Eur J Nutr. 2012 Dec 9.
Principi N, Bianchini S, Baggi E, Esposito S.
Pediatric Clinic 1, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 9, 20122, Milan, Italy.
It has recently been demonstrated that vitamin D (VD) deficiency during pregnancy and lactation can give rise to problems in mothers and their children.
To discuss the implications of VD deficiency during pregnancy and the best VD supplementation to use in order to avoid risks for the mother and child.
PubMed was used to select all of the clinical studies published in the last 15 years concerning VD deficiency in pregnant women and its impact on the fetuses, neonates and infants, as well as the use of VD supplementation during pregnancy.
Several studies have suggested that VD deficiency is associated with possible major outcomes in the preconception period, during pregnancy, perinatally and in childhood. A 25(OH)D concentration of >32 and <50-60 ng/mL seems to be associated with the lowest risk of disease, and the administration of 2,000 IU/day to pregnant and breastfeeding women seems to maintain adequate 25(OH)D levels.
However, not all the experts agree with these conclusions because some of them do not think that VD deficiency can really cause extraskeletal manifestations and consider that the traditionally suggested 400-600 IU/day can be enough to permit an adequate bone development.
Despite an increasing amount of data seems to suggest that pregnant women need a greater amount of VD than recommended in the past, further studies are needed to determine how much VD has to be given to assure a regular evolution of the pregnancy and an adequate development of the fetus and the young child.
- Overview Pregnancy and vitamin D has the following summary
|IU||Cumulative Benefit||Blood level||Cofactors||Calcium||$*/month|
|200|| Better bones for mom|
with 600 mg of Calcium
|6 ng/ml increase||Not needed||No effect||$0.10|
|400|| Less Rickets (but not zero with 400 IU)|
3X less adolescent Schizophrenia
Fewer child seizures
|20-30 ng/ml||Not needed||No effect||$0.20|
|2000|| 2X More likely to get pregnant naturally/IVF |
2X Fewer dental problems with pregnancy
8X less diabetes
4X fewer C-sections (>37 ng)
4X less preeclampsia (40 ng vs 10 ng)
5X less child asthma
2X fewer language problems age 5
|42 ng/ml||Desirable||< 750 mg||$1|
|4000|| 2X fewer pregnancy complications |
2X fewer pre-term births
|49 ng/ml|| Should have |
|< 750 mg||$3|
|6000||Probable: larger benefits for above items|
Just enough D for breastfed infant
More maternal and infant weight
|< 750 mg||$4|