Vitamin D in pregnancy‐time for action: a paediatric audit

Sharma, Sushmita; Khan, Nasiruddin; Khadri, A; Julies, P; Gnanasambandam, S; Saroey, S; Jacobs, Benjamin; Beski, S.; Coren, M; Alexander, Suzanne

doi:10.1111/j.1471-0528.2009.02285.x

Cited by 13 publications

(8 citation statements)

References 6 publications

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“…Neonatal vitamin D status is highly related to the amount of transfused vitamin D through placenta and its levels at birth [34] and maternal vitamin D deficiency causes vitamin D deficiency in infants [35]. The findings of the present study also confirm this relationship; serum levels of 25-hydroxyvitamin D in mothers and infants had a significant correlation within both exposed and non-exposed groups [5,33,34,36,37].…”

Section: Discussionsupporting

confidence: 82%

The effect of cigarette smoke exposure on vitamin D level and biochemical parameters of mothers and neonates

Banihosseini

Baheiraei

Shirzad

et al. 2013

J Diabetes Metab Disord

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BackgroundExposure to cigarette smoke during pregnancy leads to several adverse effects on mother and child. The purpose of this study was to evaluate the effect of being a passive smoker during pregnancy on vitamin D level and related biochemical indices including parathyroid hormone, calcium, phosphorus and alkaline phosphatase in mothers and newborns.MethodsOne hundred eight pregnant women and their newborns participated in a historical cohort study in two equal groups (n = 54) with and without cigarette smoke exposure. Maternal blood and urine samples and blood samples of umbilical cord were obtained in the delivery room. Concentration of 25-hydroxy vitamin D and related biochemical indices in samples of maternal and cord blood were investigated. Exposure to cigarette smoke was evaluated through questionnaire and maternal urine and umbilical cord serum cotinine levels.ResultsThe mean level of 25-hydroxyvitamin D in maternal serum was 9.28 ± 5.19 ng/mlin exposed and 10.75 ± 5.26 ng/ml in non-exposed group(p > 0.05). The mean concentration of 25-hydroxy vitamin D in cord serum was 10.83 ± 6.68 ng/ml in the exposed and 11.05 ± 4.99 ng/ml in the non-exposed group(p > 0.05). The exposed mothers had significantly higher parathyroid hormone level (p = 0.013), lower serum calcium (p = 0.024) and higher serum alkaline phosphatase (p = 0.024). There was a significant correlation between maternal and umbilical cord serum 25-hydroxyvitamin D within both exposed and non-exposed groups (p < 0.001).ConclusionMaternal exposure to cigarette smoking during pregnancy negatively influences serum calcium level and increase parathyroid hormone and alkaline phosphatase in mothers.

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Section: Discussionsupporting

confidence: 82%

The effect of cigarette smoke exposure on vitamin D level and biochemical parameters of mothers and neonates

Banihosseini

Baheiraei

Shirzad

et al. 2013

J Diabetes Metab Disord

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“…Vitamin D deficiency itself is common during pregnancy in the European and North American populations [4]–[6] and is associated with complications during the perinatal period [2] [7].…”

Section: Introductionmentioning

confidence: 99%

Maternal Vitamin D Status in Preeclampsia: Seasonal Changes Are Not Influenced by Placental Gene Expression of Vitamin D Metabolizing Enzymes

et al. 2014

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Preeclampsia, a hypertensive disorder in pregnancy develops in 2–8% of pregnancies worldwide. Winter season and vitamin D deficiency have been associated with its onset.ObjectiveTo investigate the influence of season on maternal vitamin D status and placental vitamin D metabolism.Methods25-OH vitamin D and 1,25-(OH)2 vitamin D were measured in maternal serum obtained during the winter or summer months from 63 pregnant women at delivery (43 healthy, 20 preeclampsia). In a subgroup, mRNA expression of CYP24A1 (24-hydroxylase), CYP27B1 (1α-hydroxylase) and VDR (vitamin D receptor) were quantified by real time PCR in placental samples of 14 women with normal pregnancies and 13 with preeclampsia.ResultsIn patients with preeclampsia,25-OH vitamin D levels were lower, but differed significantly from controls only in summer (18.21±17.1 vs 49.2±29.2 ng/mL, P<0.001), whereas 1,25-(OH)2 vitamin D levels were significantly lower only in winter (291±217 vs 612.3±455 pmol/mL, P<0.05). A two-factorial analysis of variance produced a statistically significant model (P<0.0001) with an effect of season (P<0.01) and preeclampsia (P = 0.01) on maternal 25-OH vitamin D levels, as well as a significant interaction between the two variables (P = 0.02). Placental gene expression of CYP24A1, CYP27B1, and VDR did not differ between groups or seasons. A negative correlation between placental gene expression of CYP24A1 and CYP27B1 was observed only in healthy controls (r = −0.81, P<0.0001).SummaryPatients with preeclampsia displayed lower vitamin D serum levels in response to seasonal changes.The regulation of placental CYP24A1, but not of the VDR or CYP27B1 might be altered in preeclampsia.

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“…Concentrations above 50 nmol/L are considered normal, but there is debate about the level of this threshold12 because although only lower levels are usually associated with clinical disease such as rickets, the optimal level for bone health may be above 50 nmol/L. A low vitamin D level in children and adolescents is common enough to be an important public health issue globally across a range of latitudes, including the United Kingdom,13 14 other European countries,15 16 17 18 19 20 the United States,21 Lebanon,22 Australia,23 24 and New Zealand 1125 26 Overt vitamin D deficiency leads to rickets, and subclinical vitamin D deficiency may also affect bone mineralisation, as assessed by dual x ray absorptiometry 15…”

Section: Introductionmentioning

confidence: 99%

Effects of vitamin D supplementation on bone density in healthy children: systematic review and meta-analysis

Winzenberg

Powell

Shaw

et al. 2011

BMJ

209

113

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Objective To determine the effectiveness of vitamin D supplementation for improving bone mineral density in children and adolescents and if effects vary with factors such as vitamin D dose and vitamin D status. Design Systematic review and meta-analysis. Data sources Cochrane Central Register of Controlled Trials, Medline (1966 to present), Embase (1980 to present), CINAHL (1982 to present), AMED (1985 to present), and ISI Web of Science (1945 to present), last updated on 9 August 2009, and hand searching of conference abstracts from key journals. Study selection Placebo controlled randomised controlled trials of vitamin D supplementation for at least three months in healthy children and adolescents (aged 1 month to <20 years) with bone density outcomes. Two authors independently assessed references for inclusion and study quality and extracted data. Data synthesis Standardised mean differences of the percentage change from baseline in bone mineral density of the forearm, hip, and lumbar spine and total body bone mineral content in treatment and control groups. Subgroup analyses were carried out by sex, pubertal stage, dose of vitamin D, and baseline serum vitamin D concentration. Compliance and allocation concealment were also considered as possible sources of heterogeneity.Results From 1653 potential references, six studies, totalling 343 participants receiving placebo and 541 receiving vitamin D, contributed data to meta-analyses. Vitamin D supplementation had no statistically significant effects on total body bone mineral content or on bone mineral density of the hip or forearm. There was a trend to a small effect on lumbar spine bone mineral density (standardised mean difference 0.15, 95% confidence interval −0.01 to 0.31; P=0.07). Effects were similar in studies of participants with high compared with low serum vitamin D levels, although there was a trend towards a larger effect with low vitamin D for total body bone mineral content (P=0.09 for difference). In studies with low serum vitamin D, significant effects on total body bone mineral content and lumbar spine bone mineral density were roughly equivalent to a 2.6% and 1.7% percentage point greater change from baseline in the supplemented group.Conclusions It is unlikely that vitamin D supplements are beneficial in children and adolescents with normal vitamin D levels. The planned subgroup analyses by baseline serum vitamin D level suggest that vitamin D supplementation of deficient children and adolescents could result in clinically useful improvements, particularly in lumbar spine bone mineral density and total body bone mineral content, but this requires confirmation.

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Vitamin D in pregnancy‐time for action: a paediatric audit

Cited by 13 publications

References 6 publications

The effect of cigarette smoke exposure on vitamin D level and biochemical parameters of mothers and neonates

The effect of cigarette smoke exposure on vitamin D level and biochemical parameters of mothers and neonates

Maternal Vitamin D Status in Preeclampsia: Seasonal Changes Are Not Influenced by Placental Gene Expression of Vitamin D Metabolizing Enzymes

Effects of vitamin D supplementation on bone density in healthy children: systematic review and meta-analysis

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