VARIATIONS IN THE BONE PROFILE AND VITAMIN D LEVELS DURING NORMAL PREGNANCY IN RURAL WOMEN
DOI:
https://doi.org/10.69656/pjp.v22i3.1884Keywords:
Bone profile, Nowshera, Pakistan, Pregnancy, Rural, Vitamin D levels, WomenAbstract
Background: Pregnancy triggers significant physiological adaptations that alter maternal bone turnover and mineral metabolism to support foetal skeletal development. Investigating these biochemical shifts in specific demographics is essential for distinguishing normal gestational variations from true pathological deficiencies. The study was conducted to evaluate alterations in bone profile and vitamin D3 levels during pregnancy in normal women residing in rural areas of District Nowshera. Methods: This cross-sectional study was conducted from April 2024 to March 2025 by the orthopaedic unit at Lady Reading Hospital in Peshawar, in collaboration with the health department of district Nowshera. A total of 90 pregnant women, aged between 18 and 35 years, from the three basic health units in the Nowshera district, were investigated. Twenty-five non-pregnant, non-lactating women who met the same inclusion and exclusion criteria were also examined. Results: Total serum calcium (p=0.2944), inorganic phosphorus (p<0.0001), and serum albumin (p<0.0001) concentrations were found to be lower in pregnant women in comparison to the control group, whereas alkaline phosphatase (p<0.0001) activity was elevated in pregnant women relative to non-pregnant women. Conclusion: The decrease in level of Calcium, Phosphorus, Albumin and Vitamin D 3, and increase in level of Alkaline Phosphatase in pregnant women underscore the necessity of creating pregnancy-specific reference ranges as needed for the professionals engaged in antenatal care.
Pak J Physiol 2026;22(3):117-20, DOI: https://doi.org/10.69656/pjp.v22i3.1884
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References
Bar A, Moran R, Mendelsohn-Cohen N, Korem Kohanim Y, Mayo A, Toledano Y, et al. Pregnancy and postpartum dynamics revealed by millions of lab tests. Sci Adv 2025;11(13):eadr7922.
Khan MH, Khan JA, Idres M and Haq IU. Biochemical and hematological parameters correlate during pregnancy. Pak J Med Res 2001;40(2):53–5.
Igbinosa II, Leonard SA, Noelette F, Davies-Balch S, Carmichael SL, Main E, et al: Racial and ethnic disparities in anemia and severe maternal morbidity. Obstetric Gynecol 2023;142(4): 845–54.
Sweeting A, Wong J, Murphy HR, Ross GP. A clinical update on gestational diabetes mellitus. Endocr Rev 2022;43:763–93.
Hereford T, Kellish A, Samora JB, Reid Nichols L. Understanding the importance of peak bone mass. J Pediatr Soc North Am 2024;7: 100031.
Kovacs CS. Maternal mineral and bone metabolism during pregnancy, lactation, and post-weaning recovery. Physiol Rev 2016;96(2):449–547.
Amrein K, Scherkl M, Hoffmann M, Neuwersch-Sommeregger S, Köstenberger M, Tmava Berisha A, et al. Vitamin D deficiency 2.0: an update on the current status worldwide. Eur J Clin Nutr 2020);74(11):1498–513.
Al Mahfooth WF, Lafta RO, Khuoo AN. A study of vitamin D level in pregnancy and the effect of its deficiency on pregnancy outcome. J Women’s Health Care 2020;9(6):500.
Abbasian M, Chaman R, Amiri M, Ajami ME, Jafari-Koshki T, Rouhani H, et al. Vitamin D deficiency in pregnant women and their neonates. Glob J Health Sci 2016;8(9):54008.
Nindrea RD, Hendriyani H. Prevalence of vitamin D deficiency among pregnant women in Southeast Asia represents public health crisis: A systematic review and meta-analysis. Clin Epidemiol Glob Health 2024;27:101574.
Ivanisevic J. Ardalic D, Zeljkovic A, Vekic J, Gojković T, Vladimirov S. Biochemical and hematological parameters in the 1st trimester of pregnancy. Arh farm (Ardh Pharm) 2023;73:62–73.
Varley H, Gowenlock AH, McMurray JR, McLauchlan DM. (Eds). Varley’s Practical clinical biochemistry. 6th ed. London, UK: Heinemann Medical Books;1988. p.1050.
Kaur S, Kaur H. Prevalence of vitamin D and B12 deficiency in pregnant women in Jammu, India. Int J Res Med Sci 2020;8(4):1245–7.
Ramasamy, I. Vitamin D metabolism and guidelines for vitamin D supplementation Clin Biochem Rev 2020;41(3):103–26.
Trishala A, Geetha, Vishnu Priya V. Serum calcium and iron in pregnancy. Int J Curr Res 2017;5:866–8.
Bako B, El-Nafaty AU, Mshelia DS, Gali RM, Isa B, Dungus MM. Prevalence and risk factors of hypocalcemia among pregnant and non-pregnant women in Maiduguri, Nigeria. Niger J Clin Pract 2021;24(1):75–80.
Appelman-Dijkstra NM, Ertl DA, Zillikens MC, Rjenmark L, Winter EM. Hypercalcemia during pregnancy: management and outcomes for mother and child. Endocrine 2021;71(3):604–10.
Mahdi MA, Elgzoly EA, Ibrahim AA, Osman HS, Mohamed RA. Measurement of plasma total protein, albumin, and urea in healthy Sudanese pregnant females. World J Pharm Res 2018;7(2):204–9.
Cantarino SG, Ortuno MTA, Aguado MD. Prevalence of Hypoproteinemia and Hypoalbuminemia in Pregnant Women from Three Different Socioeconomic Populations. Int J Environ Res Public Health 2020;17(17):6275.
Chakraborty S, Pramanik J, Mahata B, Revisiting steroidogenesis and its role in immune regulation with the advanced tools and technologies. Genes Immun 2021;22(3):125–40.
Titaux C, Ternynck C, Pauchet M, Stichelbout M, Bizet G, Maboudou P, et al. Total alkaline phosphatase levels by gestational age in a large sample of pregnant women. Placenta 2023;132:32–7.
Gupta S, Choudhary VR, Kumar N, Agarwal V, Jain M. To study ALP levels of antenatal patients as a predictive marker and fetal outcome. Int J Acad Med Pharm 2023;5 3):334–8.
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Copyright (c) 2026 Bilal Hassan Khan, Latif Khan, Aiman Hassan, Hazrat Akbar
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