hemorrhage. The primary outcomes assessed were postpartum hemorrhage and severe postpartum hemorrhage which were defined as bleeding of 500 mL and 1000 mL or more, respectively, occurring two hours after delivery. The secondary outcome of this study was atonic postpartum hemorrhage.

The results revealed that postpartum hemorrhage affected 31.3% of the women, with severe cases observed in 6.4% of the participants. Atonic postpartum hemorrhage, a specific subtype characterized by the inability of the uterus to contract effectively, occurred in 21% of the overall population. Surprisingly, the study found that 57% of the women had vitamin D insufficiency or deficiency, but this did not correlate with an increased risk of postpartum hemorrhage or atonic postpartum hemorrhage.

The study utilized various adjustment methods that accounts for maternal, obstetrical, and neonatal confounders. Despite a comprehensive analysis, the results concluded that the vitamin D status of women at the time of delivery did not serve as a predictor for postpartum hemorrhage. The results of this study emphasize the complexity of maternal health and the further continued investigation into multifaceted aspects could positively influence pregnancy outcomes.

Source:

Sörsjö Stevenazzi, A., Pihl, S., Blomberg, M., & Axelsson, D. (2024). The association between maternal vitamin D deficiency and postpartum hemorrhage and uterine atony. Acta Obstetricia et Gynecologica Scandinavica, 103(2), 286–293. https://doi.org/10.1111/aogs.14719