Most Pregnant Women in Mediterranean Are Vitamin D Deficient – May 2015

Title of Medscape Multispecialty

Reporting on Hypovitaminosis D in pregnancy: can the Mediterranean paradox be explained? A systematic review

Talk was presented at 17th European Congress of Endocrinology – May 2015
Spyridon Karras1, Stavroula A Paschou1, Eleni Kandaraki1, Panagiotis Anagnostis1, Cédric Annweiler 2,3, Basil C Tarlatzis1, Bruce W Hollis 4, William B Grant 5 & Dimitrios G Goulis1
1Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece;
2Department of Geriatric Medicine, University Hospital, Angers, France;
3Department of Medical Biophysics, Robarts Research Institute, Schulich School of Medicine and Dentistry, University of Western Ontario, Ontario, Canada;
4Medical University of South Carolina Children’s Hospital, Charleston, South Carolina, USA;
5Sunlight, Nutrition, and Health Research Center, San Francisco, California, USA.

Introduction: Despite high levels of sunshine, maternal hypovitaminosis D during pregnancy is prevalent in the Mediterranean region, consisting a paradox. The aim of the study was to systematically review trials that investigated vitamin D concentrations during pregnancy in this region, in order to determine predictors of hypovitaminosis D and explain the paradox.

Methods: After applying inclusion/exclusion criteria, 15 studies were entered into the systematic review, involving 2649 pregnant women and 1820 neonates. The main outcome was maternal vitamin D concentration. Possible predictors of the outcome included study, maternal and neonatal characteristics (

• age,
• BMI,
• race,
• socioeconomic status,
• skin type,
• gestational age,
• sun exposure,
• calcium and vitamin D intake and supplementation,
• smoking status,
• parity,
• season of delivery,
• pregnancy complications).

Results: Studies differed widely in vitamin D deficiency criteria, methods of measurement and outcomes.
However, prevalence of maternal and neonatal hypovitaminosis D was up to 90%.
Predictors of maternal hypovitaminosis D were

• dark skin phototype
• race and
• sartorial habits

Only a few pregnant women met the recommended dietary daily intake of calcium and vitamin D. Vitamin D supplementation was not a common practice.

Conclusions: Hypovitaminosis D during pregnancy is prevalent in the Mediterranean region. Racial, social and cultural habits, as well as the absence of preventive strategies seem to negate the benefits of sun exposure.

 Download the PDF from VitaminDWiki

---

See also VitaminDWiki

• Pregnancy category listing has 923 items along with related searches
• Dark skin pregnancies and Vitamin D - many studies
• Overview Middle East and vitamin D
  
• 84 percent had less than 30 ng of vitamin D (10,000 patients in Saudi Arabia) Sept 2014
• If heavily clothed, very little vitamin D – Dec 2012
• ALL of the top 10 health problems of women are associated with low vitamin D
• 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 cofactors	< 750 mg	$3
6000	Probable: larger benefits for above items Just enough D for breastfed infant More maternal and infant weight		Should have cofactors	< 750 mg	$4

And: Pregnancy problems vs Vitamin D level - GrassrootsHealth Feb 2015

From June 2014