Pregnancy and Lactation

Kovacs, Christopher S.; Kronenberg, Henry M.

doi:10.1002/9781118453926.ch20

Cited by 6 publications

(5 citation statements)

References 63 publications

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“…In the present study, there was a high frequency of hypocalcaemia in the control group, but no hypocalcaemia observed in subjects of the vitamin D-treated group. Generally, hypoalbominaemia due to high intravascular volume is considered as the major cause of mild hypocalcaemia in pregnancy ( 21 ) . In the present study, serum albumin levels were not measured and serum Ca was not corrected for serum albumin.…”

Section: Discussionmentioning

confidence: 99%

Effect of vitamin D administration in vitamin D-deficient pregnant women on maternal and neonatal serum calcium and vitamin D concentrations: a randomised clinical trial

et al. 2013

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There are several studies in which a correlation between maternal vitamin D deficiency and serum mineral disorders in the mother and the newborn has been reported. The present randomised clinical trial was designed to investigate the effect of vitamin D administration on maternal and fetal Ca and vitamin D status. The trial was carried out on 160 pregnant women. Vitamin D-deficient (25-hydroxyvitamin D (25(OH)D) , 30 ng/ml) pregnant women were recruited at 26-28 weeks of pregnancy. In the control group, a multivitamin supplement containing 400 IU vitamin D 3 /d was given. Patients in the treatment group were treated with 50 000 IU vitamin D 3 weekly for a total duration of 8 weeks. At delivery, maternal and fetal Ca and 25(OH)D levels in both groups were compared. In total, 81 % of pregnant women were vitamin D deficient. At the time of delivery, Ca and vitamin D levels were higher in the treatment group compared with the control group (92 (SD 3) v. 85 (SD 4) mg/l, respectively, P¼ 0·001 for serum Ca; 47·8 (SD 11·1) v. 15·9 (SD 6·6) ng/ml, respectively, P, 0·001 for vitamin D). At the time of delivery, 32·7 % of women in the control group had hypocalcaemia, while no hypocalcaemic case was detected in the vitamin D-treated group. Mean neonatal serum 25(OH)D was higher in the treatment group compared with the control group (27·7 (SD 5·2) v.10·9 (SD 4·4) ng/ml, respectively, P, 0·01). The neonatal Ca level in the treatment group was significantly higher than that of the control group (99 (SD 3) v. 91 (SD 3) mg/l, respectively, P, 0·001). The administration of vitamin D to pregnant women with vitamin D deficiency improves both maternal and neonatal Ca levels. Key words: Vitamin D deficiency: Pregnancy: HypocalcaemiaVitamin D is an essential substance for maintaining the natural bone architecture. Vitamin D deficiency can lead to complications including osteomalacia and secondary osteoporosis (1) . During pregnancy, considerable amounts of Ca are transferred from the mother to the fetus, and the preparation of such supply of Ca is mainly achieved by the regulation of increased intestinal Ca absorption. Moreover, during pregnancy, the concentration of 1,25-dihydroxyvitamin D increases two to three times above the normal range mainly because of the increase in renal 1-a-hydroxylase activity (2) . Theoretically, vitamin D deficiency in mothers could lead to a low production of 1,25-dihydroxyvitamin D due to substrate reduction. Maternal 1,25-dihydroxyvitamin D is transported to the fetus through the placenta, and the cord blood vitamin D level is equal to or at most 25 % lower than the maternal concentration (3) .There are only a few foods that are good sources of vitamin D, and in countries with no food fortification industries, the generation of vitamin D in the skin is the major source of vitamin D in the body. However, many studies have reported high frequencies of vitamin D deficiency in sunny countries (4 -7) .Vitamin D deficiency is highly common in Iran, and based on several reports, up to 80 % of women...

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Section: Discussionmentioning

confidence: 99%

Effect of vitamin D administration in vitamin D-deficient pregnant women on maternal and neonatal serum calcium and vitamin D concentrations: a randomised clinical trial

et al. 2013

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Section: Resultsmentioning

confidence: 99%

“…[10] A combination of factors suggested to tally with this condition, are pregnancy-associated factors such as: immobilization, femoral venous stasis, obturator nerve pressure and hormonal variations of pregnancy, apart from traditional breastfeeding and osteoporosis risk factors involving: infective or inflammatory diseases, previous trauma, vascular lesions, neoplasia, alcoholic consumption, smoking, steroids, medications intake, hypothyroidism, low vitamin D or osteogenesis imperfecta. [4,11] During pregnancy, several maternal adaptations occur for supplying the required calcium. The proportion of intestinal calcium absorption doubles, which is featured to be principally expedited by raised 1,25-dihydroxyvitamin D (1,25-OH D) levels generated by the maternal kidneys, [11,12] albeit, other factors such as prolactin and placental lactogen may also contribute.…”

Section: Skeletal Adaptations During Pregnancy/lactation and Pathophy...mentioning

confidence: 99%

“…[4,11] During pregnancy, several maternal adaptations occur for supplying the required calcium. The proportion of intestinal calcium absorption doubles, which is featured to be principally expedited by raised 1,25-dihydroxyvitamin D (1,25-OH D) levels generated by the maternal kidneys, [11,12] albeit, other factors such as prolactin and placental lactogen may also contribute. [11] Other alterations include parathyroid hormone (PTH) diminution and PTHrp increase precipitated by the placenta and bosoms, which are considered to conduce to the augmentation of 1,25-OH D by stimulating renal 1-alpha hydroxylase.…”

Section: Skeletal Adaptations During Pregnancy/lactation and Pathophy...mentioning

confidence: 99%

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The correlation between transient osteoporosis of the hip and pregnancy: A review

Galanis,

Dimopoulou,

Karampinas

et al. 2023

Medicine

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Transient osteoporosis of the hip is indubitably a comparatively infrequent entity affecting both men and women worldwide. Its occurrence in the course of pregnancy, specifically in the third trimester, and lactation are of paramount concernment. The exact association between transient hip osteoporosis and pregnancy is precarious. Etiology and potential pathophysiological mechanisms behind this correlation are still to be utterly defined. Magnetic resonance imaging is highly regarded as the gold standard imaging method for assiduous assessment of this disorder. Physicians of copious medical specialties should practice scrupulous techniques for early and pertinent diagnosis when pregnant women are presented with persistent hip pain, as differential diagnosis with femoral head avascular necrosis can be exceedingly arduous. Treatment is predominantly conservative with protected weight-bearing and analgesic medication in the first line of management. In terms of prognosis, the disease ordinarily resolves spontaneously after a few months. Further research is required in order to elucidate the ambiguity surrounding the establishment of globally approved diagnosis and treatment guidelines for pregnancy-associated transient hip osteoporosis. This paper aims to accentuate the significance of this particular disorder by providing a succinct review of the existing literature, augmenting clinicians’ knowledge about the features of pregnancy-related transient proximal femur osteoporosis.

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“…1 The third trimester is critical for foetal skeletal development as most of the placental transport of calcium and phosphorous 2 and up to 80% of foetal bone mineralisation occur during this period. 3 Nearly one third of children born at VLBW suffer from metabolic bone disease of prematurity, a condition defined by radiological and biochemical signs of demineralisation. 2,[4][5][6] Previous studies have not clearly established whether preterm birth is associated with long-term detrimental effects on bone health.…”

Section: Backg Rou N Dmentioning

confidence: 99%