Pregnancy and lactation are usual but stressful physiological conditions accompanied by changes in calcium and phosphate metabolism and their regulatory hormones which may lead to calcium-related disorders in pregnant women. This study aimed to evaluate the changes in serum levels of calcium, phosphate, vitamin D and their regulatory hormones in pregnant and lactating women in Zaria, Nigeria. A cross‑sectional descriptive study was conducted at Ahmadu Bello University Teaching Hospital, Zaria for three (3) months. Blood samples were collected, anthropometric measurements (weight, height and body mass index) of 179 women were taken. Serum calcium, phosphate, vitamin D, parathyroid hormone and calcitonin were determined using standard methods. Data were presented as mean ± SD, analysis was performed using one-way ANOVA and Pearson’s correlation analysis. Values were considered significant at p ≤ 0.05. There was a significant decrease in serum calcium concentration (p < 0.01) during the third trimester of pregnancy and lactation. An increase in serum concentration of vitamin D, parathyroid hormone, and calcitonin in the 2nd trimester and a decrease during the third trimester and lactation although not statistically significant when compared with the control. There was a negative correlation between serum calcium concentration and gestational age (r = 0.255) while no correlation between gestational age and serum phosphate concentration. Changes in serum calcium, vitamin D, parathyroid hormone and calcitonin during pregnancy and lactation has been demonstrated suggesting a relationship between calcium metabolism and these hormones at some stages of pregnancy
Abrams SA. In utero physiology: role in nutrient delivery and fetal development for calcium, phosphorus, and vitamin D. The American Journal of Clinical Nutrition 2007 85(2), 604S-607S.
Ardawi MS, Nasrat HA. Calcium-regulating hormones and parathyroid hormone-related peptide in normal human pregnancy and postpartum: a longitudinal study. European Journal of Endocrinology 1997 137(4), 402–409
Benali AI, Demmouche A. Calcium deficiency among pregnant women and their newborns in Sidi Bel Abbes region, Algeria. Journal of Nutrition and Food Sciences 2014 4(6), 318.
Essley B, McNanley T, Cooper B, McIntyre A, Witter F, Harris Z, O’Brien K. Osteoprotegerin in pregnant adolescents differs by race and is related to infant birth weight Z-score. J Dev Orig Health Dis. 2011;2:272–9 DOI: 10.1017/S2040174411000511.7.
Fiske CH, Subbarow YJ. The colorimetric determination of phosphorus. Biol Chem 1925;66:375 400.
Fukumoto S. Phosphate metabolism and vitamin D. Bonekey Reports 2014. Retrieved from http://www.nature.com/bonekeyreports/2014/140205/bonekey2013231/full/bonekey2013231.html
Gbadegesin A, Sobande A, Adedeji O, Disu E, Korede O, Dosunmu A, Shakunle A. Maternal serum vitamin D levels and pregnancy outcomes: from Lagos. The Journal of Obstetrics and Gynaecology 2017 37(1), 25-28.
Gillies B, Tonkin BA, Ma Y, Kirby BJ, St-Arnaud R, Sims NA. Kovacs CS. Pregnancy and post-lactation recovery rescue low bone mass and hypocalcemia in Cyp27b1 null mice that cannot make calcitriol (Abstract). Journal of Bone and Mineral Research 2015 30
Holt E. Calcium physiology in pregnancy 2013 Upto Date retrieved from http://cursoenarm.net/UPTODATE/contents/mobipreview.htm?29/41/30367?source=see_link
Ikepkeazu JE, Ibegbu MD, Ugwoke HA. Evaluation of serum calcium and inorganic phosphate levels in pregnant and lactating women in Enugu Metropolis. Bioresearch 2010 8 (1) 622 – 625.
Kametas N, McAuliffe F, Krampl E. Maternal electrolyte and liver function changes during pregnancy at high altitude. Clinica Chimica Acta 2003 328(1-2), 21-29
Kirby BJ, Ma Y, Martin HM, Buckle Favaro KL, Karaplis AC, Kovacs CS. Upregulation of calcitriol during pregnancy and skeletal recovery after lactation do not require parathyroid hormone. Journal of Bone and Mineral Research 2013 28(9), 1987–2000
Kovacs CS. Maternal mineral and bone metabolism during pregnancy, lactation, and post-weaning recovery Physiological Reviews 2016 96(2), 449–547
Kovacs CS. Vitamin D in pregnancy and lactation: maternal, fetal, and neonatal outcomes from human and animal studies. The American Journal of Clinical Nutrition 2008 88(2), 5205 – 5285.
Kumar A, Agarwal K, Devi SG, Gupta RK, Batra S. Hypocalcemia in pregnant women. Biological Trace Element Research, 2010 136(1), 26 – 32
Levine BS, Rodriguez M, Felsenfeld AJ. Serum calcium and bone: Effect of PTH, phosphate, vitamin D and uremia. Nefrologia, 2014 34(5), 658 – 69.
Madar AA, Stene LC, Meyer HE. Vitamin D status among immigrant mothers from Pakistan, Turkey and Somalia and their infants attending child health clinics in Norway. British Journal of Nutrition 2009 101, 1052–1058. Doi:10.1017/S0007114508055712
Madukosiri CH, Adoga GI. Elemental status of pregnant and lactating women in Bassa LGA of Plateau state, Nigeria. Pakistan Journal of Nutrition, 2011 10(5), 401 – 404.
Marwaha RK, Tandon N, Chopra S, Agarwal N, Garg MK, Sharma B, Puri S. Vitamin D status in pregnant Indian women across trimesters and different seasons and its correlation with neonatal serum 25-hydroxyvitamin D levels. British Journal of Nutrition 2011 106(9), 1383–1389
Møller UK, Streym S, Mosekilde L, Heickendorff L, Flyvbjerg A, Frystyk J, Rejnmark L. Changes in calcitropic hormones, bone markers and insulin-like growth factor I (IGF-I) during pregnancy and postpartum: a controlled cohort study. Osteoporosis International 2013 24(4), 1307–1320
Morin LG. Direct colorimetric determination of serum calcium with o cresolphthalein complexone. Am J Clin Pathol 1974;61:114 7. 15.
National Bureau of Statistics 2015. 25th February 2015 accessed via http://www.nigerianstat.gov.ng/ @ 11.53hrs.
Okonofua F, Houlder S, Bell J, Dandona P. Vitamin D nutrition in pregnant Nigerian women at term and their newborn infants. Journal of Clinical Pathology 1986 39(6), 650-653
Roth DE, Al Mahmud A, Raqib R, Akhtar E, Perumal N, Pezzack B, Baqui AH. Randomized placebo-controlled trial of high-dose prenatal third-trimester vitamin D3 supplementation in Bangladesh: the AViDD trial. Nutrition Journal 2013 12, 47. doi: 10.1186/1475-2891-12-47.
Schoenmakers I, Jarjou LM, Goldberg GR, Tsoi K, Harnpanich D, Prentice A. Acute response to oral calcium loading in pregnant and lactating women with a low calcium intake: a pilot study. Osteoporosis International 2013 24(8), 2301–2308
Seely EW, Brown EM, DeMaggio DM, Weldon DK, Graves SW. A prospective study of calciotropic hormones in pregnancy and post-partum: reciprocal changes in serum intact parathyroid hormone and 1,25-dihydroxyvitamin D. American Journal of Obstetrics & Gynecology 1997 176(1 Pt. 1), 214–217
Silva OL, Titus-Dillon P, Becker KL, Richard HS, Charles FM. Increased Serum Calcitonin in Pregnancy Journal of the National Medical Association, 1981 73(7), 649–652
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2022 Nigerian Journal of Physiological Sciences