Browsing by Author "Cauce, Vinita"

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    Assessment of shoulder girdle elevation motion using daid smart shirt : A reliability and validity study
    (SciTePress, 2019) Semjonova, Guna; Vetra, Janis; Okss, Aleksandrs; Katashevs, Aleksejs; Cauce, Vinita; Vilas-Boas, Joao; Pezarat-Correia, Pedro; Cabri, Jan; Rīga Stradiņš University
    Muscle function around the shoulder girdle can be impaired by pain, which leads to abnormal movement e.g. elevation. Movement faults should be assessed specifically, therefore individual sport rehabilitation strategies can be implemented. Smart garments are efficient for upper body movement assessment. There is a lack of literature stating that smart textile garments are reliable and valid for shoulder gridle elevation. The purpose of the study was to examine reliability and validity of the DAid smart shirt during shoulder girdle elevation. Twenty-one female volunteers aged 24.3. (SD3.3), body mass index 19.3 (SD 0.5) were recruited. The DAid smart shirt and 2D movement video analysis software Quintic Biomechanics v26, UK were the assessment tools utilized. Cronbach alpha coefficient and Interclass Correlation Coefficient were calculated to assess the within-session test-retest reliability. Bland - Altman analysis was applied to determine validity. Results: reliability for the right side measures: Cronbach alpha coefficient α ≥ 0.9, ICC ≥ 0.9. Reliability for the left side measures: Cronbach alpha coefficient α ≥ 0.9, ICC ≥ 0.91. Bland-Altman analysis presents that DAid smart shirt measures are valid during shoulder girdle elevation. Conclusion: smart shirt measures are reliable and valid during shoulder girdle elevation movements.
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    Changes in Health Behaviour and Emotional Well-Being of Pregnant Women during the COVID-19 Pandemic in Latvia
    (2022-02-01) Rezgale, Roberta; Cauce, Vinita; Bule, Violeta; Piskurjova, Anna; Meija, Laila; Rīga Stradiņš University
    Pregnancy is a vulnerable period of life for changes in physical and mental health, which could be exacerbated by COVID-19. The aim of this study was to assess the impact of COVID-19 on health behaviour and emotional well-being among pregnant women in Latvia. The cross-sectional study included 269 women: pregnant women in the third trimester and women until the 7th day post-partum. The study was conducted between July and October 2020, performed by a trained interviewer. Information regarding demographic, anthropometric data, self-assessment of changes in nutritional habits, daily physical activities, and emotional well-being due to the COVID-19 pandemic was collected. 31.6% reported cooking at home more often and only 10.4% reported eating more often and/or larger portions, 23.2% were going on walks outdoors more often, 32.9% were feeling anxious, insecure about health of themselves and relatives, and 24.8% were lacking communication with friends and family. Latvian women were emotionally more affected than other nationalities (p = 0.015). Overall, women 30+ years of age were more often affected then women aged up to 30 years (p = 0.014). These results suggest that the COVID-19 pandemic had notable impact on health behaviour and emotional well-being in pregnant women in Latvia, especially on women 30+ years of age, who may need more careful counselling.
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    Colistin Use Patterns and Toxicity in Critically Ill Patients in Pauls Stradiņš Clinical University Hospital
    (2018-08-01) Aitullina, Aleksandra; Krūmiņa, Angelika; Cauce, Vinita; Purviņa, Santa; Department of Pharmacology; Department of Infectology; Department of Physics
    Colistin is used systemically in critically ill patients for treatment of infections caused by multi-drug resistant (MDR) Gram-negative bacteria, e.g., Acinetobacter baumanii. It is potentially nephro-and neurotoxic. It is recommended to decrease the dose of colistin in case of renal impairment or renal replacement therapies (RRT) but clear recommendations are not available yet. The aim of this retrospective study was to determine colistin use patterns in critically ill patients in Pauls Stra-dins University Hospital. Forty patients were included in this study. The most common indications for colistin were pneumonia associated with mechanical ventilation or sepsis caused by MDR A. baumanii. Median duration of colistin therapy was 11.5 (IQR 7.0; 17.0) days and median cumulative dose was 91.5 (43.0; 150.0) million units (MU). The usual regimen was 9 MU as loading dose and 3 MU three times daily as maintenance dose, but in case of renal impairment and RRT colistin regimens varied a lot between the patients. In 21% (7 from 33) of cases, acute kidney injury (AKI) was observed during colistin therapy (serum creatinine increases more than twice from baseline). All these AKI cases occurred in patients with previously normal renal function and none of the patients in this group needed RRT.
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    Consumption of the whole-grain rye bread and progression of prostate cancer
    (2013-11-01) Meija, Laila; Cauce, Vinita; Siksna, Inese; Joffe, Rafaels; Ignace, Gita; Bobere, Natalija; Lietuvietis, Vilnis; Lejnieks, Aivars; Söderholm, Paivi; Adlercreutz, Herman; Rīga Stradiņš University
    Whole-grain rye intake has been suggested to have anti-cancer effect, including changes in serum hormones and reduced prostate specific antigen (PSA) in animals and humans. In this study, we investigated the effect of high intake of whole-grain rye bread on prostate cancer progression as assessed by PSA concentration in men diagnosed with prostate cancer. Fifteen men with prostate cancer who did not receive prior therapy were randomised and given a daily supplement of 250 g refined wheat bread for two weeks and, afterwards, 250 g whole-grain rye bread for six weeks. Blood samples were taken from fasting men at baseline and after two and six weeks to measure the PSA and sex hormones. The dietary intake was: energy intake 3452 kcal; protein intake 166 g, carbohydrate intake 334 g, fat 149 g, saturated fat intake 52 g, and fibre intake 40 g. Plasma total PSA, free PSE, testosterone concentrations and free androgen index tended to be higher after refined white bread treatment and lower after whole-grain rye treatment. However, none of the differences were statistically significant. There were no significant changes in sex hormone binding globulin, luteinising hormone, and follicle stimulating hormone. In this intervention trial, whole-grain rye consumption did not result in significant changes in PSA and sex hormones, which may be related to high fat intake. Further prospective trials are indicated to evaluate the potential of whole-grain rye bread, taking into account other factors.
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    Eradication of damaged keratinocytes in cutaneous lichen planus forms demonstrated by evaluation of epidermal and follicular expression of CK15, indices of apoptosis and regulatory protein S100
    (2016) Upeniece, Ilze; Groma, Valērija; Skuja, Sandra; Cauce, Vinita; Department of Dermatology and Venereology; Joint Laboratory of Electron Microscopy; Institute of Anatomy and Anthropology; Department of Physics
    The study of cytoskeleton arrangement and its contribution to survival of cell-to-cell contacts appears to be essential for understanding of numerous cellular and tissue processes. Applying CK15, S100 labeling and TUNEL reaction to cutaneous lichen planus subtypes, we found CK15 expression in the outer and inner root sheath of hair follicles, the basal epidermal layer, and eccrine glands. Its follicular expression was decreased in nearby inflammatory infiltrates. The CK15 immu-nopositivity was mostly described as weak (92.3%) for lichen planus but equally subdivided into weak, moderate and strong in lichen planopilaris (χ2 = 32.514; df = 4; p < 0.001). The greatly varying apoptotic index was the highest in the lichen planopilaris involving the scalp: 81.2 ±10.7; 87.8 ±10.7 and 88.0 ±10.5 for the basal, spinous and upper epidermal layers, respectively. S100 positive epidermal and follicular cells did not differ in the lesions demonstrated in the study groups; still immunoreactivity was more pronounced in the scalp region of lichen planopilaris. Damage of cell-to-cell contacts was confirmed by electron microscopy. Apart from immunocyte-mediated keratinocyte death, cytoskeleton-based injury and loss of cell-to-cell and matrix contacts may be of great importance, leading to eradication of degrading cells and thus contributing to the pathogenesis of lichen planus.
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    Factors determining competitiveness in healthcare institutions in Latvia - Results of the EKOSOC-LV national research programme
    (2019) Villeruša, Anita; Behmane, Daiga; Kokarēviča, Anita; Berķis, Uldis; Cauce, Vinita; Rīga Stradiņš University; Department of Public Health and Epidemiology
    Competitiveness as a factor of a company selling its services in the market is becoming more relevant in the healthcare sector. The number of institutions that offer their services to international patients is growing. Research shows that the development of medical tourism is country-specific. The main objective of this publication is to discover positive and negative factors for engagement in the provision of services to non-residents. The data was obtained from a cross-sectional study in which 86 managers of health care institutions in Latvia completed a questionnaire. A total of 80.2% of health care institutions had provided services to non-resident patients in the previous year while 19.8% did so regularly. Institutions mainly used websites to advertise their services. Only a small number of institutions employed a marketing specialist or had a strategy to attract non-resident patients. Heads of institutions pointed to a number of internal and external barriers in this connection, including lack of staff, low motivation, limited language skills, inadequate infrastructure, insufficient state-level support to promote the export of services, the social environment, and problems in the health system itself. The study revealed areas that need to be improved regarding future policies to attract non-resident patients and to increase global competitiveness.
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    HLA Class II-DRB,-DQA and-DQB genotypes in peripheral blood shows shifts during the course of sepsis
    (2019-03-01) Bara, Linda; Eglite, Jelena; Ošs, Peteris; Cauce, Vinita; Lietuvietis, Vilnis; Viksna, Ludmila; Hagina, Elvira; Krumina, Angelika; Klīniskās imunoloģijas un imunoģenētikas starpkatedru laboratorija; Department of Physics; Department of Infectology
    Undeniably, sepsis is still a profoundly damaging and life-threatening condition for many individuals. With multiple changes in sepsis patients it is difficult to precisely classify an individual's response in sepsis as proinflammatory or immunosuppressed. The aim of this study was to investigate genetically determined predisposition to developed sepsis by analysis of distribution of human leukocyte antigen (HLA) class II genes. Samples from patients with sepsis were collected at Pauls Stradiņš Clinical University Hospital, Latvia, in an intensive care unit between October 2016 and May 2017. The study group included 62 patients with sepsis, who were genotyped for HLA-DR; DQ using real time polymerase chain reaction-sequence specific primer (RT PCR-SSP). As a control group, data of 100 individuals were taken from the genetic bank of RSU Joint Laboratory of Clinical Immunology and Immunogenetics. The summarised results showed that the frequency of alleles DRB1∗04:01 (OR = 5.54; 95% CI = 1.88-16.29); DRB1∗07:01 (OR = 19.03; 95% CI = 2/37-152.82); DQA1∗05:01 (OR = 14.17; 95% CI = 5.67-35.4); and DQB1∗02:01 (OR = 50.00; 95% CI = 2.90-861.81) were significantly increased in patients with sepsis compared to the control group patients. The frequency of DRB1∗16:01 (OR = 0.17, 95% CI = 0.04-0.59); DRB1∗17:01 (OR = 0.04; 95% CI = 0.00-0.69); DQA1∗01:01 (OR = 0.04; 95% CI = 0.00-0.31); DQA1∗01:02 (OR = 0.03; 95% CI = 0.00-0.23); DQB1∗02:02 (OR = 0.12; 95% CI = 0.03-0.42) alleles was lower in sepsis patients than in control subjects. The most frequent HLA-DRB1/DQA1/DQB1 haplotypes that was significantly increased in patients with sepsis were: DRB1∗01:01/DQA1∗05:01/DQB1∗03:01 (OR = 12.6; 95% CI = 1.51-105.0; p < 0.003). Sepsis patients with pneumonia and alleles and DRB1 04:01; 07:01, DQB1 02:01 had the highest mortality rate. Undoubtedly, our preliminary data showed that development of sepsis can be associated with alleles and haplotypes of HLA class II genes. For more precise conclusion the research should be continued to include a larger patient group.
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    Improving the recovery of patients with subacromial pain syndrome with the daid smart textile shirt
    (2020-09-15) Semjonova, Guna; Vetra, Janis; Cauce, Vinita; Oks, Alexander; Katashev, Alexei; Eizentals, Peteris; Department of Morphology; Faculty of Medicine; Statistics Unit
    Wearable technologies provide many possibilities for applications in medicine, and especially in physiotherapy, where tracking and evaluation of body motion are of utmost importance. Despite the existence of multiple smart garments produced for applications in physiotherapy, there is limited information available on the actual impact of these technologies on the clinical outcomes. The objective of this paper is to evaluate the impact of the Double Aid (DAid) smart shirt, a purely textile‐based system, on the training process of patients with subacromial pain syndrome. A randomized controlled trial was performed where patients with subacromial pain syndrome had to perform the assigned training exercises while employing the DAid smart shirt system. The core point of each exercise was to perform a movement while holding the shoulders stationary. The smart shirt was designed to sense even slight shoulder motion thus providing the patient with feedback on the accuracy of the motion, and allowing the patient to adjust the movement. The appropriate muscles should be strengthened through an increased effort to control the shoulder motion. The recovery of patients using the feedback system at the end of the treatment was compared to that of a reference group through standardized tests—the Disabilities of the Arm, Shoulder, and Hand score (DASH score), Closed Kinetic Chain Upper Extremity Stability test (CKCUES test), and internal/external rotation ratio. The test group that used the DAid system demonstrated significantly better results of the performed tests for all applied outcome measures compared to the reference group (p <0.001). An overall positive impact on the patient recovery was observed from the DAid smart shirt system when applied for rehabilitation training of patients with subacromial pain syndrome.
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    The Intake of Omega-3 Fatty Acids, the Omega-3 Index in Pregnant Women, and Their Correlations with Gestational Length and Newborn Birth Weight
    (2024-07) Nikolajeva, Ksenija; Aizbalte, Olga; Rezgale, Roberta; Cauce, Vinita; Zacs, Dzintars; Meija, Laila; Department of Doctoral Studies; Rīga Stradiņš University; Faculty of Medicine; Department of Public Health and Epidemiology
    Background: During pregnancy, the demand for omega-3 fatty acids, notably docosahexaenoic acid (DHA), escalates for both maternal and foetal health. Insufficient levels can lead to complications and can affect foetal development. This study investigated omega-3 status and its relation to dietary intake in pregnant Latvian women, along with its impact on gestational duration and newborn birth weight. Methods: The study comprised 250 pregnant and postpartum women with a mean age of 31.6 ± 4.8 years. Nutrition and omega-3 supplementation data were collected through a questionnaire covering 199 food items and 12 supplements. Fatty acids in erythrocyte membrane phospholipids were analysed via gas chromatography with flame ionization detection. Results: The median omega-3 fatty acid intake, including eicosapentaenoic acid (EPA) and DHA from diet and supplements, was 0.370 g/day, which is deemed sufficient. However, the median weekly fish intake (126.0 g) and daily nut/seed intake (7.4 g) were insufficient. The median omega-3 supplement intake was 1.0 g/day. No correlation between omega-3 supplement intake and the omega-3 index was observed. There was a weak correlation between the DHA intake from fish and the omega-3 index (r = 0.126, p = 0.047), while a significant correlation between the total EPA and DHA intake from various sources and the omega-3 index was noted (r = 0.163, p = 0.01). Most women (61.6%) had an omega-3 index < 4%, while 34.8% had an index between 4 and 8%, and only 3.6% had an index > 8%. Notably, significant differences in EPA levels and the omega-3 index were found among respondents with differing infant birth weights (p < 0.05). Conclusions: The omega-3 intake during pregnancy adheres to the established guidelines, although fish consumption remains insufficient. A preconception evaluation of the omega-3 index is advocated to optimize prenatal intake. The indications suggest potential correlations between EPA levels, the omega-3 index, and infant birth weight.
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    Iron Status in Pregnant Women in Latvia : An Epidemiological, Cross-Sectional, Multicenter Study According to WHO and UK Criteria
    (2022-07) Rezgale, Roberta; Pudule, Iveta; Cauce, Vinita; Klaramunta Antila, Kristine; Bule, Violeta; Lazdane, Gunta; Rezeberga, Dace; Meija, Laila; Faculty of Medicine; Rīga Stradiņš University
    Background and Objectives: During pregnancy, iron deficiency anaemia is a common problem associated with health risks for both the mother and her foetus/infant. This study aimed to investigate the prevalence of iron deficiency, iron deficiency anaemia, and related dietary patterns in pregnant women in Latvia. Materials and Methods: This cross-sectional, multicentre study included pregnancy data from 974 women. The sample selection was based on the stratification principle (population of women of childbearing age in regions of Latvia). Maternal demographic details, anthropometric measurements, iron status, dietary patterns, and supplementation information were obtained from maternal files and during interviews held in eight outpatient departments of medical institutions and maternity departments. The prevalence was assessed. Chi-square tests and logistic regression were used to identify associations between iron deficiency and sociodemographic characteristics, dietary patterns, and iron supplement intake during pregnancy. The criterion used for the diagnosis of iron deficiency anaemia is a Hb level < 110 g/L in the 1st and 3rd trimesters and <105 g/L during the 2nd trimester as recommended by the WHO. However, the UK guideline was used for borderline iron deficiency, which is an SF level < 30 μg/L in all trimesters. Results: The observed prevalence of anaemia was 2.8% in the first trimester, 7.9% in the second trimester, and 27.0% in the third trimester. The prevalence of iron deficiency was 46.7% in the first trimester, 78.1% in the second trimester, and 91.7% in the third trimester. No associations with dietary patterns were found. Single women had 1.85 times the odds (95% CI 1.07 to 3.18) of being anaemic than married women. Conclusions: Iron deficiency affects a large proportion of pregnant women in Latvia in all trimesters, with iron deficiency anaemia affecting pregnant women in the third trimester. Monitoring and intervention should be performed in a timely and more targeted manner.
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    Latvian health care competitiveness in relation to its infrastructure and available resources
    (EDP Sciences, 2018-12-31) Kokarevica, Anita; Villerusa, Anita; Behmane, Daiga; Berkis, Uldis; Cauce, Vinita; Berkis, U.; Vilka, L.; Rīga Stradiņš University
    Resources are one of the essential indicators for the functioning of the health care system. Better health care provision is an essential prerequisite for the export of services. Traditionally a competitive health care system is linked to a number of factors (price, quality, reliability, products and services) largely determined by the new technologies, innovations and implementation the new methods. The authors of this article analyzed and collected data from the European Commission Eurostat and OECD data. Current situation in health care in Latvia is characterized by populations’ restricted access to health care services, high out-of-pocket payments and poor health outcomes of the population. More than 10% of Latvian population can’t afford medical care. The ratio of public funding for healthcare in Latvia is among the lowest in EU countries. Latvia spends 5.3% (USD PPP 1217) of GDP on health, lower than the OCED country average of 8.9% (USD PPP 3453). Latvia is facing a dramatic gap between the availability of hospital beds and long term care beds and the lowest prevalence of general medical practitioners among all Baltic States 321.6 per 100 000. These mentioned factors may hinder the development of health care in Latvia and reduce the ability to participate in international health service market.
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    Longitudinal Analysis of Latvian Child Growth : Anthropometric Parameters Dynamics from Birth to Adolescence
    (2024-04-03) Umbraško, Silvija; Martinsone-Berzkalne, Liene; Plavina, Liana; Cauce, Vinita; Edelmers, Edgars; Starikovs, Aleksandrs; Vetra, Janis; Institute of Anatomy and Anthropology; Statistics Unit
    This study provides a comprehensive analysis of the physical development patterns from birth to adolescence, utilizing a longitudinal dataset of 70 children monitored from birth until 17 years of age. The research focuses on the variability of growth trajectories, emphasizing the role of genetic and environmental factors in influencing these patterns. Key findings indicate that most children undergo one or two periods of accelerated growth, with significant variability in the timing and magnitude of these growth spurts. The study also highlights the adaptive nature of growth changes over generations, influenced by ecological, nutritional, and socio-economic conditions. The longitudinal approach reveals critical insights into the timing of peak growth velocities, demonstrating that girls reach their growth peak approximately one year earlier than boys. The analysis of intergenerational growth patterns suggests a significant increase in average height over the century, attributed to genetic diversity and changes in lifestyle and nutrition. This study’s findings emphasize the importance of updating physical development standards regularly to reflect the changing genetic and environmental landscape. The variability in growth patterns and their correlation with health outcomes in later life highlights the need for targeted public health strategies that address the underlying socio-economic and environmental determinants of health. This research contributes to the understanding of physical development trajectories and provides a foundation for future studies aimed at optimizing health outcomes from early childhood through adolescence. The primary objective of this article is to meticulously analyze the dynamics of height growth and accurately identify the periods of accelerated bodily development within the context of longitudinal research.
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    Milk as an essential source of iodine in Latvian population
    (2017-12) Neimane, Lolita Vija; Konrade, Ilze; Avotiņa, Gita; Klaviņa, Aneka; Zagorska, Jeļena; Martinsone, Inese; Cauce, Vinita; Kalere, Ieva; Baylon, Vincenzo; Lejnieks, Aivars; Department of Sports and Nutrition; Department of Internal Diseases; Laboratory of Hygiene and Occupational Diseases; Department of Physics
    Milk and dairy products are studied as alternative iodine sources, because salt iodisation is controversial due to high salt consumption leading to cardiovascular diseases. However, the iodine concentration in milk markedly varies. This study evaluated the iodine concentration in cow's milk available in the Latvian market. Iodine and fat concentration was analysed with a spectrophotometer "Varian Cary 50" based ISO 2446:2008 in 20 milk samples. Data from the Central Statistical Bureau and survey among pregnant women were used to analyse milk product consumption and its impact on iodine status. Average iodine concentration in milk samples was 457.6 (179.6) μg/L, winter samples had a higher concentration of iodine than summer samples: 563.4 (329.6) μg/L and 469.2 (162.0) μg/L, but this is not statistically significant p < 0.05. Iodine concentration in skimmed milk was 490 μg/L, milk with the reduced fat content 501.7 (174.8) μg/L, and whole milk - 422.6 (192.1)1 μg/L. Milk consumption decreased from 2002 to 2014, while yogurt and cheese consumption increased. Higher consumption of milk and milk products was related to higher urinary iodine concentration ρ = 0.115; p = 0.003. Milk and milk products are an important iodine source in Latvia and their consumption should be promoted.
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    Severe Sepsis-Clinical Manifestations and Pharmaco-Economic Analysis in an Intensive Care Unit in Latvia
    (2016-08-01) Bridina, Linda; Krūmiņa, Angelika; Šuba, Olegs; Cauce, Vinita; Vanags, Indulis; Viksna, Ludmila; Department of Infectology; Department of Physics; Department of Anaesthesiology, Intensive Care and Clinical simulations
    Sepsis is widespread among hospitalised patients worldwide. In fact, severe sepsis and septic shock is a major cause of patient admission and mortality in intensive care units and the difficulty in diagnosing the initial stage of the disease is a major obstacle to the reduction of mortality from sepsis. Retrospective analysis of medical records of 72 patients was carried out within the framework of the study. The study included patients of both sexes and all ages, who were hospitalised at the stationary "Gaiezers" of the Riga East Clinical University Hospital from 2011 to 2014. The study aim was to determine the clinical course of treated septic patients and conduct a pharmaco-economic analysis. In the course of the disease, almost half of the patients-34 (48.6%) showed development of septic shock. Mortality in these patients exceeded a half (60.0%; 21 patients). Artificial lung ventilation during hospitalisation was received by 43 (59.7%) of patients. Artificial lung ventilation had been required in a significantly larger number of cases in the dead patient group (75%, p = 0.01). The average costs per one patient day (including bed-day price and manipulation costs) was 383 euros. Septic shock was associated with high mortality. Severe sepsis is an expensive diagnosis, as the average cost of one patient exceeds costs of other departments by 4.5 times.
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    Vitamin D Intake and Serum Levels in Pregnant and Postpartum Women
    (2023-08) Meija, Laila; Piskurjova, Anna; Nikolajeva, Ksenija; Aizbalte, Olga; Rezgale, Roberta; Lejnieks, Aivars; Cauce, Vinita; Department of Sports and Nutrition; Department of Public Health and Epidemiology; Department of Doctoral Studies; Department of Internal Diseases
    Maternal vitamin D deficiency, which is highly prevalent in pregnant women in Europe, is linked to adverse health effects for both the mother and child. The objective was to assess vitamin D status in pregnant women by evaluating their dietary and supplemental vitamin D intake, serum vitamin D levels, parathyroid hormone levels, and lifestyle factors. This cross-sectional study, with a total of 735 participants (145 pregnant and 590 up to the seventh day postpartum), took place in Latvia. Blood samples, a food frequency questionnaire, and medical documentation were used for data collection. The median serum vitamin D concentration was 34.0 ng/mL, with pregnant women having higher levels (42.9 ng/mL) than postpartum women (31.8 ng/mL). There was no association between vitamin D serum concentration and dietary intake of vitamin D (p > 0.05), whereas there was a significant correlation with use of vitamin D supplements (r = 0.41; p < 0.001 in pregnant women and r = 0.35; p < 0.001 in postpartum women). This study demonstrated that a minority of pregnant women (21.9%) had optimal serum vitamin D concentration (>45 ng/mL), and diet had no significant impact on vitamin D levels. Thus, our proposed recommendation for vitamin D intake during pregnancy was 63 mcg (2500 IU) year-round for optimal levels in pregnant women in Northeastern Europe.