Many groups of pregnant women are at high risk of being vitamin D deficient – Jan 2013

Vitamin D deficiency in pregnancy - still a public health issue.

Matern Child Nutr. 2013 Jan;9(1):23-30. doi: 10.1111/mcn.12014.
McAree T, Jacobs B, Manickavasagar T, Sivalokanathan S, Brennan L, Bassett P, Rainbow S, Blair M.
North West London Hospital NHS Trust, RNOH NHS Trust, Harrow, UK. trixie.mcaree at nhs.net

The objectives of this study were to quantify the prevalence of vitamin D insufficiency and deficiency in pregnancy, explore associated risk factors and discuss the public health implications. The study used retrospective analysis of randomly selected data. This is the first report on serum vitamin D levels in an unselected multi-ethnic population of pregnant women collected between April 2008 and March 2009.

Women with sufficient stored serum were randomly selected from among all women who delivered between April 2008 and March 2009. Serum vitamin D levels were determined using liquid chromatography coupled to tandem mass spectrometry.
Vitamin D levels were analysed with respect to

• ethnicity (marking skin tone),
• calendar quartile,
• body mass index (BMI),
• trimester and
• parity.

Deficiency was defined as <25 nmol L(-1) , insufficiency 25-75 nmol L(-1) and adequacy >75 nmol L(-1) .
Three hundred and forty-six women were included and represented the total population regarding skin tone, quartile, BMI, gestation and parity.
Overall, 18% [95% confidence interval (CI): 15-23%] of sample women had adequate vitamin D levels; 36% were deficient, 45% insufficient.
Among women with dark skin, only 8% (95% CI: 5-12%) had adequate levels compared with 43% (95% CI: 33-53%) of those with light skin.
Obese women were found have significantly lower vitamin D levels than non-obese women.
Vitamin D deficiency and insufficiency are prevalent year-round among pregnant women in North West London, especially those with darker skin.
Existing supplementation guidelines should be supported; however, other measures are required to improve status among all women.

© 2012 Blackwell Publishing Ltd. PMID: 23230904

High Risk Groups

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PDF is attached at the bottom of this page

High Risk if a woman is pregnant with just one of the following

Much higher risk if in more than one: e.g. dark skin and recent birth

• dark skin
• obese trimester (the most bone growth)
• winter
• recent birth (about 15 months for mom's body to re-stock vitamin D)
• twins, triplets, etc.
• have a vitamin D deficiency related disease (MS, diabetes, . . . )
  especially diseases which are in vicious cycles ( low D ==> disease ==> lower D)

Vitamin D deficiency has gotten much worse in England in the past 40 years

1. More obese women
2. More Dark Skin women
3. More women wearing concealing clothes
4. 15 reasons for the vitamin D decrease in the past 40 years which has the following chart

Chart of 2008 actual, and guessed 1978 vitamin D levels in England

See also VitaminDWiki

• All items in Pregnancy and Vitamin D 923 items
• Dark skin pregnancies and Vitamin D - many studies
• Overview Obesity and Vitamin D
• Overview Pregnancy and vitamin D which had the following table April 2013

IU	Cumulative Benefit	Blood level	Cofactors	Calcium	$*/year
400	Less Rickets (but not zero with 400 IU) 3X less adolescent Schizophrenia Fewer child seizures	20-30 ng/ml	Not needed	No effect	$3
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	$15
4000	2X fewer pregnancy complications 2X fewer pre-term births	49 ng/ml	Must have cofactors	< 750 mg	$75
6000	Probable: larger benefits for above items Perhaps prevent 2nd autistic child    clinical trials underway Just enough D for breastfed infant		Must have cofactors	< 750 mg	$85

Some recent studies of Pregnancy and Vitamin D behind firewalls as of April 2013

http://www.ncbi.nlm.nih.gov/pubmed/23547547 Vitamin d supplementation for women during pregnancy.
http://www.ncbi.nlm.nih.gov/pubmed/23168244 Vitamin D in pregnancy at high latitude in Scotland.
http://www.ncbi.nlm.nih.gov/pubmed/23533189 Vitamin D sufficiency in pregnancy. free 7 day trial firewall