Maternal and Pediatric Health Outcomes in relation to Gestational Vitamin D Sufficiency

Abstract

Juxtaposed with monumental improvement in maternal-fetal outcomes over the last century, there has been the recent emergence of rising rates of gestational complications including preterm birth, operative delivery, and gestational diabetes. At the same time, there has been a burgeoning problem with widespread vitamin D deficiency among populations of many developed nations. This paper provides a brief review of potential health outcomes recently linked to gestational vitamin D deficiency, including preterm birth, cesarean delivery, and gestational diabetes. Although immediate costs for obstetric complications related to gestational vitamin D insufficiency may be modest, the short- and long-term costs for pediatric healthcare resulting from such gestational complications may be enormous and present an enduring burden on healthcare systems. With increasing evidence pointing to fetal origins of some later life disease, securing vitamin D sufficiency in pregnancy appears to be a simple, safe, and cost-effective measure that can be incorporated into routine preconception and prenatal care in the offices of primary care clinicians. Education on gestational nutritional requirements should be a fundamental part of medical education and residency training, instruction that has been sorely lacking to date.

Estimated economic benefit of increasing 25-hydroxyvitamin D concentrations of Canadians to or above 100 nmol/L

“…“The currently available results indicate that vitamin D supplementation during pregnancy reduces the risk of preterm birth, low birth weight, dental caries of infancy, and neonatal infectious diseases such as respiratory infections and sepsis.” 81 Furthermore, with unfolding research into fetal origins of pediatric and adult disease, evidence increasingly indicates that gestational vitamin D indices may determine health in later life 82 . For example, an interesting cohort study correlating maternal vitamin D levels at 18 weeks' pregnancy and health outcomes of progeny found that gestational vitamin D deficiency was associated with a higher risk of impaired lung development in 6-year-old offspring, neurocognitive difficulties at age 10 years, increased risk of eating disorders in adolescence, and lower peak bone mass at 20 y 83 …”

Serum 25(OH) Vitamin D Levels in Polish Women during Pregnancies Complicated by Hypertensive Disorders and Gestational Diabetes

“…Principal risk factors of GDM include older age at conception and obesity. According to literature, a growing proportion of women decide to get pregnant at an older age, and the average age of getting pregnant is still increasing [21,22]. Metabolic disorders associated with GDM may negatively affect fetal development, which typically results in macrosomia, complicated labor, and perhaps also some postnatal complications related to fetal programming [23].…”

“…Although the biological role of vitamin D has been studied extensively, the consequences of its deficiency for maternal, fetal and neonatal health are still unclear [4,22,24]. The aim of this study was to determine serum concentrations of 25(OH)D in Polish women with uncomplicated pregnancies and pregnancies complicated by hypertension, preeclampsia and diabetes mellitus.…”

Role of Vitamin D in the Hygiene Hypothesis: The Interplay between Vitamin D, Vitamin D Receptors, Gut Microbiota, and Immune Response

“…To date, multiple studies have reported that maternal vitamin D insufficiency and deficiency can also lead to child allergies (55, 56), eczema, asthma (57), and autoimmune diseases (58–60). Maternal serum 25(OH)D 3 levels can directly affect infant vitamin D levels and immune programing (54, 61), and interestingly 1,25(OH) 2 D 3 , can cross the placenta and enter the fetal cord blood (39).…”