Sheltered lifestyle could be causing childhood rickets

More pregnant women may be Vitamin D deficient than previously thought, putting their unborn child at risk of rickets.

A study of 90 pregnant women who attend Newtown Medical Health Services in Wellington has found 87 per cent vitamin D deficient, with 61 per cent severely deficient in the vitamin.

The study, which appears in this week's New Zealand Medical Journal, highlights the magnitude of vitamin D deficiency among pregnant women.

The study, authored by Wellington Hospital endocrinologist Dr Carl Eagleton and Newtown Medical Health Services GP Dr Annie Judkins, was prompted by anecdotal reports of an increase in childhood rickets in southeast Wellington. Newtown, a small primary healthcare organisation, has had 10 cases of childhood rickets over the past three years.

The PHO, which caters to a diverse population, found vitamin D deficiency to be prevalent across almost all ethnic groups, regardless of whether subjects wore veils, or were dark-skinned - two risk factors.

Even among pregnant women of European descent, vitamin D deficiency was found in 67 per cent of those studied.

Only 22 per cent of subjects wore veils, while just over a third of the subjects lived in apartments, limiting any links to sunlight exposure and their ability to sit outside for periods of time.

All the vitamin D-deficient women studied received supplementation in the form of a vitamin D2 tablet.

Dr Cameron Grant, a paediatrician at the Starship children's hospital in central Auckland, said while vitamin D deficiency was not uncommon, he was surprised at how prevalent the study showed it to be.

A four-year study led by Dr Grant found 10 per cent of Auckland infants do not get enough vitamin D. There were also varying levels of deficiencies in other nutrients.

He was recently awarded $150,000 by the Health Research Council for a pilot study aiming to prevent childhood illnesses through early life nutrition supplementation.

As well as building healthy bones, vitamin D is crucial to immunity, he said.

Studies have linked a D-deficiency to increased susceptibility to pneumonia. "Our lifestyle is perhaps more indoors than it was a generation ago," Dr Grant said.

Sunlight remains the simplest way to get vitamin D, and getting a healthy dose without the associated risks was possible in the morning and late afternoon, he said.


Kids' disease

* Softening and weakening of the bones in children caused by severe and prolonged vitamin D deficiency

* Signs of rickets include bowed legs, leg fractures, and impaired growth

* Medical problems seen in children with rickets include skeletal deformity, growth disturbance and uncontrolled muscle spasms

* Replacing vitamin D eliminates most symptoms, although positioning or bracing may be used to reduce or prevent deformities. Some skeletal deformities require corrective surgery