Ineffectiveness of antenatal guidance intervention for vitamin D insufficiency and deficiency in pregnant women in Kyoto, Japan

We aimed to describe the vitamin D status of young women living in two Chinese cities in the spring – Beijing in the north (latitude 39° north) and Hong Kong (latitude 22° north) in the south. We also examined the relationship between serum 25-hydroxyvitamin D and parathyroid hormone (PTH) concentrations to determine a threshold for serum 25-hydroxyvitamin D above which there is no further suppression of PTH. Finally, we examined whether dietary Ca intake influences this relationship. Non-pregnant women aged 18–40 years (n 441) were recruited between February and June. Fasting blood was collected and dietary intakes were assessed using 5 d food records. Mean serum 25-hydroxyvitamin D concentration was lower in Beijing than Hong Kong women (29 v. 34 nmol/l; P < 0·001). Vitamin D deficiency ( ≤ 25 nmol/l) was indicated in 40 % of Beijing and 18 % of Hong Kong women, and over 90 % of women in both cities were insufficient ( ≤ 50 nmol/l). Mean Ca and vitamin D intakes were 478 mg/d and 2·0 μg/d, respectively. The relationship between 25-hydroxyvitamin D concentration and PTH was linear throughout the range with a slope of − 0·36 (different from 0; P < 0·001; R 0·26), with no apparent threshold. There was no influence of Ca intake on the relationship between 25-hydroxyvitamin D and PTH concentration. Vitamin D deficiency is common and insufficiency is very common in non-pregnant women in Hong Kong and Beijing during spring. Serum 25-hydroxyvitamin D was inversely associated with PTH with no apparent threshold. Strategies such as vitamin D fortification or supplementation may be required.

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Opinions and Practice of US-Based Obstetrician-Gynecologists regarding Vitamin D Screening and Supplementation of Pregnant Women

Journal of Pregnancy ◽

10.1155/2016/1454707 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7

Author(s):

Sara A. Mohamed ◽

Ayman Al-Hendy ◽

Jay Schulkin ◽

Michael L. Power

Keyword(s):

Vitamin D ◽

Pregnant Women ◽

Patient Population ◽

Vitamin D Insufficiency ◽

Vitamin D Supplementation ◽

Institute Of Medicine ◽

Vitamin D Status ◽

Online Questionnaire ◽

Endocrine Society ◽

Hydroxyvitamin D

Vitamin D deficiency/insufficiency is prevalent among pregnant women. Recommendations for adequate levels of circulating 25-hydroxyvitamin D and appropriate vitamin D supplementation during pregnancy differ between the Institute of Medicine and the Endocrine Society. Obstetrician-gynecologists must make clinical decisions in this environment of uncertain guidance. An online questionnaire regarding physician practice patterns for screening and supplementing pregnant women was administered to 225 randomly selected practicing obstetrician-gynecologists of whom 101 (45%) completed the questionnaire. A majority indicated that vitamin D insufficiency was a problem in their patient population (68.4%) and that most of their pregnant patients would benefit from vitamin D supplementation (66.3%). Half (52.5%) would recommend vitamin D supplementation during pregnancy to some patients, but only 16.8% to all. Only one in four (25.8%) routinely screen their pregnant patients for vitamin D status. Physicians who indicated that vitamin D status was a problem in their patient population were more likely to screen routinely (32.8% versus 9.7%,P=0.002) and believe their patients would benefit from supplementation (91.2% versus 16.1%,P=0.001). Opinion regarding supplementation levels and indicators of adequacy were split between the two competing recommendations, suggesting that clinical practice will likely remain variable across physicians, with uncertain public health consequences.

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An evaluation of association of vitamin D insufficiency with gestational hypertension in pregnant women

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20183299 ◽

2018 ◽

Vol 7 (8) ◽

pp. 3109

Author(s):

Khan Arshiya ◽

Srivastava Meenakshi

Keyword(s):

Blood Pressure ◽

Vitamin D ◽

Pregnant Women ◽

Vitamin D Deficiency ◽

Task Force ◽

Gestational Hypertension ◽

Fasting Blood Glucose ◽

Vitamin D Insufficiency ◽

Vitamin D Supplementation ◽

Cross Sectional

Background: Preeclampsia (PE) is a disease specific to pregnancy affecting many bodily systems. This is characterized by high blood pressure and proteinuria after the 20th week of pregnancy. The objective of this study was to evaluate of association of vitamin D insufficiency with gestational hypertension in pregnant women.Methods: This was a cross-sectional study. A total of 104 pregnant women were included in the study. The diagnosis of gestational hypertension was confirmed using the “Report of the American College of Obstetricians and Gynaecologists’ Task Force on Hypertension in Pregnancy” criteria. Based on these criteria, patients with systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg (measured after a period of rest of four hours, twice daily) and proteinuria (≥300 mg protein/24 h) were diagnosed as gestational hypertension.Results: Vitamin D deficiency was found among 78.9% (90/114) women. There was no significant (p >0.05) difference in age of women between vitamin D deficient and sufficient. Vitamin D level was significantly (p = 0.0001) lower among the women between Vitamin D deficient (15.93±4.66) and sufficient (35.70±3.25). There was no significant (p >0.05) association of Vitamin D level with parity, family history of hypertension, blood pressure, gestational age and fasting blood glucose. There was significant (p = 0.0001) difference in BMI between Vitamin D deficient (30.10±4.95) and sufficient (24.04±2.75). Tobacco consumption was also associated with the level of Vitamin D. There was significant negative correlation between BMI and Vitamin D level (r = -0.56, p = 0.00011).Conclusions: The present study demonstrates that vitamin D plays a role in the ethology and pathophysiology of gestational hypertension. Among the population having the risk of vitamin D deficiency, the risk of pregnancy induced hypertension may be decreased through vitamin D supplementation.

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Vitamin D deficiency and insufficiency in pregnant women: a longitudinal study

British Journal Of Nutrition ◽

10.1017/s0007114509297236 ◽

2009 ◽

Vol 102 (6) ◽

pp. 876-881 ◽

Cited By ~ 152

Author(s):

Valerie A. Holmes ◽

Maria S. Barnes ◽

H. Denis Alexander ◽

Peter McFaul ◽

Julie M. W. Wallace

Keyword(s):

Vitamin D ◽

Longitudinal Study ◽

Pregnant Women ◽

Hypovitaminosis D ◽

Vitamin D Insufficiency ◽

Vitamin D Supplementation ◽

Vitamin D Status ◽

Maternal Vitamin ◽

Hydroxyvitamin D ◽

Supplement Use

Maternal vitamin D insufficiency is associated with childhood rickets and longer-term problems including schizophrenia and type 1 diabetes. Whilst maternal vitamin D insufficiency is common in mothers with highly pigmented skin, little is known about vitamin D status of Caucasian pregnant women. The aim was to investigate vitamin D status in healthy Caucasian pregnant women and a group of age-matched non-pregnant controls living at 54–55°N. In a longitudinal study, plasma 25-hydroxyvitamin D (25(OH)D) was assessed in ninety-nine pregnant women at 12, 20 and 35 weeks of gestation, and in thirty-eight non-pregnant women sampled concurrently. Plasma 25(OH)D concentrations were lower in pregnant women compared to non-pregnant women (P < 0·0001). Of the pregnant women, 35, 44 and 16 % were classified as vitamin D deficient (25(OH)D < 25 nmol/l), and 96, 96 and 75 % were classified as vitamin D insufficient (25(OH)D < 50 nmol/l) at 12, 20 and 35 weeks gestation, respectively. Vitamin D status was higher in pregnant women who reported taking multivitamin supplements at 12 (P < 0·0001), 20 (P = 0·001) and 35 (P = 0·001) weeks gestation than in non-supplement users. Vitamin D insufficiency is evident in pregnant women living at 54–55°N. Women reporting use of vitamin D-containing supplements had higher vitamin D status, however, vitamin D insufficiency was still evident even in the face of supplement use. Given the potential consequences of hypovitaminosis D on health outcomes, vitamin D supplementation, perhaps at higher doses than currently available, is needed to improve maternal vitamin D nutriture.

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Vitamin D insufficiency in healthy pregnant women living in Warsaw

Ginekologia Polska ◽

10.17772/gp/1590 ◽

2013 ◽

Vol 84 (5) ◽

Cited By ~ 9

Author(s):

Zbigniew Bartoszewicz ◽

Agnieszka Kondracka ◽

Małgorzata Krasnodębska-Kiljańska ◽

Beata Niedźwiedzka ◽

Michał Popow ◽

...

Keyword(s):

Vitamin D ◽

Pregnant Women ◽

Vitamin D Insufficiency

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Vitamin D Insufficiency in HIV-infected Pregnant Women Receiving Antiretroviral Therapy is Not Associated With Morbidity, Mortality or Growth Impairment in Their Uninfected Infants in Botswana

The Pediatric Infectious Disease Journal ◽

10.1097/inf.0000000000000428 ◽

2014 ◽

Vol 33 (11) ◽

pp. 1141-1147 ◽

Cited By ~ 5

Author(s):

Kathleen Powis ◽

Shahin Lockman ◽

Laura Smeaton ◽

Michael D. Hughes ◽

Wafaie Fawzi ◽

...

Keyword(s):

Vitamin D ◽

Antiretroviral Therapy ◽

Pregnant Women ◽

Vitamin D Insufficiency ◽

Growth Impairment

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High Prevalence of Vitamin D Insufficiency in Black and White Pregnant Women Residing in the Northern United States and Their Neonates

Journal of Nutrition ◽

10.1093/jn/137.2.447 ◽

2007 ◽

Vol 137 (2) ◽

pp. 447-452 ◽

Cited By ~ 403

Author(s):

Lisa M. Bodnar ◽

Hyagriv N. Simhan ◽

Robert W. Powers ◽

Michael P. Frank ◽

Emily Cooperstein ◽

...

Keyword(s):

United States ◽

Vitamin D ◽

Pregnant Women ◽

Vitamin D Insufficiency ◽

Black And White ◽

High Prevalence ◽

Northern United States

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Effect of vitamin D supplementation on vitamin D status in pregnant women: findings from the MO-VITD study

Proceedings of The Nutrition Society ◽

10.1017/s0029665120000476 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Raghad Alhomaid ◽

Maria Mulhern ◽

Laura Cassidy ◽

Eamon Laird ◽

Martin Healy ◽

...

Keyword(s):

Vitamin D ◽

Cord Blood ◽

Pregnant Women ◽

Vitamin D Insufficiency ◽

Vitamin D Supplementation ◽

Normal Weight ◽

Vitamin D Status ◽

Obese Women ◽

Maternal Vitamin ◽

Treatment Groups

AbstractPregnant women who are overweight/obese are particularly vulnerable to vitamin D insufficiency owing to higher physiological requirements and lower status (25(OH)D concentrations) associated with obesity. Achieving adequate maternal vitamin D status with current recommendations (10μg/d) remains controversial.This study examined supplementation effects (10μg-vs-20μg vitamin D3/d) throughout pregnancy (12 weeks gestation until delivery) on vitamin D status of normal weight, overweight and obese pregnant women and on cord blood, using a double-blind randomised vitamin D intervention study (MO-VITD). 240 pregnant women were recruited throughout the year at antenatal clinics in Northern Ireland (equal numbers of normal weight (18.5–24.9 kg/m2), overweight (25–29.9 kg/m2), and obese (> 30kg/m2)). Non-fasting maternal blood samples were collected at 12, 28 and 34–36 weeks gestation and from the umbilical cord after delivery and analysed for total serum 25(OH)D using LCMS.A high prevalence of vitamin D insufficiency (25–50nmol/L) was found in the 1st trimester in both treatment groups (41.5% and 48.8%; 10μg vs. 20μg respectively). Maternal 25(OH)D concentrations increased from the 1st to 3rd trimester in both the 10μg/d and 20μg/d groups, with a higher increase in the 20μg group (17.1 ± 24.7 and 28.8 ± 33.3nmol/L, P = 0.002). There was no difference in cord blood 25(OH)D concentrations between treatment groups.Women who started pregnancy with insufficient 25(OH)D concentrations remained insufficient throughout pregnancy in the 10μg/d group (49.9 ± 28.2nmol/L at trimester 3). In the 20μg/d group, women starting pregnancy as insufficient achieved levels of sufficiency in the 2nd (58.9 ± 30.6nmol/L) and 3rd (64.0 ± 35.9nmol/L) trimesters. Women who started pregnancy with sufficient vitamin D status (25(OH)D > 50nmol/L), maintained levels of sufficiency throughout pregnancy irrespective of treatment group (83.1 ± 24.4 and 96.7 ± 30.7 at trimester 3 in 10μg/d and 20 μg/d groups respectively); findings were similar across all BMI categories.Obese women who started pregnancy with an insufficient status were found to have deficient cord blood (25(OH)D < 25 nmol/L) in both the 10μg/d and 20μg/d groups (19.4 ± 20.2 vs. 19.5 ± 9.4nmol/L respectively), whilst obese women who started pregnancy with sufficient status (> 50nmol/L) had cord blood concentrations considered insufficient (40.2 ± 18.4 vs. 44.2 ± 15.6nmol/L; 10μg vs. 20μg groups respectively).Based on our findings of the high prevalence of vitamin D insufficiency in early pregnancy, maternal vitamin D supplementation of 20μg/d is advisable to maintain maternal vitamin D status in pregnant women in Northern Ireland.

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