Implications of maternal vitamin D deficiency for the fetus, the neonate and the young infant
- 1.3k Downloads
It has recently been demonstrated that vitamin D (VD) deficiency during pregnancy and lactation can give rise to problems in mothers and their children.
To discuss the implications of VD deficiency during pregnancy and the best VD supplementation to use in order to avoid risks for the mother and child.
PubMed was used to select all of the clinical studies published in the last 15 years concerning VD deficiency in pregnant women and its impact on the fetuses, neonates and infants, as well as the use of VD supplementation during pregnancy.
Several studies have suggested that VD deficiency is associated with possible major outcomes in the preconception period, during pregnancy, perinatally and in childhood. A 25(OH)D concentration of >32 and <50–60 ng/mL seems to be associated with the lowest risk of disease, and the administration of 2,000 IU/day to pregnant and breastfeeding women seems to maintain adequate 25(OH)D levels. However, not all the experts agree with these conclusions because some of them do not think that VD deficiency can really cause extraskeletal manifestations and consider that the traditionally suggested 400–600 IU/day can be enough to permit an adequate bone development.
Despite an increasing amount of data seems to suggest that pregnant women need a greater amount of VD than recommended in the past, further studies are needed to determine how much VD has to be given to assure a regular evolution of the pregnancy and an adequate development of the fetus and the young child.
KeywordsBone development Pregnancy Respiratory infection Vitamin D Vitamin D deficiency Vitamin D supplementation
- 9.Hollis BV, Wagner CL (2012) Vitamin D and pregnancy: skeletal effects, nonskeletal effects, and birth outcomes. Calcified Tiss Int (Epub 24 May 2012)Google Scholar
- 10.Nguyen TM, Guillozo H, Marin L, Tordet C, Koite S, Garabedian M (1996) Evidence for a vitamin D paracrine system regulating maturation of developing rat lung epithelium. Am J Physiol 271(3pt1):L392–L399Google Scholar
- 14.Hollis BW (2005) Circulating 25-hydroxyvitamin D levels indicative of vitamin D sufficiency: implications for establishing a new effective dietary intake recommendation for vitamin D. J Nutr 135:317–322Google Scholar
- 15.Dawson-Hughes B, Heaney RP, Holick MF, Lips P, Meunier PJ, Vieth R (2004) Vitamin D round table. In: Burckhardt P, Dawson-Hughes B, Heaney R (eds) Nutritional aspects of osteoporosis, 2nd edn. Elsevier Science and Technology Books, Burlington, MA, pp 263–270Google Scholar
- 18.Bodnar LM, Simhan HN, Powers RW, Frank MP, Cooperstein E, Roberts JM (2007) High prevalence of vitamin D insufficiency in black and white pregnant women residing in the northern United States and their neonates. J Nutr 137:447–452Google Scholar
- 20.Hamilton SA, McNeil R, Hollis BW, Davis DJ, Winkler J, Cook C et al (2010) Profound vitamin D deficiency in a diverse group of women during pregnancy living in a sun-rich environment at latitude 32°N. Int J Endocrinol 2010:917428Google Scholar
- 28.Burris HH, Rifas-Shiman SL, Camargo CA Jr, Litonjua AA, Huh SY, Rich-Edwards JW et al (2010) Plasma 25-hydroxyvitamin D during pregnancy and small-for-gestational age in black and white infants. Ann Epidemiol (Epub 31 May 2012)Google Scholar
- 29.Olsen SF, Halldorsson TI, Willett WC, Knudsen VK, Gillman MW, Mikkelsen TB et al (2007) Milk consumption during pregnancy is associated with increased infant size at birth: prospective cohort study. Am J Clin Nutr 86:1104–1110Google Scholar
- 41.Camargo CA Jr, Rifas-Shiman SL, Litonjua AA, Rich-Edwards JW, Weiss ST, Gold DR et al (2007) Maternal intake of vitamin D during pregnancy and risk of recurrent wheeze in children at 3 y of age. Am J Clin Nutr 85:788–795Google Scholar
- 42.Rothers J, Wright AL, Stern DA, Halonen M, Camargo CA Jr (2011) Cord blood 25-hydroxyvitamin D levels are associated with aeroallergen sensitization in children from Tucson, Arizona. J Allergy Clin Immunol 128:1093-9.e1–1093-9.e5Google Scholar
- 45.Pike KC, Inskip HM, Robinson S, Lucas JS, Cooper C, Harvey NC et al (2012) Maternal late-pregnancy serum 25-hydroxyvitamin D in relation to childhood wheeze and atopic outcomes. Thorax (Epub 15 June 2012)Google Scholar
- 48.Stene LC, Joner G (2003) Use of cod liver oil during the first year of life is associated with lower risk of childhood-onset type 1 diabetes: a large, population-based, case–control study. Am J Clin Nutr 78:1128–1134Google Scholar
- 49.Staples J, Ponsonby AL, Lim L (2010) Low maternal exposure to ultraviolet radiation in pregnancy, month of birth, and risk of multiple sclerosis in offspring: longitudinal analysis. BMJ 340:c1640Google Scholar
- 52.National Institute for Clinical Excellence (2011) Improving the nutrition of pregnant and breastfeeding mothers and children in low-income households, NICE public health guidance, July 2011. Available at: http://www.nice.org.uk/nicemedia/live/11943/40097/40097.pdf. Accessed on 14 June 2012
- 53.Institute of Medicine (US) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium, Ross AC, Taylor CL, Yaktine AL, Del Valle HB (eds) (2011) Dietary reference intakes for calcium and vitamin D. National Academies Press (US), Washington DC, USAGoogle Scholar
- 56.Vieth R, Chan PC, McFarlane GD (2001) Efficacy and safety of vitamin D3 intake exceeding the lowest observed adverse effect level. Am J Clin Nutr 73:288–294Google Scholar
- 57.First Nations, Inuit and Métis Health Committee, Canadian Paediatric Society. Vitamin D supplementation: recommendations for Canadian mothers and infants. Reference no. FNIMH 07-01. Available at: www.cps.ca/english/statements/ii/fnim07-01.htm. Accessed on 14 June 2012
- 61.Hathcock JN, Shao A, Vieth R, Heaney R (2007) Risk assessment for vitamin D. Am J Clin Nutr 85:6–18Google Scholar
- 62.Luxwolda MF, Kuipers RS, Kema IP, van der Veer E, Dijck-Brouwer DA, Muskiet FA (2012) Vitamin D status indicators in indigenous populations in East Africa. Eur J Nutr (Epub 10 Aug 2012)Google Scholar
- 63.De-Regil LM, Palacios C, Ansary A, Kulier R, Peña-Rosas JP (2012) Vitamin D supplementation for women during pregnancy. Cochrane Database Syst Rev 2:CD008873Google Scholar