There has been a recent up surge of Vitamin D (Vit D) deficiency, affecting almost a billion people worldwide, irrespective of age or gender. It virtually affects every system of the body. The problem however is more pronounced in the yet developing countries, like ours, despite abundant sun shine. Pregnancy being a sensitive period, with unique symbiosis between mother and foetus, the expectant mothers and their babies suffer signifi-cant ill effects of deficient Vit D levels, in their sys-tems.
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Considering this problem in Pakistan
It is necessary to look at the diversified amalgam of variations in climate, altitude and environment etc, from the north to the south of the country. Taking into consideration the high mountains up in the north, through the planes to the areas of Sindh in the south with Balochistan on the side and Mackran way down west wards, present an arena of its own kind.
The sea shore annexed to the Indus delta is im-portant for supply of sea food (fish, etc).
Thus studies on Vitamin D status of pregnant women in one place are not necessarily applicable to the others. Moreover Pakistan has a highly stratified society, “with rich being very rich and poor being very poor”.
In the latter, issue of Vit D deficiency of various grades, starts with the lack of opportunity to avail benefit of sunshine or even to get permission there of, in our by and large patriarchal society. The latter also leading to women subordination results in the men and sons eating better of what-ever food is available, with the left overs allocated to women (whether pregnant or not) and daugh-ters, hence how much of Vit D content is expected to be consumed by the mothers of the nation! Fur-thermore a study mentions that 2/3 of people of Sindh alone are food insecure.1
On the other hand the women of well to do fami-lies have sufficient access to sun shine and Vit D containing foods but they need to be disciplined about these matters. Most pregnant women are unaware of the importance of these factors.
Thus with lack of women empowerment, educa-tion, awareness and continuing poverty, it is un-likely that the relevant Millennium Goals will be met with!
Furthermore there is a dire need to know the Bur-den of Vit D deficient woman, which is touched upon later.
Before contemplating upon management of Vit D deficiency in pregnancy, the basics of this signifi-cant vitamin have to be highlighted.
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