Preterm labor has remained one of the most enigmatic challenges in the field of perinatal medicine.
Globally, preterm birth impacts approximately 1.3 million people. Within the United States, it complicates roughly nine percent of all births; in some urban demographics, this figure approaches 18 percent.
While technological advances have improved outcomes in preterm infants, prematurity is still the most common underlying cause of perinatal and infant morbidity and mortality. Surviving neonates potentially experience lifelong consequences involving gastrointestinal, respiratory, neuro-developmental and other co-morbidities.
The preterm birth of an infant brings considerable emotional and economic issues for families; additionally there exists marked implications for public sector services, such as health insurance, educational and other social support systems. The annual societal economic burden associated with preterm birth in the United States runs in the billions of dollars.
Preterm birth represents a complex and often intertwined group of problems within overlapping factors of influence. Etiologies may include genetics, biological factors, medical conditions, environmental and neighborhood characteristics, and nutrient deficiencies; these factors are particularly compounded among those who are socioeconomically disadvantaged or are members of racial and ethnic minority groups.
While research has focused on many aspects of the preterm labor puzzle, environment and vitamin deficiencies — particularly of vitamin D — still remain in a rudimentary phase. Vitamin D is the only vitamin that humans can make with exposure to sunlight. As a causality, it additionally is involved in a number of bodily processes involving bones, muscles, respiratory, brain development, immunologic and cardiovascular function.
It should be noted that people of a darker hue have a decreased ability to synthesize this vitamin. Urban environments where skyscrapers, office working, and use of underground public transportation are the norm, preclude to limited sunlight exposure and predispose those residing in these environments, to an increased risk of vitamin D deficiency.
Preliminary research from a small study out of South Carolina has also revealed that a deficiency of this vitamin may play a factor in preterm birth. Pregnant African American and Hispanic women, noted to be deficient in vitamin D, were given supplementation of the vitamin. These same women, once their levels reached a particular therapeutic level, were noted to have a 62 percent lower rate of premature delivery as compared to their cohorts.
OB-GYN physicians don’t routinely assess vitamin D levels as it relates to prematurity risk. How can you, as a patient, determine your level — two ways — via your doctor, or you can access a self-test kit yourself at www.nutrientpower.org
. This kit will also assess for other vitamin levels, and omega-3s. The other benefit to this site is the enrollment in a nationwide study looking at vitamin D levels and health outcomes.
So the question at hand is: Can a simple, inexpensive micronutrient like vitamin D and time in the sunlight be a tool in the preterm labor plight? Ongoing research and time will soon figure out the puzzle.