Windrim Catherine M, Kane Daniel, Kelleher Grainne, Mocanu Edgar
Obstetrics and Gynecology, Rotunda Hospital, Dublin, Ireland.
Royal College of Surgeons Ireland Unit, Rotunda Hospital, Dublin, Ireland.
Int J Gynaecol Obstet. 2025 Sep;170(3):1199-1204. doi: 10.1002/ijgo.70124. Epub 2025 Apr 7.
To evaluate the burden of vitamin D deficiency in female patients attending a fertility clinic in a tertiary referral center, assess temporal trends-including the potential impact of COVID-19 lockdowns-and explore socioeconomic disparities in vitamin D levels.
This retrospective cohort study analyzed vitamin D measurements from 765 female patients (mean age 35.7 ± 5.8 years) attending a fertility clinic between March 2010 and May 2022. Vitamin D status was categorized as deficient (<30 nmol/L), insufficient (30-50 nmol/L), or normal (>50 nmol/L). Comparative analyses examined pre- and post-COVID periods and healthcare funding status.
Overall, 39.9% (n = 305) of patients exhibited suboptimal vitamin D levels, with 8.8% (n = 67) deficient and 31.1% (n = 238) insufficient. Mean serum 25(OH)D was 62.8 ± 27.4 nmol/L. No statistically significant difference was observed between pre-COVID (44.2% suboptimal) and post-COVID (38.1% suboptimal) periods (OR 0.78, 95% CI: 0.57-1.06, P = 0.110). However, marked seasonal variation was identified, with winter values significantly lower than summer values (45.3 ± 24.6 vs. 72.1 ± 28.3 nmol/L, P < 0.001). Furthermore, state-funded patients had a significantly higher rate of suboptimal vitamin D status (50.2%, n = 107) compared to self-funded patients (35.9%, n = 198, P < 0.001).
Our findings demonstrate a high prevalence of suboptimal vitamin D levels in a subfertility population, with significant seasonal fluctuations and notable socioeconomic disparities. Despite initial concerns, COVID-19 lockdown measures did not appear to adversely affect overall vitamin D status. These results support the incorporation of routine vitamin D screening in infertility evaluations and the implementation of targeted supplementation, particularly in economically vulnerable groups and during winter months.
评估在一家三级转诊中心的生育诊所就诊的女性患者维生素D缺乏的负担，评估时间趋势，包括新冠疫情封锁措施的潜在影响，并探讨维生素D水平的社会经济差异。
这项回顾性队列研究分析了2010年3月至2022年5月期间在一家生育诊所就诊的765名女性患者（平均年龄35.7±5.8岁）的维生素D测量值。维生素D状态分为缺乏（<30 nmol/L）、不足（30 - 50 nmol/L）或正常（>50 nmol/L）。比较分析考察了新冠疫情前后时期以及医疗资金状况。
总体而言，39.9%（n = 305）的患者维生素D水平未达最佳，其中8.8%（n = 67）缺乏，31.1%（n = 238）不足。血清25(OH)D平均水平为62.8±27.4 nmol/L。在新冠疫情前（未达最佳水平的占44.2%）和新冠疫情后（未达最佳水平的占38.1%）期间未观察到统计学上的显著差异（比值比0.78，95%置信区间：0.57 - 1.06，P = 0.110）。然而，发现了明显的季节性变化，冬季值显著低于夏季值（45.3±24.6对72.1±28.3 nmol/L，P < 0.001）。此外，与自费患者（35.9%，n = 198）相比，国家资助患者维生素D状态未达最佳的比例显著更高（50.2%，n = 107，P < 0.001）。
我们的研究结果表明，在亚生育人群中维生素D水平未达最佳的患病率很高，存在显著的季节性波动和明显的社会经济差异。尽管最初有所担忧，但新冠疫情封锁措施似乎并未对总体维生素D状态产生不利影响。这些结果支持在不孕症评估中纳入常规维生素D筛查，并实施有针对性的补充，特别是在经济弱势群体和冬季月份。
