Severe vitamin D deficiency among pregnant women delivering at a governmental hospital in Nablus, West Bank, Palestine: a cross-sectional study

Vitamin D deficiency is common in pregnancy, but data from the West Bank, Palestine, are scarce. The primary objective was to estimate the prevalence of vitamin D deficiency and severe deficiency among women admitted for delivery; the secondary objective was to explore associations of severe deficiency with maternal characteristics and with delivery and neonatal outcomes. This cross-sectional study was conducted at Rafidia Governmental Surgical Hospital, Nablus, between December 2020 and May 2021, using convenience sampling. Data were collected through structured interviews and medical records, and serum 25-hydroxyvitamin D [25(OH)D] was measured by electrochemiluminescence immunoassay before delivery. Vitamin D status was classified as severe deficiency (< 10 ng/mL), deficiency (< 20 ng/mL), insufficiency (20–29.9 ng/mL), and sufficiency (≥ 30 ng/mL). Prevalence was estimated with 95% confidence intervals (CIs); associations were explored using bivariate tests and modified Poisson and log-linear regression. Among 193 women (mean age 27.7 ± 5.5 years), the median 25(OH)D was 7.9 ng/mL (interquartile range 5.2–11.5). Overall, 94.8% (95% CI 90.7–97.2) were deficient, including 67.4% (95% CI 60.5–73.6) with severe deficiency; 4.1% were insufficient, and 1.0% were sufficient. Severe deficiency was not significantly associated with the sociodemographic, lifestyle, or obstetric characteristics examined. Supplement use (24.9% of women) was independently associated with higher 25(OH)D concentrations (adjusted geometric mean ratio 1.27, 95% CI 1.06–1.53). No statistically significant associations were detected between severe deficiency and cesarean delivery (adjusted prevalence ratio 1.18, 95% CI 0.90–1.56), low birth weight, neonatal oxygen requirement, or neonatal intensive care unit admission; these estimates were imprecise. Vitamin D deficiency was nearly universal among women delivering at this hospital, two-thirds had severe deficiency, and supplement use was low. These findings support improving vitamin D supplementation coverage during pregnancy; larger multicenter studies across seasons are needed to assess maternal and neonatal outcomes.