ArticleArchives of women's mental health2026
Vitamin D levels and perinatal anxiety in an anxiety-focused behavioral intervention program in Pakistan.
Article in Archives of women's mental health, 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
purposeThis study investigates Vitamin D levels across the perinatal period and relationships with perinatal anxiety and immune markers in women in Pakistan.
methodsWe analyzed plasma levels of 25-hydroxyvitamin D and cytokines and chemokines from 117 participants from the "Happy Mother-Healthy Baby" trial, which evaluated a non-specialist delivered cognitive behavioral therapy intervention for perinatal anxiety. Blood samples were collected at four timepoints: T1 (10-22 weeks), T2 (22-26 weeks), T3 (34-38 weeks), and T4 (six weeks postpartum). Participants were categorized into anxiety groups using K-means clustering. Mixed-effect models were used to examine Vitamin D trajectories, and moderation analysis explored the impact of immune markers on the Vitamin D-anxiety relationship.
resultsVitamin D levels were severely deficient across all timepoints (< 5 ng/ml) and declined significantly from T1 to T2 (β = -0.549, p = .006) before rebounding postpartum (β = 1.492, p < .0001). Despite this widespread Vitamin D deficiency, no significant differences in Vitamin D trajectories were observed across anxiety groups. Higher innate immune activity correlated with higher Vitamin D levels at T1. IL-6 and CXCL-8 levels moderated the Vitamin D and anxiety relationship at T2 (IL-6: β = 2.98, p = .015; CXCL-8: β = 0.72, p = .030); among those with higher levels of IL-6 and CXCL-8, higher Vitamin D levels were associated with higher levels of anxiety.
conclusionsThese findings indicate the need for further research on maternal Vitamin D deficiency and its relationship with immune function in low- and middle-income countries.
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