Acta Obstet Gynecol Scand 1998; 77: 970–973 Copyright C Acta Obstet Gynecol Scand 1998 Printed in Denmark – all rights reserved Acta Obstetricia et Gynecologica Scandinavica ISSN 0001-6349 ORIGINAL ARTICLE Maternal vitamin-D deficiency in Pakistan MEHNAZ ATIQ 1 , AMIN SURIA 2 , SHAIKH QAMARUDDIN NIZAMI 1 AND IQBAL AHMED 1 From the 1 Departments of Pediatrics and 2 Pharmacology, The Aga Khan University Hospital, Karachi, Pakistan Acta Obstet Gynecol Scand 1998: 77: 970–973. C Acta Obstet Gynecol Scand 1998 Objective of the study. This study was performed to assess the vitamin D status of healthy Pakistani nursing mothers and their breastfed infants. Methods. Seventy-one nursing mothers and their breastfed infants belonging to upper and lower socio-economic class were examined 6 weeks to 11 months after delivery. Serum 25- hydroxy vitamin D [25(OH)D], serum calcium, phosphorus and alkaline phosphatase were measured. Results. The mean serum 25(OH)D in mothers was 36.7∫32.4 nmol/L and 41.25∫35.4 nmol/ L in infants. Thirty-four (48%) mothers and 37 (52%) infants had levels less than 25 nmol/ L. Significantly higher levels were found in uneducated mothers (pΩ0.01), mothers of lower socio-economic class (p∞0.001) and in those living in mud houses (p∞0.001). A significant correlation was found between serum 25(OH)D levels of infants under three months of age and their mothers (p∞0.01). Conclusions. High prevalence of vitamin D deficiency was found in nursing mothers and their infants predominantly in the upper socioeconomic class. Key words: nursing mothers; 25 hydroxy cholecalciferol; vitamin D deficiency Submitted 22 September, 1997 Accepted 22 April, 1998 Following several reports on osteomalacia among immigrant Asian women, Heckmatt et al. and other clinicians measured serum concentration of 25-hydroxy vitamin D in pregnant Asian women of Indo-Pakistani origin residing in the United Kingdom and Norway and found a high incidence of severe vitamin D deficiency among them (1, 2, 3). They also reported low cord blood levels of 25- hydroxy vitamin D [25(OH)D], higher incidence of neonatal hypocalcemia, rickets and enamel hypo- plasia of primary dentition in their infants. This high incidence was attributed to an environmental change and Rashid et al. (4) speculated that vit- amin D deficiency is less likely to develop in women residing in Pakistan due to the abundant sunshine available. Ahmed et al., in a report on hypocalcemic vitamin D deficiency rickets in breast fed infants in Karachi found severe vitamin D deficiency in all mothers (15/15) in whom serum vitamin D levels were measured (5). As a follow up of this paper the present study was undertaken to C Acta Obstet Gynecol Scand 77 (1998) find out the vitamin D status of healthy nursing mothers and their infants and factors contributing to any deficiency seen. Material and methods From June 1993 to May 1995, serum levels of 25(OH)D were measured in 71 nursing Pakistani mothers and their infants, 6 weeks to 11 months after delivery. Twenty-five and nineteen mothers belonged to the upper and middle socioeconomic classes respectively and were selected from the Well Baby Clinic of the Aga Khan University Hospital, Karachi, Pakistan, where infants are brought in by mothers for immunization after 6 weeks of deliv- ery. Twenty-seven mothers belonged to the lower socioeconomic class and were enrolled from the outpatient of a government general hospital. Forty-eight subjects were included in the study in Summer-Autumn (April to October months) and the rest in Winter-Spring.