Endocrine Abstracts

Background: Approximately a third of pregnant women in the UK are Vitamin D deficient, which may confer deleterious consequences, including an increased risk of pre-eclampsia, gestational diabetes mellitus, and intrauterine growth restriction. Vitamin D supplementation in pregnancy has shown to be beneficial, including a reduced risk of pre-eclampsia and pre-term birth, compared to placebo. This audit investigated the extent to which women attending an ante-natal centre adhered to the standards set out by The National Institute for Health Care Excellence (NICE) regarding Vitamin D supplementation in pregnancy.

Methods: This was a single-centre cross-sectional audit carried out between September-December 2017. Pregnant women attending ante-natal clinics received a questionnaire regarding their experiences with Vitamin D supplementation during their pregnancy.

Results: Data from 141 pregnant women was collected. 44% (n=62) received written and/or verbal advice about Vitamin D supplementation, (NICE standards =100%). 48% (n=67) were eligible for the Healthy Start supplementation; among these 75% (n=50) were offered supplementation. 87% (n=122) had one or more risk factors for Vitamin D deficiency, of which 67% (n=40, NICE standards =100%) were asked about supplementation. Among those asked, 50% (n=20, NICE standards =100%) received the correct dosage.

Conclusions: Adherence to the NICE guidelines regarding Vitamin D supplementation in these patients was suboptimal. Lack of adherence may be attributed to insufficient training of clinicians on the importance of Vitamin D supplementation, causing them to underestimate the concerns around gestational Vitamin D deficiency. Furthermore, there is no mandatory screening system in place for ante-natal patients that are at risk of Vitamin D deficiency or are eligible for Healthy Start. Various recommendations may therefore be proposed, such as implementing a mandatory ante-natal screening tool and providing more clinician training, in order to ensure that Vitamin D supplementation during pregnancy is standard of care.