Influencia de los niveles maternos de 25-Hidroxivitamina D y resultados perinatales en gestantes con infección Covid-19

Resum

Vitamin D is a fat-soluble secosteroid hormone. Although vitamin D has classically been attributed to skeletal functions, its extra-skeletal functions are increasingly recognized. In addition, pregnancy is a special state where vitamin D is going to be regulated differently and it acquires specific new functions. Vitamin deficiency has been related to adverse effects on pregnancy and offspring, such as placental insufficiency, preterm delivery, gestational diabetes, or low birth weight, among others. On the other hand, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) emerged in December 2019 in Wuhan, China, and quickly spread throughout the territory and the rest of the countries causing coronavirus disease 2019 (COVID19). The different physiological changes that occur during pregnancy may predispose pregnant women with this infection to a higher risk of complications. The role of vitamin D in immunity has a particular importance in the recent SARS-CoV-2 pandemic. The main objective of this study was to establish a relationship between 25(OH)D levels in the pregnant woman and COVID-19 infection. The relevance of sociodemographic factors on the incidence of infection and vitamin D levels, as well as obstetric and perinatal outcomes, were also evaluated. A comparative observational case-control study was performed among singleton gestations that delivered in the same period, with a study population of 256 pregnant women (82 positive and 174 negative). 25(OH)D levels were significantly lower in pregnant women with COVID-19 infection than in those without infection. Additionally, 89% of the positive pregnant women had 25(OH)D deficiency, while the percentage was 75.30% for the negative pregnant women, finding statistically significant differences (ORa=2.58; 95% CI 1.08-6.15; p=0.03). The percentage of pregnant women with infection who were engaged in agriculture was 27.50%, while in pregnant women without infection the percentage was 12.80%, being statistically significant (ORa: 2.59; IC al 95% de 1.26-5.33; p=0.01). We have observed that consumption of folic acid acts like a protective factor, since pregnant women who did not consume folic acid were 4.72 times more likely to have an infection (ORa: 0.21; IC al 95% 0.05-0.89; p= 0.03). Obstetric and perinatal results show that pregnant women with COVID-19 infection had a significantly higher risk of preterm delivery than pregnant women without infection (ORa: 4.30; IC al 95% de 1.79-10.31; p=0.001). Moreover, their newborns had a significantly higher risk of growth retardation (ORa: 2.41; IC al 95% de 1.02-5.68; p=0.04). Our results suggest that decreased vitamin D levels may be a risk factor for developing COVID-19 infection in pregnant women upon coronavirus exposur