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
- 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.
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
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
- see also
- Overview Pregnancy and vitamin D
- Number of articles in both categories of Pregnancy and:Dark Skin
27 ; Depression 21 ; Diabetes 43 ; Obesity 15 ; Hypertension 43 ; Breathing 33 ; Omega-3 39 ; Vitamin D Receptor 24 Click here for details
- All items in category Infant/Child
- Pregnancy needs at least 40 ng of vitamin D, achieved by at least 4,000 IU – Hollis Aug 2017
- 38+ papers with Breastfed etc, in the title
- Call to action – more Vitamin D for pregnancies, loading doses are OK – Holick Aug 2019
- 53+ preeclampsia studies
- 94+ studies with PRETERM in the title
- "polycystic ovary syndrome" OR PCOS 303 items as of Jan 2018
- 94+ Gestational Diabetes
- c-section OR "caesarean section" (various spellings) 937 items in text as of Aug 2020
- postpartum depression 208 items as of Aug 2018
- 31 VitaminDWiki pages had MISCARRIAGE in title as of Aug 2022
- Search VitaminDWiki for "Assisted reproduction" 33 items as of Aug 2022
- Fertility and Sperm category listing has
131 items along with related searches
- (Stunting OR “low birth weight” OR LBW) 1180 items as of June 2020
- Less labor pain if higher level of vitamin D – August 2021
- Healthy pregnancies need lots of vitamin D
- Ensure a healthy pregnancy and baby - take Vitamin D before conception
Healthy pregnancies need lots of vitamin D has the following summaryProblem
Reduces Evidence 0. Chance of not conceiving 3.4 times Observe 1. Miscarriage 2.5 times Observe 2. Pre-eclampsia 3.6 times RCT 3. Gestational Diabetes 3 times RCT 4. Good 2nd trimester sleep quality 3.5 times Observe 5. Premature birth 2 times RCT 6. C-section - unplanned 1.6 times Observe Stillbirth - OMEGA-3 4 times RCT - Omega-3 7. Depression AFTER pregnancy 1.4 times RCT 8. Small for Gestational Age 1.6 times meta-analysis 9. Infant height, weight, head size
within normal limits
RCT 10. Childhood Wheezing 1.3 times RCT 11. Additional child is Autistic 4 times Intervention 12.Young adult Multiple Sclerosis 1.9 times Observe 13. Preeclampsia in young adult 3.5 times RCT 14. Good motor skills @ age 3 1.4 times Observe 15. Childhood Mite allergy 5 times RCT 16. Childhood Respiratory Tract visits 2.5 times RCT
RCT = 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"
gestational diabetes mellitus (GDM)
gestational hypertension (GHTN)/preeclampsia (PE)
preterm labor (PTL),Vitamin D during pregnancy – dramatic changes in both metabolism and genes – Feb 2017
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- All items in category Infant/Child