Maternal vitamin D levels during pregnancy and neonatal health: evidence to date and clinical implications

Karras, Spyridon Ν.; Fakhoury, Hana; Muscogiuri, Giovanna; Grant, William B.; Ouweland, J. M. Van den; Colao, A.; Kotsa, Kalliopi

doi:10.1177/1759720x16656810

Cited by 69 publications

(68 citation statements)

References 93 publications

(119 reference statements)

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“…Moreover, low levels of vitamin D during pregnancy have been reported in many populations worldwide, even in those with abundant sun exposure [24]. Previous findings have reported a varied prevalence of 18 to 84% for hypovitaminosis D during pregnancy, depending on the population studied [25-28].…”

Section: Introductionmentioning

confidence: 99%

Rationale and Design of Khuzestan Vitamin D Deficiency Screening Program in Pregnancy: A Stratified Randomized Vitamin D Supplementation Controlled Trial

Rostami¹,

Tehrani²,

Simbar³

et al. 2017

JMIR Res Protoc

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BackgroundAlthough there have been marked improvements in our understanding of vitamin D functions in different diseases, gaps on its role during pregnancy remain. Due to the lack of consensus on the most accurate marker of vitamin D deficiency during pregnancy and the optimal level of 25-hydroxyvitamin D, 25(OH)D, for its definition, vitamin D deficiency assessment during pregnancy is a complicated process. Besides, the optimal protocol for treatment of hypovitaminosis D and its effect on maternal and neonatal outcomes are still unclear.ObjectiveThe aim of our study was to estimate the prevalence of vitamin D deficiency in the first trimester of pregnancy and to compare vitamin D screening strategy with no screening. Also, we intended to compare the effectiveness of various treatment regimens on maternal and neonatal outcomes in Masjed-Soleyman and Shushtar cities of Khuzestan province, Iran.MethodsThis was a two-phase study. First, a population-based cross-sectional study was conducted; recruiting 1600 and 900 first trimester pregnant women from health centers of Masjed-Soleyman and Shushtar, respectively, using stratified multistage cluster sampling with probability proportional to size (PPS) method. Second, to assess the effect of screening strategy on maternal and neonatal outcomes, Masjed-Soleyman participants were assigned to a screening program versus Shushtar participants who became the nonscreening arm. Within the framework of the screening regimen, an 8-arm blind randomized clinical trial was undertaken to compare the effects of various treatment protocols. A total of 800 pregnant women with vitamin D deficiency were selected using simple random sampling from the 1600 individuals of Masjed-Soleyman as interventional groups. Serum concentrations of 25(OH)D were classified as: (1) severe deficient (<10ng/ml), (2) moderate deficient (10-20ng/ml), and (3) normal status (>20ng/ml). Those with severe and moderate deficiency were randomly divided into 4 subgroups and received vitamin D3 based on protocol and were followed until delivery. Data was analyzed according to the intention-to-treat principle.ResultsRecruitment commenced in July, 2014, and as estimated, nearly 3.5 years is needed to complete the study. Results of this study will (1) provide reliable information regarding the prevalence of vitamin D deficiency during pregnancy using universal vitamin D screening approach and (2) determine the beneficial effects of universal screening and compare the various treatment protocols in terms of pregnancy outcomes.ConclusionsSince vitamin D deficiency is a prevalent disorder in pregnancy among Iranian population, this study will ensure creation of reliable evidence-based findings and will enable clinicians to better evaluate and treat vitamin D deficient pregnant women.Trial RegistrationInternational Standard Randomized Controlled Trial Number (ISRCTN): 2014102519660N1; http://www.irct.ir/searchresult.php?keyword=&id=19660&number=1&prt=7805&total=10&m=1 (Archived by WebCite at http://www.webcitation.org/6p3lk...

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Section: Introductionmentioning

confidence: 99%

Rationale and Design of Khuzestan Vitamin D Deficiency Screening Program in Pregnancy: A Stratified Randomized Vitamin D Supplementation Controlled Trial

Rostami¹,

Tehrani²,

Simbar³

et al. 2017

JMIR Res Protoc

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“…3 Cochrane veri tabanında Whitworth ve ark. (2010) tarafından yapılan, 37.505 kadının dahil edildiği 11 çalışmanın meta analiz sonuçlarında, gebeliğin erken dönem-lerinde fetal değerlendirme için rutin ultrason kullanımı, çoğul gebeliği saptamada hatayı azaltıcı bir faktör olarak belirlenmiştir. 4 Gebeliğin son dö-nemlerindeki rutin ultrason görüntülemesinin yapılması ile doğum sırasında indüksiyon kullanımının azalması birbiriyle ilişkili bulunmuş-tur.…”

Section: Ruti̇n Ultrason İzlemi̇unclassified

“…(2016) tarafından annenin D vitamini düzeyinin hamilelik ve yenidoğan sağlığına etkilerini incelemek amacıyla yapılan bir başka çalışmada; gebelik sırasında D vitamini desteğinin preterm doğum, düşük doğum ağırlığı ve solunum yolu enfeksiyonları ve sepsis gibi yenidoğan hastalıklarına karşı risk azaltıcı etkisi olduğu gösterilmiştir. 37 Rodriguez ve ark. (2015) tarafın-dan annenin dolaşımındaki 25-hidroksivitamin D 3 konsantrasyonu ile gebelik ve doğum sonuçları arasındaki ilişkinin belirlenmesi amacıyla 2.382 anneçocuğun izlendiği bir çalışmada ise; gebelikte D vitamini durumu ile GDM, preterm doğum, intrauterin gelişme geriliği (IUGG), düşük doğum ağırlığı (DDA) ve antropometrik doğum sonuçları arasında bir ilişki olduğuna dair herhangi bir kanıt bulunamamıştır.…”

Section: Vi̇tami̇ni̇ Desteği̇unclassified

Evidence-Based Practices During Pregnancy and Midwifery Approach

Kurtoğlu¹,

Yılmaz²

2018

Turkiye Klinikleri J Health Sci

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Ö ÖZ ZE ET T Gebelik dönemi bir kadının hayatındaki en önemli, danışmanlığa en ihtiyaç duyduğu dö-nemlerden biridir. Anne ve yeni doğanın mortalite ve morbiditesini azaltmaya yönelik global stratejiler, gebelik dönemindeki bakımın kalitesine giderek daha fazla ağırlık vermektedir. Günümüzde kanıt temelli yaklaşımla bilimsel bilgiyi oluşturmak ve tüm sağlık profesyonellerinin bu bilgiye ulaşabilmesi ve standart düzeyde uygulayabilmesi amacıyla klinik uygulama rehberleri ve protokoller oluşturulmuştur. Ebelerin gebeye destek olmak ve ebelik bakımının kalitesini artırmaya yönelik bilgi, beceri ve uygulamalarının kanıt temelli olması, gebelik ve doğum ile ilgili hedeflenen sağlık göstergelerine ulaşılmasını sağlayacaktır. Antenatal takiplerde gebelere bakım veren ebelerin, gebeye sunacağı hizmet, danışmanlık ve eğitimin, güncel literatür ışığında yenilenmiş, bilimsel verilere dayalı olması gerekmektedir. Bu derleme, Türkiye de gebeye antenatal bakım hizmeti veren ebeler ve doğum öncesi bakımda yer alan diğer sağlık profesyonellerine katkıda bulunması amacıyla; rutin ultrason izlemi, rutin gebelik izlemi, gestasyonel diyabet taraması ve tanısı, gebelikte beslenme ve egzersiz, gebelikte beslenmeyi etkileyen rahatsızlıklara yönelik uygulamalar, gebelikte vitamin ve minerallerin kullanımına yönelik uygulamalar, gebelikte zararlı alışkanlıklara yönelik uygulamalar, gebelikte psiko-sosyal ve aile içi şiddetin değerlendirilmesi, gebelikte tetanoz aşısı ve ebe liderliğindeki sürekli bakım konularını güncel literatür ve klinik uygulama rehberleri doğrul-tusunda kanıta dayalı olarak irdelemektedir.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Gebelik; kanıta dayalı uygulamalar; prenatal bakım; ebe A AB BS S T TR RA AC CT T The pregnancy period is one of the most important periods in a woman's life, the most needed period of counseling. Global strategy to reduce maternal and newborn mortality and morbidity are going to give more weight to the quality of care in pregnancy. Today, clinical practice guides and protocols have been established in order to create scientific knowledge with an evidence-based approach and to enable all health professionals to access this information and apply it at the standard level. Midwives information to improve the quality of midwifery care and support to pregnant women, to have the skills and evidence-based practices will ensure the achievement of the targeted health indicators related to pregnancy and childbirth. The antenatal care, counseling and education that will be delivered to antenatal follow-ups should be based on updated scientific evidence in the light of current literature. This review examines the continuing care of routine ultrasonographic follow-up, routine pregnancy monitoring, gestational diabetes screening and diagnosis, use of vitamins and minerals in pregnancy, nutrition and exercise in pregnancy, applications for discomforts affecting pregnancy, harmful habits in pregnancy, psychosocial and domestic violence assessment, pregnancy tetanus vaccination and midwife-led...

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“…Serum 25-OHD concentration provides the best indication of vitamin D status. 5 Vitamin D deficiency is the most common cause of hypocalcaemia after the first 3 days of life. 6 High-dose vitamin D therapy with 1000-5000 IU/day for 3 months is preferred for less than 12 months old.…”

Section: Casementioning

confidence: 99%

Maternal hypovitaminosis D: a cause of neonatal hypocalcemic seizures

Deepika

Raghoji

Ramakrishna

et al. 2017

Int J Contemp Pediatr

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Neonatal late onset hypocalcemia is the one which occurs after 72 hours of life. 1,25 (OH)2- vitamin D and Parathormone (PTH) play crucial role in regulation of calcium and phosphorus homeostasis in the body. Vitamin D helps in the absorption of calcium and phosphorus from the gut. PTH promotes absorption of calcium from thick ascending loop of henle and distal tubule whereas it increases excretion of phosphorus. During hypocalcemia, parathormone level shoot up in the body to maintain normal calcium levels. In a patient with poor resources of vitamin D, there is disturbance of Calcium, phosphorus homeostasis leading on to clinical manifestations. Exclusively breast-fed infants without vitamin D supplementation and infants born to mothers with Vitamin D deficiency are at risk to develop Hypovitaminosis D and manifest symptoms of hypocalcemia.

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Maternal vitamin D levels during pregnancy and neonatal health: evidence to date and clinical implications

Cited by 69 publications

References 93 publications

Rationale and Design of Khuzestan Vitamin D Deficiency Screening Program in Pregnancy: A Stratified Randomized Vitamin D Supplementation Controlled Trial

Rationale and Design of Khuzestan Vitamin D Deficiency Screening Program in Pregnancy: A Stratified Randomized Vitamin D Supplementation Controlled Trial

Evidence-Based Practices During Pregnancy and Midwifery Approach

Maternal hypovitaminosis D: a cause of neonatal hypocalcemic seizures

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