A Exploratory Study to Investigate the Prevalence of Vitamin D Deficiency Among Pregnant Women

Prepared by the researche : Abd Al-Salam Salem Masoud  , Al-Busaifi – Hearing and speech section – Sorman College of Medical Technology – Sabratha University

DAC Democratic Arabic Center GmbH

Journal of Progressive Medical Sciences : Second issue – August 2025

A Periodical International Journal published by the “Democratic Arab Center” Germany – Berlin

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Abstract

This study aims to identify the prevalence of vitamin D deficiency among pregnant women attending Al-Jalaa Maternity Hospital in Tripoli, and those attending the Obstetrics and Gynecology Department at Al-Hadaba Al-Khadra Hospital. The study used a descriptive and analytical approach. The study also used a questionnaire to collect data and information, with a sample of (250 ) A pregnant woman attending Al-Jalaa Maternity Hospital in Tripoli, and attending the Obstetrics and Gynecology Department at Al-Hadaba Al-Khadra Hospital. The study also used a number of statistical methods to achieve its goals, including the arithmetic mean, the standard deviation, the percentage, the relative weight, the Pearson correlation coefficient, and the reliability coefficient. Cronbach’s alpha, the reliability coefficient using the split-half method, and the t-test. The results of this study resulted in a low percentage of vitamin D deficiency according to the responses of the study sample members, and there was also a moderate awareness of the symptoms of vitamin D deficiency and its importance to the body. There are some symptoms of vitamin D deficiency in some pregnant women, although this does not confirm the existence of a deficiency of this vitamin in these women. The responses of the study sample members also confirmed that a large number of women do not follow a healthy diet because of its negative impact on the mother’s health. And the fetus, and on the levels of vitamin D in the body, and after subjecting the study sample members to a test to determine the rate of vitamin D deficiency, the results indicated that there is a small percentage of the study sample members who suffer from vitamin D deficiency, and this deficiency is not to a large degree. There are statistically significant differences in the level of responses of the study sample members, which are attributed to the health institutions variable, in favor of Al-Jalaa Hospital for Women and Maternity in Tripoli.

Introduction:

Vitamin D deficiency represents a significant global health concern that has attracted considerable scientific attention due to its widespread prevalence across diverse populations. Although the existence of Vitamin D was suspected as early as the 17th century, it was not officially discovered until 1920 (Giovannucci et al., 2008). Classified among the fat-soluble vitamins (A, D, E, K) (Anaizi, 2010), Vitamin D can be obtained through natural dietary sources, fortified foods, and nutritional supplements. However, the majority of the body’s requirement-approximately 90%-is synthesized endogenously through skin exposure to ultraviolet B (UVB) sunlight Vitamin D functions as a hormone when synthesized in the body and as a vitamin when obtained through external sources (Tasset, 2014). Its deficiency has been directly linked to several musculoskeletal disorders, such as rickets in children and osteoporosis in adults, as well as to a range of chronic conditions, including cardiovascular diseases, infections, and diabetes (Basil et al., 2013) Beyond its physiological functions, Vitamin D has garnered research interest for its role in brain health and cognitive function Studies have highlighted its involvement in neurochemical balance and neurological processes, with implications for academic performance. Adequate Vitamin D levels are associated with enhanced learning, memory, and concentration, while deficiency may impair information retention, focus, and cognitive flexibility (Tolppanen, 2012). Furthermore, Vitamin D status has been linked to emotional and psychological well-being, with lower levels correlating with fatigue, depressive symptoms, and diminished academic motivation Although Vitamin D-rich foods such as fortified milk and fatty fish are commonly recommended (Muthanna et al., 2023), recent research has raised questions regarding the assumption that higher serum levels confer additional health benefits. Several studies have indicated that excessive levels of Vitamin D do not necessarily offer greater protection against disease, emphasizing the importance of maintaining optimal-not merely elevated-levels Recent investigations have also focused on the role of Vitamin D in brain development, as numerous receptors for the vitamin have been identified in brain regions critical to learning and memory processes (Abdulrahman et al., 2018). In addition to its role in cognitive health, Vitamin D is essential for maternal and fetal well-being during pregnancy. As a result, growing attention has been directed toward assessing pregnant women’s awareness of Vitamin D, particularly in relation to its deficiency and health implications This study aims to explore the level of awareness regarding Vitamin D among a sample of pregnant women attending Al-Jalaa Maternity Hospital in Tripoli, as well as to examine the prevalence of deficiency in this population.

Research Problem:

Given the significant role that Vitamin D plays in overall human health-and particularly in the health of pregnant women -this study emerges within the framework of improving maternal healthcare services. Through the researcher’s observation of the widespread prevalence of Vitamin D deficiency among pregnant women, and based on various collected observations and supporting information, the necessity of this study became evident Accordingly, the researcher conducted this study to explore the level of awareness among a sample of pregnant women attending Al-Jalaa Maternity Hospital in Tripoli, as well as those attending the Obstetrics and Gynecology Department at Al-Hadhba Al-Khadra Hospital, regarding the importance of Vitamin D. The study also aims to identify the symptoms associated with its deficiency and determine the prevalence rate of Vitamin D deficiency among these women.

Research Questions:

The study seeks to address the following research questions:

1- What is the prevalence rate of Vitamin deficiency among pregnant women attending a number of medical hospitals?

2- Are there statistically significant differences in the responses of the study sample that can be attributed to the variable of healthcare institutions?

Research Objectives:

This study aims to identify the prevalence rate of Vitamin D deficiency among pregnant women attending Al-Jalaa Maternity Hospital in Tripoli and those visiting the Obstetrics and Gynecology Department at Al-Hadhba Al-Khadra Hospital.

Significance of the Study:

The significance of the current study can be highlighted through the following points:

1-The study provides valuable insight into the current field reality regarding the prevalence of Vitamin D deficiency among pregnant women attending Al-Jalaa Maternity Hospital in Tripoli.

2- It serves as a scientific contribution toward the development of medical and healthcare services offered to women, particularly in the context of pregnancy and childbirth.

3- The findings of the study may serve as a foundation for proposing recommendations and suggestions that could assist specialists in reducing cases of Vitamin D deficiency, thereby contributing to the protection of both mothers and their unborn children from future health complications.

Scope and Delimitations of the Study:

Topical Scope:

1- The study focuses: on identifying the prevalence rate of Vitamin D deficiency among pregnant women attending Al-Jalaa Maternity Hospital in Tripoli and those visiting the Obstetrics and Gynecology Department at Al-Hadhba Al-Khadra Hospital.

2- Geographical Scope: The study was conducted at Al-Jalaa Maternity Hospital in Tripoli and the Obstetrics and Gynecology Department at Al-Hadhba Al-Khadra Hospital, involving pregnant women receiving care at these institutions.

Time Scope: The study was carried out during the year 2024.

4- Human Scope: The study sample consisted of 250 pregnant women attending Al-Jalaa Maternity Hospital in Tripoli and the Obstetrics and Gynecology Department at Al-Hadhba Al-Khadra Hospital.

Study Procedures:

Research Methodology: To address the research questions, the researcher employed the descriptive-analytical method, as it is considered the most appropriate approach for studies aiming to investigate phenomena as they exist in reality.

Study Sample: The sample was selected through direct communication with a number of pregnant women attending Al-Jalaa Maternity Hospital in Tripoli and those visiting the Obstetrics and Gynecology Department at Al-Hadhba Al-Khadra Hospital. The sample was randomly selected from the study population.

Pilot Sample: The pilot sample consisted of 30 pregnant women, including participants from Al-Jalaa Maternity Hospital in Tripoli and others from the Obstetrics

The table number (1) shows the distribution of the exploratory study sample

Actual Study Sample: The actual study sample consisted of 250 pregnant women attending Al-Jalaa Maternity Hospital in Tripoli and the Obstetrics and Gynecology Department at Al-Hadhba Al-Khadra Hospital.

The following table presents the distribution of the actual study sample according to the healthcare institutions.

Table No. (2) shows the distribution of the actual study sample according to the variable of medical institutions

Study Instrument:

The study instrument consisted of:

Questionnaire (prepared by the researcher): The questionnaire included 14 items aimed at assessing the level of awareness among pregnant women regarding the symptoms of Vitamin D deficiency, its importance to human health, and its prevalence among women attending Al-Jalaa Maternity Hospital in Tripoli and the Obstetrics and Gynecology Department at Al-Hadhba Al-Khadra Hospital.

2- Medical Tests for Vitamin D Levels: The study participants underwent medical testing to determine their serum Vitamin D levels. This was conducted to identify the prevalence of Vitamin D deficiency among the pregnant women attending Al-Jalaa Maternity Hospital in Tripoli and the Obstetrics and Gynecology Department at Al-Hadhba Al-Khadra Hospital.

Validity and Reliability of the Study Instrument:

1-Content Validity: The questionnaire was presented to a panel of five experts specialized in the field to review its items and provide feedback. Their opinions were carefully considered and incorporated to ensure the content validity of the instrument.

2- Internal Consistency Validity: The questionnaire was administered to a pilot sample of 30 pregnant women attending Al-Jalaa Maternity Hospital in Tripoli and the Obstetrics and Gynecology Department at Al-Hadhba Al-Khadra Hospital. The Pearson correlation coefficient was used to measure the correlation of each item with the overall instrument. The results were as follows:

Table No. (3) shows the correlation of each statement with the questionnaire using the Pearson correlation coefficient

Based on the results presented in the previous table, it was found that the correlation coefficients of all questionnaire items with the overall instrument were statistically significant at the 0.01 level, indicating that all items of the questionnaire exhibit a high degree of internal validity.

Reliability of the Study Instrument:

To assess the reliability of the questionnaire, the following method was used:

Cronbach’s Alpha Coefficient: The Cronbach’s alpha reliability coefficient was calculated to measure the internal consistency of the questionnaire. This analysis was conducted using the SPSS statistical software, based on the data obtained from the pilot sample. The results are presented in the following table:

“Table No. (4) presents the reliability analysis of the questionnaire, assessed using Cronbach’s Alpha coefficient

Based on the results presented in the previous table, it can be concluded that the questionnaire demonstrates a high level of reliability.

Split-Half Method: The questionnaire items were divided into two halves-odd-numbered items versus even-numbered items. The Pearson correlation coefficient was used to determine the correlation between the two halves. The reliability was then adjusted using the Spearman-Brown prophecy formula and the Guttman split-half coefficient, as shown in the following table:

Table (5) displays the reliability of the questionnaire as determined by the split-half method

Based on the results obtained from the previous table, it can be concluded that the questionnaire exhibits a high degree of reliability.

Data Collection: Data were collected through a paper-based questionnaire, which was distributed to a number of pregnant women attending Al-Jalaa Maternity Hospital in Tripoli and the Obstetrics and Gynecology Department at Al-Hadhba Al-Khadra Hospital. Out of 300 distributed questionnaires, a total of 250 completed questionnaires were returned. Additionally, medical tests for detecting Vitamin D deficiency were used to support the study findings.

Data Analysis: In order to achieve the objectives of the study and answer its research questions, the researcher utilized the Statistical Package for the Social Sciences (SPSS) to analyze the collected data. A set of appropriate statistical methods was employed, including the arithmetic mean, standard deviation, relative weight, percentage, frequency distribution, and the t-test to examine the significance of differences between means.

Study Results:

Results for Research Question:

What is the prevalence rate of Vitamin D deficiency among pregnant women attending various hospitals? To answer this question, the relative weights for each item in the questionnaire were calculated. The results were as follows:

Table (6) shows the relative weights of the responses of the study sample individuals to the questionnaire items

Based on the results obtained from the previous table, it is observed that there is a low reported prevalence of Vitamin D deficiency according to the responses of the study participants. Additionally, there appears to be a moderate level of awareness regarding the symptoms of Vitamin D deficiency and its importance to the body Some pregnant women reported symptoms that may be associated with Vitamin D deficiency; however, these symptoms alone do not confirm an actual deficiency. The participants’ responses also indicated that a significant number of women do not follow a healthy dietary regimen, which negatively affects both maternal and fetal health, as well as the body’s Vitamin D levels.

After the study participants underwent clinical testing for Vitamin D deficiency, the results were as follows:

Table (7) shows the average vitamin D level among the study sample participants who visit Al-Jalaa Maternity Hospital in Tripoli

Based on the results obtained from the previous table, it was observed that a normal level of Vitamin D was found in a large portion of the study sample, with 130 participants (representing 86.66%) exhibiting adequate levels. In contrast, 20 participants (representing 13.33%) were found to have low Vitamin D levels.

As for the pregnant women in the study sample who were attending the Obstetrics and Gynecology Department at Al-Hadhba Al-Khadra Hospital, the results were as follows:

Table No. (8) shows the average level of Vitamin D among the study sample of women attending the Obstetrics and Gynecology Department at Al-Hadbah Al-Khadra Hospital

Based on the results of the previous tables, we conclude the following:

Table No. (9) shows the overall results of the average Vitamin D levels among the study sample

Based on the results obtained from the previous table, it was observed that a normal level of Vitamin D was present in a large portion of the study sample, with 200 participants representing 80% of the total. In contrast, 50 participants (representing 20%) were found to have low Vitamin D levels.)

Results for Research Question:

“Are there statistically significant differences in the responses of the study sample that can be attributed to the variable of healthcare institutions?

To answer this question, the means, standard deviations, T-values, degrees of freedom, and significance levels for the responses of the study participants were calculated. The results were as follows:

Table No. (10) shows the use of several statistical methods to determine the level of differences in the responses of the study sample individuals attributed to the variable of healthcare institutions

The results obtained from the previous table indicate the presence of statistically significant differences at the 0.01 significance level, attributed to the variable of healthcare institutions, favoring Al-Jalaa Maternity Hospital for Women and Childbirth in Tripoli.

Conclusions:

After a thorough examination of the chapters of this study, the following conclusions can be drawn:

1-There is a low prevalence of Vitamin D deficiency based on the responses of the study participants.

2-There is a moderate level of awareness regarding the symptoms of Vitamin D deficiency and its importance to the body among the study participants.

3-The responses indicated that a significant number of women do not follow a healthy diet, which negatively impacts both maternal and fetal health, as well as Vitamin D levels in the body.

4-After subjecting the study sample to a test for Vitamin D deficiency, the results indicated that a small proportion of participants were found to have a deficiency. However, the deficiency was not of a severe degree.

5-There were statistically significant differences in the responses of the study sample, attributed to the variable of healthcare institutions, in favor of Al-Jala Women’s and Maternity Hospital in Tripoli.

Recommendations:

Following the comprehensive journey through this study, the researcher recommends the following:

1-Emphasize the importance of a healthy diet for women, especially during pregnancy stages.

2- Raise community awareness about the importance of Vitamin D, its symptoms, and preventive measures through educational lectures, seminars, and various media programs (visual, audio, and stages.

3- Encourage individuals to visit healthcare facilities for medical check-ups upon experiencing any symptoms of Vitamin D deficiency.

4- Advise against the unsupervised use of medications and dietary supplements, as this may pose serious health risks.

5- Drioritize the healthcare and monitoring.

Suggestions:

The researcher suggests the following:

Conducting further studies that examine the subject of this research with greater precision and depth.

Healthcare authorities should consider the results of this study, along with previous and future related studies, and incorporate them into research planning and policy-making.

References:

Arabic References:

Abdulrahman, et, al. (2018). Lack of association between plasma 25-hydroxyvitamin D and cognitive function or academic performance in adolescents. Journal of Kuwait University.

Second: Foreign references:

1- Anaizi, N. (2010). Rediscovering vitamin D. Libyan Journal of Medicine, 5(1).

2- Bassil, D, Rahme, M, Hoteit, M, & Fuleihan, G. E. H. (2013). Hypovitaminosis D in the Middle East and North Africa: prevalence, risk factors and impact on outcomes. Dermato- Endocrinology, 5(2), 274-298.

3- Giovannucci, E, Liu, Y, Hollis, B. W, & Rimm, E. Β. (2008). 25- hydroxyvitamin D and risk of myocardial infarction in men: a prospective study. Archives of Internal Medicine, 168(11), 1174- 1180.

4- Muthanna, Fares MS, et, al. “Prevalence and Impact of Fatigue on Quality of Life (QOL) of Cancer Patients Undergoing Chemotherapy: A Systematic Review and Meta- Analysis.” Asian Pacific journal of cancer prevention: APJCP 24.3 (2023): 769.

 5-Tolppanen, Anna-Maija (2012), Association of serum 25-hydroxyvitamin D3 and D2 with academic performance, Research Report, Norwich Medical School. University of East Anglia. UK.

6- Tasset, J, L. (2014). A Systematic review of vitamin D deficiency in pregnancy in india and its impact on maternal and fetal outcomes (Doctoral dissertation, University of Cincinnati)