Maternal and Pediatric Health Outcomes in relation to Gestational Vitamin D Sufficiency

Juxtaposed with monumental improvement in maternal-fetal outcomes over the last century, there has been the recent emergence of rising rates of gestational complications including preterm birth, operative delivery, and gestational diabetes. At the same time, there has been a burgeoning problem with widespread vitamin D deficiency among populations of many developed nations. This paper provides a brief review of potential health outcomes recently linked to gestational vitamin D deficiency, including preterm birth, cesarean delivery, and gestational diabetes. Although immediate costs for obstetric complications related to gestational vitamin D insufficiency may be modest, the short- and long-term costs for pediatric healthcare resulting from such gestational complications may be enormous and present an enduring burden on healthcare systems. With increasing evidence pointing to fetal origins of some later life disease, securing vitamin D sufficiency in pregnancy appears to be a simple, safe, and cost-effective measure that can be incorporated into routine preconception and prenatal care in the offices of primary care clinicians. Education on gestational nutritional requirements should be a fundamental part of medical education and residency training, instruction that has been sorely lacking to date.

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The impact of vitamin D deficiency on maternal outcomes in pregnancy

INTERNATIONAL JOURNAL OF ENDOCRINOLOGY ◽

10.22141/2224-0721.17.1.2021.226433 ◽

2021 ◽

Vol 17 (1) ◽

pp. 63-69

Author(s):

A. Konwisser ◽

O. Korytko

Keyword(s):

Vitamin D ◽

Preterm Birth ◽

Gestational Diabetes ◽

Vitamin D Deficiency ◽

Vitamin D Supplementation ◽

Maternal Outcomes ◽

Level Of Evidence ◽

The Impact ◽

In Pregnancy ◽

Risk Of Preeclampsia

Results show vitamin D supplementation during pregnancy improves maternal and infant 25(OH)D concentrations and may play a role in maternal insulin resistance and fetal growth. Literature search was performed using PubMed Database of the National Library of Medicine, with date limits from January 2015 to November 2020. We used the keywords: Vitamin D, pregnancy, vitamin D supplementation, hypovitaminosis D, preeclampsia, gestational diabetes, preterm birth, and other related terms. The studies of interest included original papers and review articles on the influence of vitamin D deficiency in pregnancy and the impact of vitamin D supplementation on the maternal outcomes. The published Cochrane review on vitamin D supplementation studies reported that women who receive vitamin D supplementation had lower risk of preeclampsia but with only borderline significance (RR 0.52, CI 0.25–1.05), whereas combined vitamin D and calcium supplementation significantly reduces the risk of preeclampsia. The overall level of evidence is high for vitamin D supplementation playing no role in the prevention of gestational diabetes. Although analysis of the recent observational studies suggests that vitamin D deficiency can increase the risk of C section, there is a need for investigators to conduct RCT to study the impact of vitamin D supplementation on C-section rates. Maternal vitamin D status closest to the delivery was most significantly associated with preterm birth, thereby proposing that later intervention could be used as a rescue treatment to decrease the risk of preterm deliveries. Though the level of evidence is moderate, our analysis shows no significant association between vitamin D and preterm deliveries. Many studies have been designed to investigate an association between postpartum depression and vitamin D. To determine the benefits of vitamin D supplementation in pregnancy would require further evaluation through large, multicenter double-blind randomized controlled clinical trials, with a focus on specific adverse pregnancy outcomes.

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Vitamin D Deficiency Linked With Gestational Diabetes

Family Practice News ◽

10.1016/s0300-7073(12)70757-0 ◽

2012 ◽

Vol 42 (19) ◽

pp. 3

Author(s):

MITCHEL L. ZOLER

Keyword(s):

Vitamin D ◽

Gestational Diabetes ◽

Vitamin D Deficiency

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Midlife vitamin d deficiency is associated with later-life depression in ageing women: data from the women’s healthy ageing project (whap)

Journal of the Neurological Sciences ◽

10.1016/j.jns.2017.08.464 ◽

2017 ◽

Vol 381 ◽

pp. 158

Author(s):

L. Skazlic ◽

A. Goodwill ◽

C. Szoeke

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Later Life ◽

Healthy Ageing

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The association between gestational vitamin D deficiency and preterm birth : A case control study

Evidence Based Women s Health Journal ◽

10.21608/ebwhj.2019.64365 ◽

2019 ◽

Vol 9 (4) ◽

pp. 605-613

Author(s):

Mohamed Ibrahim ◽

Rehab Abd Elrahman ◽

Marwa El-Kateb

Keyword(s):

Vitamin D ◽

Preterm Birth ◽

Vitamin D Deficiency ◽

Case Control Study ◽

Case Control ◽

Control Study

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Future perspectives in addressing the global issue of vitamin D deficiency

Proceedings of The Nutrition Society ◽

10.1017/s0029665119001538 ◽

2020 ◽

Vol 79 (2) ◽

pp. 246-251 ◽

Cited By ~ 4

Author(s):

M. M. Mendes ◽

K. Charlton ◽

S. Thakur ◽

H. Ribeiro ◽

S. A. Lanham-New

Keyword(s):

Public Health ◽

Vitamin D ◽

Health Outcomes ◽

Vitamin D Deficiency ◽

Public Health Problem ◽

Population Level ◽

The Body ◽

Global Public Health ◽

Global Issue ◽

Wide Range

Vitamin D is a fundamentally critical nutrient that the human body requires to function properly. It plays an important role in musculoskeletal health due to its involvement in the regulation of calcium and phosphorus. Having a low level of vitamin D in the body may be detrimental for a wide range of health outcomes, including risk of osteoporotic and stress fractures, risk of CVD and some cancers, and lowering of the capability of the immune system. Vitamin D is an unusual nutrient; it is not a vitamin, in the true sense of the word but a pro-hormone. The main source of vitamin D is UV exposure, not dietary intake. Interestingly, there are two forms of vitamin D, vitamin D2 and vitamin D3, both of which are metabolised into 25-hydroxyvitamin D (25(OH)D) in the liver, the biomarker of vitamin D status. Vitamin D deficiency is a global public health problem, especially amongst older people and ethnic minority groups. The newest publication from the UK Government's Public Health England Department recommends that vitamin D intake should be 10 μg daily and this recommendation compares well (albeit lower) with other guidelines such as the Institute of Medicine recommendation of 15 μg for those aged 1–70 years and 20 μg for those 70 years or over. Few countries, however, have a specific vitamin D policy to prevent deficiency in populations. Finland leads the way, demonstrating impressive results in reducing population-level vitamin D deficiency through mandatory food fortification programmes. Collaboration between academia, government and industry, including countries from varying latitudes, is essential to identify long-term solutions to the global issue of vitamin D deficiency. This paper provides a narrative review of the evidence related to the role of vitamin D deficiency in health outcomes, outlines controversies regarding setting levels of adequacy, identifies the prevalence of vitamin D deficiency across the globe, and identifies population-level strategies adopted by countries to prevent vitamin D deficiency.

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Hypovitaminosis D in pregnancy and its correlation with preeclampsia and gestational diabetes mellitus

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20170551 ◽

2017 ◽

Vol 6 (3) ◽

pp. 890 ◽

Cited By ~ 1

Author(s):

Ankita Kumari ◽

Shaila Mitra ◽

Harish C Tiwari ◽

Reena Srivastav

Keyword(s):

Diabetes Mellitus ◽

Vitamin D ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Vitamin D Deficiency ◽

Serum Vitamin ◽

Hypovitaminosis D ◽

Health Concern ◽

Control Group ◽

The Impact

Background: Hypovitaminosis D has been associated with a number of adverse pregnancy outcomes, and has been recognised as a public health concern. The objective of this study was to determine the impact of Vitamin D deficiency on maternal complications like gestational diabetes mellitus (GDM) and preeclampsia (PE) among pregnant women.Methods: This was a case control study undertaken at antenatal clinics and indoor of BRD Medical College, Gorakhpur, Uttar Pradesh, India. Two maternal blood samples, one at <20 weeks and other at term along with cord blood at delivery were taken. Patients were classified into preeclampsia (n=60), gestational diabetes mellitus (n=35) and control group (n=180) after abstracting past medical records at delivery. Vitamin D was estimated by 25- Hydroxyvitamin D125 RIA kit and categorized according to ACOG criteria. Statistical analysis was done by using chi square test, binary logistic regression and Pearson’s correlation coefficient to compare between two variables. P<0.05 was considered statistically significant.Results: Out of 275 women included in the study, 78% of women were Vitamin D deficient. Mean serum vitamin D was significantly lower among preeclamptic women 11.53±6.22 ng/ml and GDM women 12.62±6.69 ng/ml as compared to controls 24.25±14.44 ng/ml (median=18.2 ng/ml) (P<0.05). Vitamin D deficiency was significantly higher in pregnant women GDM (94.28% vs 68.3%) and preeclampsia (96.67% vs 68.3%) when compared to uncomplicated group.Conclusions: Maternal vitamin D deficiency is highly prevalent in early pregnancy and is significantly associated with elevated risk for GDM and preeclampsia.

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