Vitamin D status during Pregnancy and Aspects of Offspring Health

Abstract

Low maternal vitamin D levels during pregnancy have been linked to various health outcomes in the offspring, ranging from periconceptional effects to diseases of adult onset. Maternal and infant cord 25(OH)D levels are highly correlated. Here, we review the available evidence for these adverse health effects. Most of the evidence has arisen from observational epidemiological studies, but randomized controlled trials are now underway. The evidence to date supports that women should be monitored and treated for vitamin D deficiency during pregnancy but optimal and upper limit serum 25(OH)D levels during pregnancy are not known.

Effect of vitamin D supplementation during pregnancy on maternal and neonatal outcomes: a systematic review and meta-analysis of randomized controlled trials

“…In an RCT (8), all women received a standard prenatal multivitamin containing 400 international units (IU) of vitamin D 3 . In addition, all women received a vitamin D 3 supplement of 0 IU (placebo), 1,600 IU, or 3,600 IU of vitamin D 3 , for a total of 400 IU, 2,000 IU, and 4,000 IU of vitamin D supplementation, respectively (Table 1).…”

“…Observational studies suggest that vitamin D is essential for many physiologic processes; thus, adequate levels are necessary and advantageous for optimal health (1)(2)(3). Despite its vitamin designation, cholecalciferol, or vitamin D 3 , can be synthesized by mammals from 7-dehydrocholesterol, via appropriate exposure to sunlight.…”

“…Cholecalciferol and ergocalciferol (vitamin D 2 ) can be obtained from the diet as well. In humans, both cholecalciferol and ergocalciferol are sequentially transformed into 25-hydroxyvitamin D 3 [25(OH)D], 25-hydroxycholecalciferol, or calcidiol, in the liver, which are subsequently transformed in kidneys and other tissues into 1,25-dihydroxyvitamin D 3 [1,25(OH)2D], 1,25-dihydroxycholecalciferol or calcitriol (1)(2)(3).…”

“…Sufficient vitamin D concentrations are needed during pregnancy to address the increasing demand for calcium, by the fetus, during its growth and development (3,4). Pregnant women who did not receive vitamin D supplementation showed a reduction in circulating 25(OH)D levels during the third trimester compared with the first trimester (4,5).…”

“…Several observational studies have reported that low maternal circulating 25(OH)D concentrations in pregnant women may have negative health consequences for both mothers and newborns (3,6). Studies have suggested that lower levels of circulating 25(OH)D are associated with risks of recurrent pregnancy losses, preeclampsia, gestational diabetes, maternal infections, preterm birth, small-for-gestational-age (SGA) infants, and poor offspring health (3,6,7).…”