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Vitamin D during pregnancy – dramatic changes in both metabolism and genes – Feb 2017

Vitamin D supplementation during pregnancy: Improvements in birth outcomes and complications through direct genomic alteration

Molecular and Cellular Endocrinology. Available online 7 February 2017, http://dx.doi.org/10.1016/j.mce.2017.01.039
Bruce W. Hollis, , Carol L. Wagner
Highlights

  • Vitamin D metabolism during pregnancy differs drastically from the nonpregnant state.
  • Vitamin D requirements during pregnancy and health effects are reviewed.
  • Vitamin D plays a significant role in health outcomes of mother and fetus.
  • Direct genomic alterations occur related to maternal vitamin D status.
  • Childhood asthma and multiple sclerosis linked with pregnancy vitamin D status.

Pregnancy represents a time of rapid change, including dramatic shifts in vitamin D metabolism.

Circulating concentrations of the active form of vitamin D—1,25(OH)2D skyrocket early in pregnancy to levels that would be toxic to a nonpregnant adult, signaling a decoupling of vitamin D from the classic endocrine calcium metabolic pathway, likely serving an immunomodulatory function in the mother and her developing fetus.
In this review, we summarize the unique aspects of vitamin D metabolism and the data surrounding vitamin D requirements during this important period. Both observational and clinical trials are reviewed in the context of vitamin D's health effects during pregnancy that include preeclampsia, preterm birth, and later disease states such as asthma and multiple sclerosis. With enhanced knowledge about vitamin D's role as a preprohormone, it is clear that recommendations about supplementation must mirror what is clinically relevant and evidence-based. Future research that focuses on the critical period(s) leading up to conception and during pregnancy to correct deficiency or maintain optimal vitamin D status remains to be studied. In addition, what effects vitamin D has on genetic signatures that minimize the risk to the mother and her developing fetus have not been elucidated. Clearly, while there is much more research that needs to be performed, our understanding of vitamin D requirements during pregnancy has advanced significantly during the last few decades.

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Abbreviations
25(OH)D, 25-hydroxyvitamin D; 1,25(OH)2D, 1,25-dihydroxyvitamin D; IOM, Institute of Medicine; RCT, Randomized Controlled Trial; VDBP, Vitamin D binding protein; UVB, Ultraviolet B-radiation; EBM, Evidence Based Medicine; FDA, Food and Drug Administration; CDC, Centers for Disease Control; VDAART, Vitamin D Antenatal Asthma Reduction Trial; AAP, American Academy of Pediatrics; WHO, World Health Organization

VitaminDWiki

These two authors have contributed a lot to the understanding of Vitamin D and pregnancy during the past decade
Breastfeeding mother getting 6400 IU of Vitamin D is similar to infant getting 400 IU – RCT Sept 2015
Search for Hollis and Wagner 454 items as of Feb 2017
Pregnancy category starts with

667 items in Pregnancy category

 - see also

Healthy pregnancies need lots of vitamin D has the following summary

Problem
ReducesEvidence
0. Chance of not conceiving3.4 times Observe
1. Miscarriage 2.5 times Observe
2. Pre-eclampsia 3.6 timesRandomized Controlled Trial
3. Gestational Diabetes 3 times Randomized Controlled Trial
4. Good 2nd trimester sleep quality 3.5 times Observe
5. Premature birth 2 times Randomized Controlled Trial
6. C-section - unplanned 1.6 timesObserve
     Stillbirth - OMEGA-3 4 timesRCT - Omega-3
7. Depression AFTER pregnancy 1.4 times Randomized Controlled Trial
8. Small for Gestational Age 1.6 times meta-analysis
9. Infant height, weight, head size
     within normal limits
Randomized Controlled Trial
10. Childhood Wheezing 1.3 times Randomized Controlled Trial
11. Additional child is Autistic 4 times Intervention
12.Young adult Multiple Sclerosis 1.9 timesObserve
13. Preeclampsia in young adult 3.5 timesRandomized Controlled Trial
14. Good motor skills @ age 31.4 times Observe
15. Childhood Mite allergy 5 times Randomized Controlled Trial
16. Childhood Respiratory Tract visits 2.5 times Randomized Controlled Trial

Example of the many charts in the PDF: large decrease in 3 health problems with 4400 IU of vitamin D
"Effect of Vitamin D Supplementation Starting at 20 weeks of Pregnancy with Respect to the Development of Complications of Pregnancy"
Image
gestational diabetes mellitus (GDM)
gestational hypertension (GHTN)/preeclampsia (PE)
preterm labor (PTL),

Attached files

ID Name Comment Uploaded Size Downloads
7772 Pregnancy complicatioms.jpg admin 02 Mar, 2017 18:16 33.97 Kb 194
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