Since we first described rickets in Kingdom of Saudi Arabia,
a country with a high sun factor, in 1980, reports have
been made from other parts of the country but not from
the north-west (Almadinah Almunawwarah Region).1–5 We
therefore decided to study the factors associated with rickets
and its presentation in Almadinah Almunawwarah to complete
the analysis. The study was conducted in the Maternity
and Children’s Hospital Almadinah Almunawarrah, a
400-bed hospital and the main pediatric referral hospital
in the region. As we found rickets in infants at a mean
age of 10 months in the Riyadh region, we proposed that
maternal vitamin D deficiency is a major factor in the pathogenesis
of rickets in breastfed infants. We confirmed this
hypothesis by reporting vitamin D deficiency in the mothers
of rachitic infants.6 Further, we found that the concentration
of 25-hydroxyvitamin D (25OHD) in the cord blood
of newborns and their mothers was low, although cord
blood calcium was higher than that of the mothers.7–10 Another
study in Riyadh confirmed our findings, showing a
drop in calcium level in the infants of vitamin D-deficient
mothers on the seventh day of life.11 The aim of the study
reported here was to investigate the factors associated with
vitamin D deficiency in all regions of Kingdom of Saudi
Arabia.