Assessment of Health-care Professional’s Knowledge Regarding the Comorbidities of Vitamin D Deficiency and its Relationship with Uterine Fibroids


  • Bayan Omar Sharif Department of Scientific, College of Nursing, University of Sulaimani, Kurdistan Region, Iraq
  • Syamnd Mirza Abdullah Department of Information Technology, Koya Technical Institute, Erbil Polytechnique University, Erbil, Iraq
  • Sarwar Arif Star Department of Health and Molecular Biology, Kurdistan Institution for Strategic Studies and Scientific Research, Sulaimani, Kurdistan Region, Iraq
  • Hadeel Abdulelah Ibrahim Department of Basic Science, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq
  • Hawar Mardan Muhammad Department of Hematology, Hiwa Hospital, Sulaimani, Kurdistan Region, Iraq
  • Zhino Raouf Ali Health Development and Training Center, Sulaimani, Kurdistan Region, Iraq
  • Hussein Mustafa Hamasalih Department of Nursing, Smart Private Hospital, Sulaimani, Kurdistan Region, Iraq



Vitamin D deficiency is a widespread global health issue, notably prevalent in the Middle East and more severe in women. Vitamin D deficiency increases the incidence of uterine fibroids in black and white women, the most frequent benign gynecologic malignancies. This study examined health-care providers’ understanding of the relationship between vitamin D insufficiency and uterine fibroid at Sulaimani Hospitals in Kurdistan, Iraq. A quantitative design, cross-sectional-descriptive study (non-probability purposive sample) of 113 female nurses and gynecologists. Data were collected using a checklist through Google Forms. The results showed that the majority of the participants were nurses (88.5%), and the remaining (11.5%) were gynecologist. Two-thirds of them work in maternity teaching hospital while others work in smart hospitals and Faroq medical cities. The results revealed that the level of knowledge was significantly associated with the position of participants and level of education (P < 0.05). As well, the study demonstrated that the majority of the participants were not trained regarding uterine fibroid and vitamin D deficiency. The study concluded that nearly a quarter of the health-care professionals had a medium level of knowledge, while nearly a quarter (24.8%) of them had a high level of knowledge. The study recommended to the Ministry of Health giving opportunities to health-care professionals, especially nurses, to participate in training courses, workshops, and conferences regarding the relationship between vitamin D deficiency and uterine fibroid.


B. Sheng, Y. Song, Y. Liu, C. Jiang and X. Zhu. “Association between vitamin D and uterine fibroids: A study protocol of an open-label, randomised controlled trial”. BMJ Open, vol. 10, no. 11, p. e038709, 2020.

W. Guo, M. Dai, Z. Zhong, S. Zhu, G. Gong, M. Chen, J. Guo and Y. Zhang. “The association between vitamin D and uterine fibroids: A mendelian randomization study”. Frontiers in Genetics, vol. 13, p. 1013192, 2022.

S. Christakos, D. V. Ajibade, P. Dhawan, A. J. Fechner and L. J. Mady. “Vitamin D: Metabolism”. Rheumatic Disease Clinics of North America, vol. 38, no. 1, pp. 1-11, 2012.

M. Chakhtoura, M. Rahme, N. Chamoun and G. E. H. Fuleihan. “Vitamin D in the Middle East and North Africa”. Bone Reports, vol. 8, pp. 135-146, 2018.

M. F. Holick. “Vitamin D deficiency”. The New England Journal of Medicine, vol. 357, pp. 266-281, 2007.

M. Ciebiera, M. Włodarczyk, M. Ciebiera, K. Zaręba, K. Łukaszuk and G. Jakiel. “Vitamin D and uterine fibroids-review of the literature and novel concepts”. International Journal of Molecular Sciences, vol. 19, p. 2051, 2018.

T. Kalampokas, M. Kamath, I. Boutas and E. Kalampokas. “Ulipristal acetate for uterine fibroids: A systematic review and meta-analysis”. Gynecological Endocrinology, vol. 32, no. 2, pp. 91-96, 2016.

F. J. Oindiand and M. A. Mwaniki. “Uterine fibroids: Clinical presentation”. In: Leiomyoma. IntechOpen, London, 2019.

M. Hajhashemi, M. Ansari, F. Haghollahi and B. Eslami. “The effect of vitamin D supplementation on the size of uterine leiomyoma in women with vitamin D deficiency”. Caspian Journal of Internal Medicine, vol. 10, no. 2, p. 125, 2019.

B. O. Sharif, S. H. Salih, N. A. Sailh and B. I. Salim. “Nurses’ knowledge regarding cardiac catheterization at general hospital in Rania City”. Kurdistan Journal of Applied Research, vol. 3, pp. 183- 187, 2018.

E. A. Stewart, C. L. Cookson, R. A. Gandolfo and R. Schulze-Rath. “Epidemiology of uterine fibroids: A systematic review”. BJOG, vol. 124, no. 10, pp. 1501-1512, 2017.

M. S. Drayer and W. H. Catherino. “Prevalence, morbidity, and current medical management of uterine leiomyomas”. International Journal of Gynecology and Obstetrics, vol. 131, no. 2, pp. 117-122, 2015.

W. H. Catherino, H. M. Eltoukhi and A. Al-Hendy. “Racial and ethnic differences in the pathogenesis and clinical manifestations of uterine leiomyoma”. Seminars in Reproductive Medicine, vol. 31, no. 5, pp. 370-379, 2013.

D. Pavone, S. Clemenza, F. Sorbi, M. Fambrini and F. Petraglia. “Epidemiology and risk factors of uterine fibroids”. Best Practice and Research Clinical Obstetrics and Gynaecology, vol. 46, pp. 3-11, 2018.

J. L. Bacon. “The menopausal transition”. Obstetrics and Gynecology Clinics of North America, vol. 44, no. 2, pp. 285-296, 2017.

J. Ying, D. Nie and S. Chen. “The relationship between the use of oral contraceptives and the risk of uterine leiomyoma in women of child bearing age of Han Chines”. Pharmaceutical Bioprocessing, vol. 6, pp. 48-52, 2018.

D. Al-Jaroudi, N. Al-Banyan, N. J. Aljohani, O. Kaddour and M. Al-Tannir. “Vitamin D deficiency among subfertile women: Case-control study”. Gynecological Endocrinology, vol. 32, no. 4, pp. 272-275, 2016.

R. Boynton-Jarrett, J. W. Rich-Edwards, H. J. Jun, E. N. Hibert and R. J. Wright. “Abuse in childhood and risk of uterine leiomyoma: The role of emotional support in biological resiliency”. Epidemiology, vol. 22, no. 1, pp. 6-14, 2011.

S. K. Laughlin, J. C. Schroeder and D. D. Baird. “New directions in the epidemiology of uterine fibroids”. Seminars in Reproductive Medicine, vol. 28, no. 3, pp. 204-217, 2010.

A. I. Vines, M. Ta and D. A. Esserman. “The association between self-reported major life events and the presence of uterine fibroids”. Women’s Health Issues, vol. 20, no. 4, pp. 294-298, 2010.

L. B. Andersen, J. S. Jørgensen, T. K. Jensen, C. Dalgård, T. Barington, J. Nielsen, S. S. Beck-Nielsen, S. Husby, B. Abrahamsen, R. F. Lamont and H. T. Christesen. “Vitamin D insufficiency is associated with increased risk of first-trimester miscarriage in the Odense child cohort”. The American Journal of Clinical Nutrition, vol. 102, no. 3, pp. 633-638, 2015.

K. F. Faridi, J. R. Lupton, S. S. Martin, M. Banach, R. Quispe, K. Kulkarni, S. R. Jones and E. D. Michos. “Vitamin D deficiency and non-lipid biomarkers of cardiovascular risk”. Archives of Medical Science, vol. 13, no. 4, pp. 732-737, 2017.

P. Skowrońska, E. Pastuszek, W. Kuczyński, M. Jaszczoł, P. Kuć, G. Jakiel, I. Wocławek-Potocka and K. Łukaszuk. “The role of vitamin D in reproductive dysfunction in women-a systematic review”. Annals of Agricultural and Environmental Medicine, vol. 23, no. 4, pp. 671-676, 2016.

B. M. Gruber-Bzura. “Vitamin D and influenza-prevention or therapy?” International Journal of Molecular Sciences, vol. 19, no. 8, p. 2419, 2018.

M. Ciebiera, M. Włodarczyk, A. Słabuszewska-Jóźwiak, G. Nowicka and G. Jakiel. “Influence of vitamin D and transforming growth factor β3 serum concentrations, obesity, and family history on the risk for uterine fibroids”. Fertility and Sterility, vol. 106, no. 7, pp. 1787-1792, 2016.

R. Bradley, J. Schloss, D. Brown, D. Celis, J. Finnell, R. Hedo, V. Honcharov, T. Pantuso, H. Peña, R. Lauche and A. Steel. “The effects of vitamin D on acute viral respiratory infections: A rapid review”. Advances in Integrative Medicine, vol. 7, no. 4, pp. 192- 202, 2020.

X. Cui, J. J. McGrath, T. H. Burne and D. W. Eyles. “Vitamin D and schizophrenia: 20 years on”. Molecular Psychiatry, vol. 26, no. 7, pp. 2708-2720, 2021.

L. M. Bodnar, M. A. Krohn and H. N. Simhan. “Maternal vitamin D deficiency is associated with bacterial vaginosis in the first trimester of pregnancy”. The Journal of Nutrition, vol. 139, no. 6, pp. 1157-1161, 2009.

P. Azize, F. Tahir and J. Kelsey. “Nurses’ knowledge and role in the management of thalassemic patients in Sulaimania thalassemia center”. Iraqi National Journal of Nursing Specialties, vol. 28, no. 2, pp.59-70, 2015.

A. L. Harris. “Vitamin D deficiency and bacterial vaginosis in pregnancy”. Nursing for Women’s Health, vol. 15, no. 5, pp. 423- 430, 2011.

S. W. Chang and H. C. Lee. “Vitamin D and health-the missing vitamin in humans”. Pediatrics and Neonatology, vol. 60, no. 3, pp. 237-244, 2019.

P. Bordelon, M. V. Ghetu and R. C. Langan. “Recognition and management of vitamin D deficiency”. American Family Physician, vol. 80, no. 8, pp. 841-846, 2009.

Z. Han, S. L. Margulies, D. Kurian and M. S. Elliott. “Vitamin D deficiency in patients with pancreatitis: Is vitamin D replacement”. Pancreatic Disorders and Therapy, vol. 6, p. 172, 2016.

T. Halder, R. Dastidar, S. Bhattacharya and D. Maji. “Prevalence of hashimoto’s thyroiditis and its association with vitamin D deficiency in West Bengal, India”. British Journal of Medicine and Medical Research, vol. 12, pp. 1-10, 2016.

K. Robien, S. J. Oppeneer, J. A. Kelly and J. M. Hamilton-Reeves. “Drug-vitamin D interactions: A systematic review of the literature”. Nutrition in Clinical Practice, vol. 28, no. 2, pp. 194-208, 2013.

A. Zittermann, S. S. Schleithoff and R. Koerfer. “Vitamin D and vascular calcification”. Current Opinion in Lipidology, vol. 18, no. 1, pp. 41-46, 2007.

A. T. Khan, M. Shehmar and J. K. Gupta. “Uterine fibroids: Current perspectives”. International Journal of Women’s Health, vol. 6, pp. 95-114, 2014.



How to Cite

Sharif, B. O., Abdullah, S. M., Star, S. A., Ibrahim, H. A., Muhammad, H. M., Ali, Z. R., & Hamasalih, H. M. (2024). Assessment of Health-care Professional’s Knowledge Regarding the Comorbidities of Vitamin D Deficiency and its Relationship with Uterine Fibroids. UHD Journal of Science and Technology, 8(1), 31–41.