The prevalence of vitamin D deficiency is high among pregnant women who wear the burqa (or burka). Lack of the sun-derived vitamin is associated with adverse maternal and fetal outcomes such as pre-eclampsia and low birth weight (LBW).
The root of the problem is obvious enough – a lack of skin exposure to sunlight leads to vitamin D deficiency.
The not-very-surprising but very worrying conclusion was drawn by a study, Prevalence of Vitamin D Deficiency in Burka-clad Pregnant Women in a 450-Bedded Maternity Hospital of Delhi.
In the study, 200 pregnant burqa-clad women aged between 18 and 40 were recruited from Kasturba hospital in Delhi. The results were as follows:
- Only 47 (23.5%) had adequate levels of vitamin D
- 75 (37.5%) were seriously vitamin D deficient
- A further 78 (39%) had inadequate levels of vitamin D
Many of the adverse outcomes were associated with this deficiency:
- 15 (7.5%) of the vitamin D deficient mothers developed pre-eclampsia
- 13 (6.5%) developed gestational diabetes mellitus (GDM); and 5 of these were vitamin D deficient
- 19 (9.5%) delivered LBW babies; and 15 of these mothers were vitamin D deficient
- 12 (6.0%) had premature babies, and of these mothers 4 were vitamin D deficient
- 12 babies had APGAR score <7 at 5 min; and of these mothers 4 were vitamin D deficient
- Babies of 12 patients (6%) were admitted to a neonatal intensive care unit; the mothers of 5 of these were vitamin D deficient
The study concluded that routine screening of vitamin D levels is recommended in burqa-clad women to improve outcomes for mother and child.
Vitamin D supplements
Vitamin D deficiency is clearly not the only determining factor in pre-eclampsia, or LBW, but the findings are thought provoking nonetheless. They are also rather depressing, given that vitamin D is cheap and easy to test for and administer.
Anyone wearing clothing that substantially covers them – or any mother-to-be whose skin receives little or no direct sunlight, for whatever reason – needs to be aware of the problem; although awareness alone is not always enough. Burqa-clad women are seldom in a position to access more sunlight, even when they are aware of the issues.
The problem does not end with burqas, of course. Use of skin products that block UVB, combined with indoor lifestyles, exacerbate the risk of low vitamin D levels.
The benefits of supplementation in these circumstances cannot be overstated.