الفهرس 
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Abstract
SUMMARY
Miscarriage is the most common adverse outcome of pregnancy, with a reported prevalence of 12–20%.
Miscarriage is multifactorial of origin, with acquired or environmental factors probably exceeding genetic factors in its causation. Identifying modifiable risk factors for miscarriage is potentially important for public health.
Vitamin D status during pregnancy has been drawing great attention. Today, vitamin D is thought to have multiple functions beyond its role(s) in bone health (due to maintaining calcium homeostasis and promoting bone mineralization
Recently, vitamin D nuclear receptors (VDR) have been identified in numerous tissues including organs involved in the reproduction and infant growth such as the ovary, testis, placenta and mammary gland
There is some evidence suggesting that it modulates human reproductive processes. In addition, it has significant roles in regulating cell proliferation and differentiation and modulating innate and adaptive immune responses.
This nested case control study aimed to assess the relationship between vitamin D deficiency in gravid women and pregnancy loss in the first trimester. The primary outcome was the relation between vitamin d level and pregnancy loss. While secondary outcome was the relation between vitamin d deficiency and obesity.
All women were subjected Detailed history (personal, present, obstetric, menstrual, family, medical and surgical), Examination (general, abdominal and local), Body mass index (BMI) calculation, gestational determination Vitamin d assessment.
from the 258 cases that passed first trimester without abortion, 40 cases were randomly included as a control group.
Our results showed that;
The abortion group was significantly older and BMI was significantly higher than control group as p<0.001 &0.007.
The mean value of 25(OH)D was significantly lower among abortion group (21.0±8.5) than control group (26.5±8.3) as p=0.005. And the majority of abortion group (42.5%) had 25(OH)D deficiency while (40.0%)&(17.5%) of cases had either 25(OH)D insufficiency or sufficiency which significantly different than control group (p=0.049)
AT age at cut off≥32.0, BMI at cut off ≥26.0 and 25(OH) D at cutoff ≤24.5 had significant moderate diagnostic performance in predicting abortion. Age ≥32.0 (years), BMI ≥26.0 (kg/m2) and 25(OH) D ≤24.5 (ng/mL) had moderate diagnostic characteristics in predicting abortion. Age ≥32.0 (years), BMI ≥26.0 (kg/m2) and 25(OH) D ≤24.5 (ng/mL) were significant predictors of increased the likelihood of first-trimesteric abortion.
CONCLUSION
Although Egypt is a country with abundant sunshine all year round, majority of pregnant females had vitamin D deficiency and insufficiency.
1. Vitamin D deficiency had a role in spontaneous abortion.
2. Vitamin D level not related to the BMI.
RECOMMENDATIONS
Vitamin D is a modifiable risk factor for early pregnancy loss
So, it is recommended to:
1. Measure and correct vitamin d level preconceptional.
2. Encourage women to be exposed to sun light twice weekly for 20 minutes.
3. Strict adherence to daily oral intake of recommended dose of vitamin D starting early in pregnancy.