title: Maternal-fetal impact of vitamin D deficiency: a critical review.
abstract: Research into the extra-skeletal functions of vitamin D has been expanding in recent years. During pregnancy, maternal vitamin D status may be of concern because of the key role of this vitamin in fetal skeletal development and due to the association between hypovitaminosis D and adverse maternal-fetal outcomes. Therefore, the objective of this manuscript was to review the maternal-fetal impact of gestational vitamin D deficiency and the benefits of vitamin D supplementation during pregnancy. A literature search was performed in PubMed and Embase employing the following keywords: vitamin D deficiency, pregnancy, 25-hydroxyvitamin D, and hypovitaminosis D. All relevant articles in English language published since 1980 were analysed by the two authors. Neonatal complications derived from vitamin D deficiency include low birth weight, growth restriction, and respiratory tract infection. In the mother, vitamin D deficiency has been associated with altered glucose homeostasis and increased incidence of gestational diabetes mellitus, pre-eclampsia, and bacterial vaginosis. However, the current state of the evidence is controversial for some other endpoints and the actual benefit of vitamin D supplementation in pregnancy remains unclear. Additional longitudinal studies may clarify the actual impact of vitamin D deficiency during pregnancy, and randomised trials are required to define the benefits of vitamin D supplementation in reducing the incidence of adverse outcomes in the mother and infant.
authors.affiliation: Postgraduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil, leticiasweinert@yahoo.com.br.
authors.forename: Letícia Schwerz
authors.initials: LS
authors.lastname: Weinert
authors.forename: Sandra Pinho
authors.initials: SP
authors.lastname: Silveiro
mesh_terms: D016640:Diabetes, Gestational / Q000209:etiology; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D011225:Pre-Eclampsia / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011295:Prenatal Care; D012141:Respiratory Tract Infections / Q000209:etiology; D016585:Vaginosis, Bacterial / Q000209:etiology; D014807:Vitamin D / Q000008:administration & dosage / Q000031:analogs & derivatives; D014808:Vitamin D Deficiency / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D
references.citation: Am J Obstet Gynecol. 2011 Jan;204(1):41.e1-9
references.pmid: 20887971
references.citation: Allergy. 2013 Feb;68(2):220-8
references.pmid: 23253182
references.citation: Diabetes. 2012 Jan;61(1):175-8
references.pmid: 22124461
references.citation: J Clin Endocrinol Metab. 2010 Nov;95(11):5105-9
references.pmid: 20719829
references.citation: BJOG. 2012 Jun;119(7):832-9
references.pmid: 22462640
references.citation: Ginekol Pol. 2013 May;84(5):363-7
references.pmid: 23819402
references.citation: J Clin Endocrinol Metab. 2012 Nov;97(11):E2070-7
references.pmid: 22990090
references.citation: Clin Pediatr (Phila). 2007 Jan;46(1):42-4
references.pmid: 17164508
references.citation: J Hum Nutr Diet. 2014 Jun;27(3):261-9
references.pmid: 24033613
references.citation: Obstet Gynecol. 2007 Mar;109(3):669-77
references.pmid: 17329519
references.citation: Am J Obstet Gynecol. 2011 Jun;204(6):556.e1-4
references.pmid: 21507371
references.citation: Diabetologia. 2012 May;55(5):1291-4
references.pmid: 22270224
references.citation: J Perinatol. 2007 Sep;27(9):568-71
references.pmid: 17625571
references.citation: Am J Hypertens. 2014 Oct;27(10):1316-20
references.pmid: 24663440
references.citation: Neurology. 2012 Nov 20;79(21):2140-5
references.pmid: 23170011
references.citation: J Am Coll Nutr. 1999 Apr;18(2):122-6
references.pmid: 10204827
references.citation: J Bone Miner Metab. 2011 Sep;29(5):615-20
references.pmid: 21384110
references.citation: Psychosom Med. 2012 Sep;74(7):751-7
references.pmid: 22879429
references.citation: Am J Obstet Gynecol. 2013 Feb;208(2):137.e1-13
references.pmid: 23131462
references.citation: Br J Nutr. 2013 Mar 14;109(5):898-905
references.pmid: 23168244
references.citation: Eur J Nutr. 2013 Apr;52(3):859-67
references.pmid: 23224056
references.citation: Br J Nutr. 2010 Jul;104(1):108-17
references.pmid: 20193097
references.citation: Lancet. 2013 Jun 22;381(9884):2176-83
references.pmid: 23518316
references.citation: BJOG. 2001 Jan;108(1):56-60
references.pmid: 11213005
references.citation: J Am Coll Nutr. 2004 Dec;23(6 Suppl):588S-595S
references.pmid: 15640511
references.citation: Am J Obstet Gynecol. 2012 Sep;207(3):182.e1-8
references.pmid: 22717271
references.citation: J Mammary Gland Biol Neoplasia. 2005 Apr;10(2):105-18
references.pmid: 16025218
references.citation: J Clin Endocrinol Metab. 2011 Jul;96(7):1911-30
references.pmid: 21646368
references.citation: Hum Reprod. 2013 Jul;28(7):1809-15
references.pmid: 23543384
references.citation: Physiol Rev. 1998 Oct;78(4):1193-231
references.pmid: 9790574
references.citation: Am J Obstet Gynecol. 2011 Sep;205(3):262.e1-8
references.pmid: 22071057
references.citation: Diabet Med. 2013 Sep;30(9):1033-9
references.pmid: 23668717
references.citation: Endocrinol Metab Clin North Am. 2012 Sep;41(3):571-94
references.pmid: 22877430
references.citation: Matern Child Nutr. 2013 Jan;9(1):23-30
references.pmid: 23230904
references.citation: Pediatrics. 2011 Jan;127(1):e180-7
references.pmid: 21187313
references.citation: Pediatrics. 2014 Jan;133(1):e143-53
references.pmid: 24344104
references.citation: Nutr J. 2013 Apr 12;12:47
references.pmid: 23587190
references.citation: Clin Chem. 2013 Feb;59(2):381-91
references.pmid: 23232064
references.citation: Am J Med Sci. 2012 Jan;343(1):2-9
references.pmid: 22143133
references.citation: J Nutr. 2010 May;140(5):999-1006
references.pmid: 20200114
references.citation: Am J Clin Nutr. 2000 Sep;72(3):690-3
references.pmid: 10966885
references.citation: Acta Neurol Scand Suppl. 2012;(195):58-62
references.pmid: 23278658
references.citation: Diabet Med. 2012 Jul;29(7):e25-32
references.pmid: 22150870
references.citation: N Engl J Med. 2007 Jul 19;357(3):266-81
references.pmid: 17634462
references.citation: J Womens Health (Larchmt). 2012 Nov;21(11):1189-95
references.pmid: 22823176
references.citation: Circulation. 2008 Jan 22;117(3):405-10
references.pmid: 18172034
references.citation: Arch Intern Med. 2008 Jun 23;168(12):1340-9
references.pmid: 18574092
references.citation: Pediatr Rep. 2013 Feb 05;5(1):e6
references.pmid: 23667735
references.citation: Ann Neurol. 2011 Jul;70(1):30-40
references.pmid: 21786297
references.citation: Curr HIV Res. 2012 Apr;10(3):202-10
references.pmid: 22384839
references.citation: BJOG. 2010 Dec;117(13):1593-8
references.pmid: 21040394
references.citation: Lancet. 2006 Jan 7;367(9504):36-43
references.pmid: 16399151
references.citation: Pediatrics. 2012 Oct;130(4):e913-20
references.pmid: 22987876
references.citation: J Clin Endocrinol Metab. 2009 Mar;94(3):940-5
references.pmid: 19106272
references.citation: Hypertension. 2010 Oct;56(4):758-63
references.pmid: 20733087
references.citation: J Clin Endocrinol Metab. 2013 Jan;98(1):398-404
references.pmid: 23162094
references.citation: Eur J Clin Nutr. 2008 Jan;62(1):68-77
references.pmid: 17311057
references.citation: Nutrients. 2012 Apr;4(4):319-30
references.pmid: 22606373
references.citation: J Clin Endocrinol Metab. 2008 Mar;93(3):677-81
references.pmid: 18089691
references.citation: Int J Gynaecol Obstet. 2012 Jan;116(1):6-9
references.pmid: 21959069
references.citation: J Clin Endocrinol Metab. 2007 Sep;92(9):3517-22
references.pmid: 17535985
references.citation: Diabetes Care. 2011 Jun;34(6):1258-64
references.pmid: 21498785
references.citation: PLoS One. 2013 Dec 26;8(12):e85081
references.pmid: 24386450
references.citation: J Clin Invest. 1984 Dec;74(6):1966-71
references.pmid: 6549014
references.citation: J Nutr. 2007 Feb;137(2):447-52
references.pmid: 17237325
references.citation: Anticancer Agents Med Chem. 2013 Jan;13(1):70-82
references.pmid: 23094923
references.citation: BMJ. 2013 Mar 26;346:f1169
references.pmid: 23533188
references.citation: PLoS One. 2012;7(10):e45201
references.pmid: 23056195
references.citation: Pediatrics. 2011 Jun;127(6):e1513-20
references.pmid: 21555499
references.citation: Ann Epidemiol. 2012 Aug;22(8):581-6
references.pmid: 22658824
references.citation: Fertil Steril. 2013 Jan;99(1):206-211
references.pmid: 23040526
references.citation: J Bone Miner Res. 2011 Oct;26(10):2341-57
references.pmid: 21706518
references.citation: Br J Nutr. 2013 Nov 14;110(9):1611-6
references.pmid: 23628132
references.citation: Cochrane Database Syst Rev. 2012 Feb 15;(2):CD008873
references.pmid: 22336854
references.citation: J Clin Endocrinol Metab. 2006 Mar;91(3):906-12
references.pmid: 16352684
references.citation: Pediatrics. 2012 Nov;130(5):e1128-35
references.pmid: 23090338
references.citation: J Endocrinol Invest. 2008 Nov;31(11):991-5
references.pmid: 19169055
references.citation: J Midwifery Womens Health. 2012 Sep-Oct;57(5):439-44
references.pmid: 22954074
references.citation: J Obstet Gynecol Neonatal Nurs. 2012 May-Jun;41(3):328-38
references.pmid: 22834880
references.citation: PLoS One. 2012;7(8):e43868
references.pmid: 22937114
references.citation: Pak J Med Sci. 2013 Jan;29(1):15-20
references.pmid: 24353500
references.citation: J Clin Endocrinol Metab. 2013 Jun;98(6):2337-46
references.pmid: 23559082
references.citation: CMAJ. 2005 Mar 15;172(6):757-61
references.pmid: 15767609
references.citation: Am J Clin Nutr. 2007 Mar;85(3):788-95
references.pmid: 17344501
references.citation: Am J Obstet Gynecol. 2010 Oct;203(4):366.e1-6
references.pmid: 20692641
references.citation: Br Med J. 1980 Mar 15;280(6216):751-4
references.pmid: 6989438