Vitamin D inadequacy in pregnancy: biology, outcomes, and interventions.
A high prevalence of maternal vitamin D inadequacy during pregnancy and at delivery has been demonstrated in various ethnic populations living at different latitudes. Because placental transfer of 25(OH)D is the major source of vitamin D to the developing human fetus, there is growing concern about adverse health impacts that hypovitaminosis D during pregnancy may have on the mother as well as the offspring in utero, in infancy, and later in life. While there is lack of consensus regarding the optimal circulating 25(OH)D concentration in pregnancy, it is evident that prior levels used to establish intake recommendations and vitamin D content of prenatal vitamin supplements were too conservative. This review summarizes vitamin D metabolism in the perinatal period, examines evidence regarding outcomes of insufficiency in the mother and offspring, discusses risk factors and prevalence of insufficiency, and considers strategies for public health intervention.
Dror
Daphna K
DK
USDA ARS Western Human Nutrition Research Center, Davis, California 95616, USA. dkdror@ucdavis.edu
Allen
Lindsay H
LH
D000222:Adaptation, Physiological; D050071:Bone Density Conservation Agents / Q000378:metabolism / Q000627:therapeutic use*; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D039382:Maternal Nutritional Physiological Phenomena / Q000502:physiology*; D018673:Nutrition Policy; D009751:Nutritional Requirements; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000517:prevention & control; D011256:Pregnancy Outcome; D039401:Prenatal Nutritional Physiological Phenomena / Q000502:physiology*; D011634:Public Health; D016896:Treatment Outcome; D014807:Vitamin D / Q000378:metabolism / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000453:epidemiology* / Q000517:prevention & control
D050071:Bone Density Conservation Agents; D014807:Vitamin D