KARACHI (APP) - A significant majority of Pakistani women, in child bearing age group report with high prevalence of hypovitaminosis D (Vitamin D deficiency) and osteomalacia (weak bones), said Prof Ayesha Khan. The senior gynecologist at a seminar held under Active Mother Active Nation (AMAN) campaign, referred to different research studies published in prestigious journals of international repute showing high prevalence of hypovitaminosis D in South Asian women of child bearing age. Pakistani women of this very group, however surpass their counterparts, she said and referred to a research conducted on various immigrants group living in Oslo, Norway (published in European Journal of Clinical Nutrition). Prevalence of hypovitaminosis D was found to be highest (64.9%) among the women born in Pakistan, said Prof Ayesha. She explained that functions of Vitamin D include bone formation, inhibition of cellular growth, stimulation of insulin secretion, modulation of immune function and inhibition of renin production. Mentioning that vitamin D is needed for mineralization of bones, metabolic processes, absorption of calcium and phosphate from intestine, synthesis of alkaline PO4, transportation of calcium and reduction in calcium excretion from kidneys, she said its deficiency leads to serious problems. Vitamin D deficiency leads to poor calcium absorption, and low calcium level stimulates parathyroid hormone (PTH) which in turn drains calcium from bones, increases the excretion of PO4 and reduces CaPO4 resulting in osteopenia and osteoporosis, she elaborated. Highlighting the consequences of hypovitaminosis D in pregnancy on children, she said that it may lead to poor calcium homeostasis, poor skull ossification, poor development of immune system, risk of developing diabetes in later life, increased risk of cancers in adulthood, hypocalcemia, convulsions, craniotabes, large fontanels and rickets. It may also result in poor maternal weight gain, small for date babies and pre-eclampsia, she added. Discussing a research on vitamin D supplementation during pregnancy, reported in British Medical Journal (BMJ), she shared the findings that mothers in treatment group had faster maternal weight gain in 3rd trimester and neonates had no hypocalcemia and had normal level of vitamin D; while the placebo group exhibited low plasma concentration of vitamin D, symptomatic hypocalcemia, small for date babies, large fontanelles and impaired ossification. The gynaecologist recommended vitamin D supplementation during lactation, as otherwise decreased concentration of vitamin D in mothers milk may lead to neonatal and infantile hypovitaminosis and decreased calcium levels, which may result in rickets. Discussing effects of hypovitaminosis beyond pregnancy, she said it may result in osteoporosis, non-specific musculoskeletal pain, polycystic ovaries, obesity, cancer and poor immune system. Dr. Ayesha extensively referred to studies suggesting that chronic non-specific musculoskeletal pain is associated with hypovitaminosis D, and advised to assess the level of vitamin D in such cases. She said, vitamin D with calcium therapy shows promising results in the cases of polycystic ovaries. Referring to a study published in Rheumatology International, she said alfacalcidol is superior to plain vitamin D (cholecalciferol) as it holds pleiotropic effects improving bone and muscle metabolism and clinical symptoms. Dr Azhar Chaghtai, Consultant Neonatologist, in his presentation said, rickets is the most common form of bone disorder and extreme vitamin D deficiency is its cause. Rickets can also present with seizure, respiratory infection and diarrhea, he said adding that neonatal Vitamin D status is strongly related to maternal vitamin D level. Deficiency of vitamin D during pregnancy, he informed, can cause intrauterine growth retardation, inborn rickets, craniotabes, delay in growth velocity during first year, delayed eruption of teeth and enamel problems, delayed closure of anterior fontanel and flaring of wrist.