The role of vitamin D in the pathogenesis of pregnancy loss syndrome: primary results of a cohort study

Annotation. Considering the dynamics of declining birth rates in Ukraine during wartime and the demographic crisis, the investigation of factors contributing to reproductive losses and the development of effective preventive measures is an extremely relevant task. Objective – to assess the contribution of vitamin D to the development of pregnancy loss syndrome. A cohort study was conducted involving 83 women of reproductive age (21 to 42 years, mean age 30.86±5.02 years) with a history of pregnancy loss syndrome who sought medical care at obstetric and gynecological hospitals in Vinnytsia between 2017 and 2022. The comparison group included 83 women with normal pregnancy and childbirth outcomes. Vitamin D levels were assessed by measuring the total 25-hydroxyvitamin D (vitamin D2 and vitamin D3) concentration in serum using the enzyme-linked immunosorbent assay (ELISA) method. Statistical processing of the obtained data was performed using the SPSS 21 statistical software package (©SPSS Inc.). The results of our study show that the level of 25(OH)D was statistically significantly lower in the group of women with pregnancy loss syndrome, including those with detected hemostasis disorders, compared to women with normal pregnancy and childbirth outcomes (p<0.05). The mean serum 25(OH)D level was 21.74±9.37 ng/mL in women with pregnancy loss syndrome and 38.31±5.96 ng/mL in the comparison group. It was found that 77.1 % of women with pregnancy loss syndrome had either vitamin D insufficiency (27.7 %) or deficiency (49.4 %) in their serum. Moreover, in this category of women, these vitamin D statuses were significantly more frequent than in women with normal pregnancy and childbirth outcomes (OR 4.92; 95 % CI [1.88-12.8] and OR 82.0; 95 % CI [10.89-617.3], respectively). So based on the conducted studies, a significant relationship between vitamin D deficiency and fetal loss syndrome has been established, including in women with hemostasis disorders, which requires studying the effectiveness of its use to improve pregnancy outcomes.