ArticleInternational journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics2026
Prenatal vitamin D levels and postpartum hemorrhage in a rural Alaska cohort.
Article in International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo examine the relationship between prenatal vitamin D serum levels and postpartum bleeding.
methodsWe conducted a retrospective electronic health record cohort study of pregnant Alaska Native and American Indian (ANAI) people in southwestern Alaska who had at least one prenatal vitamin D level measurement recorded and had a vaginal birth between January 2017 and December 2019. Prenatal vitamin D level was the independent variable; postpartum abnormal bleeding and hemorrhage occurrence after a vaginal birth were the primary outcomes.
resultsA total of 1343 index pregnancies were included in this study, of which 1258 (94%) had a vaginal birth with 370 (29%) experiencing blood loss ≥500 mL and 127 (10%) ≥1000 mL. Risk factors included prior postpartum hemorrhage, suspected macrosomia, twin gestation, magnesium sulfate use in the setting of pre-eclampsia, induction time >36 h, oxytocin use >12 h and third stage of labor >20 min. Deficient vitamin D levels (under 12 ng/mL) were found in 10.5%, 4.8%, and 5.3% of records in the first, second and third trimesters, respectively. Logistic regression indicated an association between vitamin D level under 12 ng/mL in the first trimester and postpartum bleeding ≥500 mL (n = 540, P = 0.0097, odds ratio [OR] = 2.2). No association was found between abnormal bleeding and being vitamin D deficient in the second and third trimesters.
conclusionThere is a need for further research of vitamin D screening and supplementation before and during pregnancy as a possible risk reduction tool for abnormal postpartum bleeding.
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