Vitamin D in pregnancy: current concepts.

Abstract

PURPOSE OF REVIEW:

Vitamin D is part of a complex steroid hormone system long known to be involved in bone metabolism. Recently, vitamin D has been implicated in physiologic processes as diverse as vascular health, immune function, metabolism and placental function. This review summarizes the current evidence for the role of vitamin D in pregnancy and perinatal outcomes A systematic review of articles published in PubMed between May 2010 and October 2011 was undertaken using key words for vitamin D and pregnancy. Seventy-eight studies were reviewed.

RECENT FINDINGS:

The biologic evidence regarding a role for vitamin D in reproductive outcomes is strong, and rates of vitamin D deficiency may be high among pregnant women. However, no consensus exists regarding optimum vitamin D levels in pregnancy or standard measurement of vitamin D deficiency. Clinical studies establishing an association between vitamin D levels and adverse pregnancy outcomes such as preeclampsia, gestational diabetes, low birthweight, preterm labor, cesarean delivery and infectious diseases have conflicting results. This is likely due to a paucity of randomized trials, heterogeneity of populations studied and low sample size with poor adjustment for confounding among observational studies.

SUMMARY:

Further research should focus on defining optimum 25-hydroxy vitamin D levels in pregnancy as well as among various subgroups of the population. Randomized trials are needed to determine whether vitamin D supplementation can improve pregnancy outcomes. Currently, the American College of Obstetrics and Gynecology and the Institute of Medicine recommend 600 IU of daily vitamin D supplementation during pregnancy to support maternal and fetal bone metabolism.

• Authors: Rachel P Urrutia, John M Thorp
• Journal: Current opinion in obstetrics & gynecology (Curr Opin Obstet Gynecol) Vol. 24 Issue 2 Pg. 57-64 (Mar 2012) ISSN: 1473-656X [Electronic] England
• PMID: 22327734 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Review, Systematic Review)

Chemical References

• Vitamin D
• 25-hydroxyvitamin D

Topics

• Bone Density
• Dietary Supplements
• Female
• Humans
• Infant, Low Birth Weight
• Infant, Newborn
• Infant, Premature
• Obstetric Labor, Premature
• Pregnancy
• Pregnancy Complications, Infectious (diagnosis, drug therapy, immunology)
• Pregnancy Outcome
• Reproductive Health
• Sunlight
• United States (epidemiology)
• Vitamin D (administration & dosage, adverse effects, analogs & derivatives, blood)
• Vitamin D Deficiency (diagnosis, drug therapy, immunology)