Skip to main content

Advertisement

Log in

Potential impact of maternal vitamin D status on obstetric well-being

  • Short Review
  • Published:
Journal of Endocrinological Investigation Aims and scope Submit manuscript

Abstract

Despite its discovery 100 years ago, vitamin D (VD) has emerged as one of the most controversial nutrients and prohormones of the 21st century. In the past few years, a growing interest in VD has been observed in the biomedical literature due to evidences demonstrating a relevant relationship not only between regulation of calcium and phosphorus homeostasis, but also multiple disease states and low VD status in the population. Indeed, several studies carried out to decipher its role in the body in almost every cell, tissue, and different organs. Recent findings suggested a significant implication of VD in different physiologic processes , such as vascular health, immune function, metabolism, and placental function. In the attempt to focus the attention on effect of VD on female reproductive health, there has been a paucity of data from randomized controlled trials to establish clear beneficial. Human and animal data suggest that low VD status is associated with impaired fertility, endometriosis, and polycystic ovary syndrome. Findings from observational studies show higher rates of preeclampsia, gestational diabetes, preterm birth, and bacterial vaginosis in women with low VD levels. By recent evidences, this review explored the association between maternal VD status and selected effects on maternal, perinatal, and infant health, and the impact of VD supplementation during pregnancy on obstetric well-being.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Barrett H, McElduff A (2010) Vitamin D and pregnancy: an old problem revisited. Best Pract Res Clin Endocrinol Metab. 24:527–539

    Article  PubMed  CAS  Google Scholar 

  2. Wagner CL, Taylor SN, Dawodu A et al (2012) Vitamin D and its role during pregnancy in attaining optimal health of mother and fetus. Nutrients 4:208–230

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  3. Urrutia RP, Thorp JM (2012) Vitamin D in pregnancy: current concepts. Curr Opin Obstet Gynecol 24:57–64

    Article  PubMed  PubMed Central  Google Scholar 

  4. Thorne-Lyman A, Fawzi WW (2012) Vitamin D during pregnancy and maternal, neonatal and infant health outcomes: a systematic review and meta-analysis. Paediatr Perinat Epidemiol 26(Suppl 1):75–90

    Article  PubMed  Google Scholar 

  5. Grundmann M, von Versen-Höynck F (2011) Vitamin D-roles in women’s reproductive health? Reprod Biol Endocrinol. 9:146

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  6. Bikle D (2009) Nonclassic actions of vitamin D. J Clin Endocrinol Metab 94:26–34

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  7. Brannon PM, Picciano MF (2011) Vitamin D in pregnancy and lactation in humans. Annu Rev Nutr 31:89–115

    Article  PubMed  CAS  Google Scholar 

  8. Haddad JG, Stamp TC (1974) Circulating 25-hydroxyvitamin D in man. Am J Med 57:57–62

    Article  PubMed  CAS  Google Scholar 

  9. Christakos S, Ajibade DV, Dhawan P et al (2010) Vitamin D: metabolism. Endocrinol Metab Clin North Am 39:243–253

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  10. Mulligan ML, Felton SK, Riek AE et al (2010) Implications of vitamin D deficiency in pregnancy and lactation. Am J Obstet Gynecol 202(429):e1–e9

    PubMed  Google Scholar 

  11. Kovacs CS (2008) Vitamin D in pregnancy and lactation: maternal, fetal, and neonatal outcomes from human and animal studies. Am J Clin Nutr 88(suppl):520S–528S

    PubMed  CAS  Google Scholar 

  12. Kovacs CS (2014) Bone development and mineral homeostasis in the fetus and neonate: roles of the calciotropic and phosphotropic hormones. Physiol Rev 94:1143–1218

    Article  PubMed  CAS  Google Scholar 

  13. Kovacs CS (2014) Bone metabolism in the fetus and neonate. Pediatr Nephrol 29:793–803

    Article  PubMed  Google Scholar 

  14. De-Regil LM, Palacios C, Ansary A et al (2012) Vitamin D supplementation for women during pregnancy. Cochrane Database Syst Rev 15(2):CD008873

    Google Scholar 

  15. ACOG Committee Opinion No. 495 (2011) Vitamin D: screening and supplementation during pregnancy. Obstet Gynecol 118(1):197–198

    Article  Google Scholar 

  16. Holick MF (2009) Vitamin D status: measurement, interpretation, and clinical application. Ann Epidemiol 19:73–78

    Article  PubMed  PubMed Central  Google Scholar 

  17. Haddow JE, Neveux LM, Palomaki GE et al (2011) The relationship between PTH and 25-hydroxy vitamin D early in pregnancy. Clin Endocrinol (Oxf). 75(3):309–314

    Article  PubMed  CAS  Google Scholar 

  18. Institute of Medicine (US) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium; Ross AC, Taylor CL, Yaktine AL et al (eds) (2011) Dietary Reference Intakes for Calcium and Vitamin D. National Academies Press (US), Washington (DC). http://www.ncbi.nlm.nih.gov/books/NBK56070/

  19. Skowrońska-Jóźwiak E, Lebiedzińska K, Smyczyńska J et al (2014) Effects of maternal vitamin D status on pregnancy outcomes, health of pregnant women and their offspring. Neuro Endocrinol Lett. 35:367–372

    PubMed  Google Scholar 

  20. Nguyen TP1, Yong HE, Chollangi T, et al. Placental vitamin D receptor expression is decreased in human idiopathic fetal growth restriction. J Mol Med (Berl). 27 Feb 2015 (Epub ahead of print)

  21. Powe CE et al (2010) First trimester vitamin D, vitamin D binding protein, and subsequent preeclampsia. Hypertension 56(4):758–763

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  22. Baker AM, Haeri S, Camargo CA, Espinola JA et al (2010) A nested case-control study of mid gestation vitamin D deficiency and risk of severe preeclampsia. J Clin Endocrinol Metab 95:5105–5109

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  23. Robinson CJ, Wagner CL, Hollis BW, et al. Maternal vitamin D and fetal growth in early-onset severe preeclampsia. Am J Obstet Gynecol 2011;204:556e551–4

  24. Marwaha RK, et al. Vitamin D status in pregnant Indian women across trimesters and different seasons and its correlation with neonatal serum 25-hydroxyvitamin D levels. Br J Nutr. 2011:1–7

  25. Brown MA, Lindheiemer MD, de Swiet M, Van Assche A, Moutquin JM (2001) The classification and diagnosis of the hypertensive disorders of pregnancy: statement from the International Society for the Study of Hypertension in Pregnancy (ISSHP). Hypertens Pregnancy 20(1):IX–XIV

  26. Bourges H, Halhali A (1993) Hypothesis to explain the association between hypocalciuria and low circulating 1,25-dihydroxyvitamin D levels in preeclampsia. Med Hypotheses 41:239–243

    Article  PubMed  CAS  Google Scholar 

  27. Bodnar LM, Catov JM, Simhan HN et al (2007) Maternal vitamin D deficiency increases the risk of preeclampsia. J Clin Endocrinol Metab 92:3517–3522

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  28. Olsen SF, Secher NJ (1990) A possible preventive effect of low-dose fish oil on early delivery and pre-eclampsia: indications from a 50-year-old controlled trial. Br J Nutr 64:599–609

    Article  PubMed  CAS  Google Scholar 

  29. Haugen M, Brantsaeter AL, Trogstad L et al (2009) Vitamin D supplementation and reduced risk of preeclampsia in nulliparous women. Epidemiology 20(5):720–726

    Article  PubMed  Google Scholar 

  30. Hypponen E, Hartikainen AL et al (2007) Does vitamin D supplementation in infancy reduce the risk of pre-eclampsia? Eur J Clin Nutr 61:1136–1139

    Article  PubMed  CAS  Google Scholar 

  31. Hewison M (2010) Vitamin D and the immune system: new perspectives on an old theme. Endocrinol Metab Clin North Am 39:365–379

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  32. Liu NQ, Kaplan AT, Lagishetty V et al (2011) Vitamin D and the regulation of placental inflammation. J Immunol 186:5968–5974

    Article  PubMed  CAS  Google Scholar 

  33. Diaz L, Arranz C, Avila E et al (2002) Expression and activity of 25-hydroxyvitamin D-1 alpha-hydroxylase are restricted in cultures of human syncytiotrophoblast cells from preeclamptic pregnancies. J Clin Endocrinol Metab 87:3876–3882

    PubMed  CAS  Google Scholar 

  34. Evans KN, Bulmer JN, Kilby MD et al (2004) Vitamin D and placental decidual function. J Soc Gynecol Investig 11(5):263–271

    Article  PubMed  CAS  Google Scholar 

  35. Saito S, Sakai M (2003) Th1/Th2 balance in preeclampsia. J Reprod Immunol 59:161–173

    Article  PubMed  CAS  Google Scholar 

  36. Cardus A, Panizo S, Encinas M et al (2009) 1,25-dihydroxyvitamin D3 regulates VEGF production through a vitamin D response element in the VEGF promoter. Atherosclerosis 204:85–89

    Article  PubMed  CAS  Google Scholar 

  37. Damm P, Kuhl C, Bertelsen A et al (1992) Predictive factors for the development of diabetes in women with previous gestational diabetes mellitus. Am J Obstet Gynecol 167:607–616

    Article  PubMed  CAS  Google Scholar 

  38. Hirai M, Suzuki S, Hinokio Y et al (2000) Variations in vitamin D-binding protein (group-specific component protein) are associated with fasting plasma insulin levels in Japanese with normal glucose tolerance. J Clin Endocrinol Metab 85:1951–1953

    PubMed  CAS  Google Scholar 

  39. Zhang C, Qiu C, Hu FB et al (2008) Maternal plasma 25-hydroxyvitamin D concentrations and the risk for gestational diabetes mellitus. PLoS One 3:e3753

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  40. Maghbooli Z, Hossein-Nezhad A, Karimi F, Shafaei AR, Larijani B (2008) Correlation between vitamin D3 deficiency and insulin resistance in pregnancy. Diabetes Metab Res Rev 24(1):27–32

    Article  PubMed  CAS  Google Scholar 

  41. Clifton-Bligh RJ, McElduff P, McElduff A (2008) Maternal vitamin D deficiency, ethnicity and gestational diabetes. Diabet Med 25(6):678–684

    Article  PubMed  CAS  Google Scholar 

  42. Rudnicki PM, Mølsted-Pedersen L (1997) Effect of 1,25-dihydroxycholecalciferol on glucose metabolism in gestational diabetes mellitus. Diabetologia 40(1):40–44

    Article  PubMed  CAS  Google Scholar 

  43. Han S, Middleton P, Crowther CA (2012) Exercise for pregnant women for preventing gestational diabetes mellitus. Cochrane Database Syst Rev 7:CD009021

    PubMed  Google Scholar 

  44. Liu PT, Stenger S, Li H et al (2006) Toll-like receptor triggering of a vitamin D-mediated human antimicrobial response. Science 311:1770–1773

    Article  PubMed  CAS  Google Scholar 

  45. Chesney RW (2010) Vitamin D and The Magic Mountain: the anti-infectious role of the vitamin. J Pediatr 56:698–703

    Article  Google Scholar 

  46. Allsworth JE, Peipert JF (2007) Prevalence of bacterial vaginosis: 2001–2004 National Health and Nutrition Examination Survey data. Obstet Gynecol 109:114–120

    Article  PubMed  Google Scholar 

  47. Bodnar LM, Krohn MA, Simhan HN (2009) Maternal vitamin D deficiency is associated with bacterial vaginosis in the first trimester of pregnancy. J Nutr 139:1157–1161

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  48. Hensel KJ, Randis TM, Gelber SE, et al. Pregnancy-specific association of vitamin D deficiency and bacterial vaginosis. Am J Obstet Gynecol 2011;204:41e41–49

  49. Diaz L, Noyola-Martinez N, Barrera D et al (2009) Calcitriol inhibits TNF-alpha-induced inflammatory cytokines in human trophoblasts. J Reprod Immunol 81:17–24

    Article  PubMed  CAS  Google Scholar 

  50. Helming L, Bose J, Ehrchen J et al (2005) 1alpha,25-Dihydroxyvitamin D3 is a potent suppressor of interferon gamma-mediated macrophage activation. Blood 106:4351–4358

    Article  PubMed  CAS  Google Scholar 

  51. Tribe RM (2001) Regulation of human myometrial contractility during pregnancy and labour: are calcium homeostatic pathways important? Exp Physiol 86:247–254

    Article  PubMed  CAS  Google Scholar 

  52. Baker AM, Haeri S, Camargo CA et al (2010) A nested case-control study of first-trimester maternal vitamin D status and risk for spontaneous preterm birth. Am J Perinatol 95:5105–5109

    CAS  Google Scholar 

  53. Hossain N, Kanani FH, Ramzan S, Kausar R, Ayaz S, Khanani R, Pal L (2014) Obstetric and neonatal outcomes of maternal vitamin D supplementation: results of an open-label, randomized controlled trial of antenatal vitamin D supplementation in Pakistani women. J Clin Endocrinol Metab 99(7):2448–2455

    Article  PubMed  CAS  Google Scholar 

  54. Brunvand L, Shah SS, Bergstrom S et al (1998) Vitamin D deficiency in pregnancy is not associated with obstructed labor. A study among Pakistani women in Karachi. Acta Obstet Gynecol Scand 77:303–306

    Article  PubMed  CAS  Google Scholar 

  55. Barker DJP, Barker DJ, Eriksson JG et al (2002) Fetal origins of adult disease: strength of effects and biological basis. Int J Epidemiol 3:1235–1239

    Article  Google Scholar 

  56. Devereux G, Litonjua AA, Turner SW et al (2007) Maternal vitamin D intake during pregnancy and early childhood wheezing. Am J Clin Nutr 85:853–859

    PubMed  CAS  Google Scholar 

  57. Leffelaar ER, Vrijkotte TG, van Eijsden M (2010) Maternal early pregnancy vitamin D status in relation to fetal and neonatal growth: results of the multi-ethnic Amsterdam Born Children and their Development cohort. Br J Nutr 104:108–117

    Article  PubMed  CAS  Google Scholar 

  58. Marya RK, Rathee S, Lata V et al (1981) Effects of vitamin D supplementation in pregnancy. Gynecol Obstet Invest 12:155–161

    Article  PubMed  CAS  Google Scholar 

  59. Mehta S, Hunter DJ, Mugusi FM et al (2009) Perinatal outcomes, including mother-to-child transmission of HIV, and child mortality and their association with maternal vitamin D status in Tanzania. J Infect Dis 200:1022–1030

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  60. Baker PN, Wheeler SJ, Sanders TA et al (2009) A prospective study of micronutrient status in adolescent pregnancy. Am J Clinical Nutrition. 89:1114–1124

    Article  CAS  Google Scholar 

  61. Leffelaar ER, Vrijkotte TG, van Eijsden M (2010) Maternal early pregnancy vitamin D status in relation to fetal and neonatal growth: results of the multi-ethnic Amsterdam Born Children and their Development cohort. Br J Nutr 104:108–117

    Article  PubMed  CAS  Google Scholar 

  62. Brooke OG, Butters F, Wood C (1981) Intrauterine vitamin D nutrition and postnatal growth in Asian infants. Br Med J (Clinical Research Ed) 283:1024

    Article  CAS  Google Scholar 

  63. Leffelaar ER, Vrijkotte TG, van Eijsden M. Maternal early pregnancy vitamin D status in relation to fetal and neonatal growth: results of the multi-ethnic Amsterdam Born Children and their Development cohort. Br J Nutr. 2010:1–10

  64. Gale CR, Robinson SM, Harvey NC et al (2008) Maternal vitamin D status during pregnancy and child outcomes. Eur J Clin Nutr 62:68–77

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  65. Camargo CA Jr, Ingham T, Wickens K et al (2011) Cord-blood 25-hydroxyvitamin D levels and risk of respiratory infection, wheezing, and asthma. Pediatrics 127:e180–e187

    Article  PubMed  Google Scholar 

  66. Yu CKH, Skyes M, Sethit T et al (2009) Vitamin D deficiency and supplementation during pregnancy. Clin Endocrinol 70:685–690

    Article  CAS  Google Scholar 

  67. Sahu M, Das V, Agarwal A et al (2009) Vitamin D replacement in pregnant women in rural north India: a pilot study. Eur J Clin Nutr 63:1157–1159

    Article  PubMed  CAS  Google Scholar 

  68. Hollis BW, Donna J, Hulsey TC et al (2011) Vitamin D supplementation during pregnancy: double blind, randomized clinical trial of safety and effectiveness. J Bone Miner Res 26(10):2341–2357

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  69. Hossain N, Kanani FH, Ramzan S, Kausar R, Ayaz S, Khanani R, Pal L (2014) Obstetric and neonatal outcomes of maternal vitamin D supplementation: results of an open-label, randomized controlled trial of antenatal vitamin D supplementation in Pakistani women. J Clin Endocrinol Metab 99(7):2448–2455. doi:10.1210/jc.2013-3491 Epub 2014 Mar 19

    Article  PubMed  CAS  Google Scholar 

  70. Diogenes ME1, Bezerra FF, Rezende EP, Taveira MF, Pinhal I, Donangelo CM. Effect of calcium plus vitamin D supplementation during pregnancy in Brazilian adolescent mothers: a randomized, placebo-controlled trial. Am J Clin Nutr. 2013; 98(1):82–91. doi:10.3945/ajcn.112.056275 Epub 2013 May 29

  71. Sahu M, Das V, Agarwal A et al (2009) Vitamin D replacement in pregnant women in rural north India: a pilot study. Eur J Clin Nutr 63:1157–1159

    Article  PubMed  CAS  Google Scholar 

  72. Jelsma JG1, van Poppel MN, Galjaard S et al. DALI: Vitamin D and lifestyle intervention for gestational diabetes mellitus (GDM) prevention: an European multicentre, randomised trial–study protocol. BMC Pregnancy Childbirth. 2013;13:142. doi:10.1186/1471-2393-13-142

  73. Yap C, Cheung NW, Gunton JE, Athayde N, Munns CF, Duke A, McLean M (2014) Vitamin D supplementation and the effects on glucose metabolism during pregnancy: a randomized controlled trial. Diabetes Care 37(7):1837–1844. doi:10.2337/dc14-0155 Epub 2014 Apr 23

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

S. Triunfo and A. Lanzone declare no conflict of interest.

Ethical approval (research involving human participants and/or animals)

Not required due to type of manuscript (review).

Informed consent

Not required due to type of manuscript (review).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to S. Triunfo.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Triunfo, S., Lanzone, A. Potential impact of maternal vitamin D status on obstetric well-being. J Endocrinol Invest 39, 37–44 (2016). https://doi.org/10.1007/s40618-015-0330-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40618-015-0330-7

Keywords

Navigation