Vitamin D deficiency and insufficiency in pregnant women: a longitudinal study

Holmes, Valerie; Barnes, Maria S.; Alexander, H. Denis; McFaul, P.; Wallace, Julie

doi:10.1017/s0007114509297236

Cited by 211 publications

(176 citation statements)

References 28 publications

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“…37,38 Controversies exist on whether P-25OHD is affected by pregnancy per se. Holmes et al 26 found lower P-25OHD concentrations in women during their second and third trimester compared with non-pregnant controls, whereas Hillman et al 27 found no such pregnancy-induced decrease in P-25OHD. Neither do our data support an effect of pregnancy on P-25OHD concentrations, although our results are limited by the fact that most of our participants used vitamin D supplements.…”

Section: Discussionmentioning

confidence: 98%

Effects of 25OHD concentrations on chances of pregnancy and pregnancy outcomes: a cohort study in healthy Danish women

et al. 2012

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BACKGROUND/OBJECTIVES: Plasma 25-hydroxyvitamin D (P-25OHD) concentrations may affect pregnancy outcomes. To elucidate this further, we studied the effects of pre-conception P-25OHD concentrations on chances for pregnancy as well as the effects of P-25OHD during pregnancy on the risk of miscarriage, birth weight and length, Apgar score and head circumference. Moreover, we studied whether pregnancy and breastfeeding patterns affect maternal P-25OHD concentrations. SUBJECTS/METHODS: A total of 153 healthy Caucasian women with pregnancy plans were followed with measurements performed before pregnancy, at pregnancy weeks 11±2, 22±1 and 35±2 as well as 15±7, 129±12 and 280±15 days postpartum. Furthermore, 75 non-pregnant, age-matched women were followed in parallel as controls. RESULTS: The 203 women were aged 29 (25 --35) years. At baseline, median P-25OHD was 59 nmol/l. Of these women, 31% had P-25OHD o50 nmol/l, whereas 12% had levels above 80 nmol/l. Within B6 months after inclusion, 63% conceived. P-25OHD was not associated with chances of conceiving or overall risk of miscarriage. However, women with a miscarriage in their second trimester (n ¼ 3) had lower P-25OHD concentrations at measurements performed in the first trimester compared with women without a miscarriage (P ¼ 0.03). P-25OHD before or during pregnancy was not associated with gestational length or infant parameters. Adjustments for possible confounders did not change the result. During pregnancy, P-25OHD changed significant over time, but similar changes occurred within the control group, indicating no effect of pregnancy per se (P ¼ 0.59). Overall, P-25OHD did not differ according to length of breastfeeding at 2 weeks, and 4 and 9 months postpartum, although women breastfeeding for 49 months had lower P-25OHD levels at the last visit compared with the controls. CONCLUSION: P-25OHD concentrations did not affect fertility or pregnancy outcomes, although low P-25OHD may be associated with an increased risk of late miscarriage. 1 In female rats, low P-25OHD concentration has been associated with gonadal insufficiency, 2 although it is unclear whether this is due to the effects of hypocalcemia rather than a direct effect of P-25OHD. The vitamin D receptor is expressed in human sperm cells, and 1,25-dihydroxyvitamin D concentration may affect sperm survival and the acquisition of fertilizing ability of sperm cells.

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Section: Discussionmentioning

confidence: 98%

Effects of 25OHD concentrations on chances of pregnancy and pregnancy outcomes: a cohort study in healthy Danish women

et al. 2012

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“…This seasonal effect is correlated with the presence of a familial risk factor for MS [Sotgiu et al 2006] or with the phenotype HLA-DRB1 in Canada [Ramagopalan et al 2009a] but not in Finland [Saastoimanen et al 2012]. These results may be related to the vitamin D status of pregnant women [Willer et al 2005;Salzer et al 2010], since 25-OH-D serum levels are at their highest in autumn and their lowest in spring in the general population as well as in pregnant women [Hypponen and Power, 2007;Holmes et al 2009;Handel et al 2010a;Lewis et al 2010]. In line with this hypothesis, it may be consistent that in sunnier countries, that is, with less contrast between the seasons, no seasonal difference in the month of birth has been observed for MS risk [Givon et al 2012;Fragoso et al 2012].…”

Section: Genetic Risk Factors For Multiple Sclerosis Possibly Involvimentioning

confidence: 99%

Contribution of vitamin D insufficiency to the pathogenesis of multiple sclerosis

Pierrot‐Deseilligny

Souberbielle

2013

Ther Adv Neurol Disord

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Abstract:The contribution of vitamin D insufficiency to the pathogenesis of multiple sclerosis (MS) is reviewed. Among the multiple recently discovered actions of vitamin D, an immunomodulatory role has been documented in experimental autoimmune encephalomyelitis and in humans. This action in the peripheral immune system is currently the main known mechanism through which vitamin D might influence MS, but other types of actions could be involved within the central nervous system. Furthermore, vitamin D insufficiency is widespread in temperate countries and in patients with MS at the earliest stages of the disease, suggesting that the deleterious effects related to vitamin D insufficiency may be exerted in these patients. In fact, many genetic and environmental risk factors appear to interact and contribute to MS. In genetics, several human leukocyte antigen (HLA) alleles (more particularly HLA-DRB1*1501) could favour the disease whereas some others could be protective. Some of the genes involved in vitamin D metabolism (e.g. CYP27B1) also play a significant role. Furthermore, three environmental risk factors have been identified: past Epstein-Barr virus infection, vitamin D insufficiency and cigarette smoking. Interactions between genetic and environmental risk or protective factors may occur during the mother's pregnancy and could continue during childhood and adolescence and until the disease is triggered in adulthood, therefore possibly modulating the MS risk throughout the first decades of life. Furthermore, some clinical findings already strongly suggest that vitamin D status influences the relapse rate and radiological lesions in patients with MS, although the results of adequately powered randomized clinical trials using vitamin D supplementation have not yet been reported. While awaiting these incontrovertible results, which might be long in coming, patients with MS who are currently in vitamin D insufficiency should be supplemented, at least for their general health status, using moderate doses of the vitamin.

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“…1 Vitamin D status at birth and during early infancy, when breast milk is the predominant source of nutrition, is determined by maternal vitamin D status. 2,3 Contemporary population-and primary care-based studies of pregnant women have shown a high prevalence of serum 25(OH)D ,20 ng/mL in Asia (70%-96%), [4][5][6] Australia (10%-47%), [7][8][9][10] Europe (15%-44%), 11,12 the United Kingdom (49%-75%), [13][14][15] India (74%), 16 and the United States (37%). 17 Although less completely studied at the population level, in primary care-based studies from the United States, serum 25(OH)D ,20 ng/mL is present in 11% to 12% of infants.…”

mentioning

confidence: 99%

Vitamin D During Pregnancy and Infancy and Infant Serum 25-Hydroxyvitamin D Concentration

Stewart

Scragg

Milne³

et al. 2014

Pediatrics

157

134

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WHAT'S KNOWN ON THIS SUBJECT: A serum 25-hydroxyvitamin D (25(OH)D) concentration of 20 ng/mL meets the requirements of at least 97.5% of the population older than 1 year. A recommended dietary intake to achieve this serum 25(OH)D concentration has not been established during infancy. WHAT THIS STUDY ADDS: METHODS:A randomized, double-blind, placebo-controlled trial in New Zealand. Pregnant mothers, from 27 weeks' gestation to birth, and then their infants, from birth to age 6 months, were randomly assigned to 1 of 3 mother/infant groups: placebo/placebo, vitamin D 3 1000/400 IU, or vitamin D 3 2000/800 IU. Serum 25(OH)D and calcium concentrations were measured at enrollment, 36 weeks' gestation, in cord blood, and in infants at 2, 4, and 6 months of age.RESULTS: Two-hundred-and-sixty pregnant women were randomized. At enrollment, the proportions with serum 25(OH)D $20 ng/mL for placebo, lower-dose, and higher-dose groups were 54%, 64%, and 55%, respectively. The proportion with 25(OH)D $20 ng/mL was larger in both intervention groups at 36 weeks' gestation (50%, 91%, 89%, P , .001). In comparison with placebo, the proportion of infants with 25(OH)D $20 ng/mL was larger in both intervention groups to age 4 months: cord blood (22%, 72%, 71%, P , .001), 2 months (50%, 82%, 92%, P , .001), and 4 months (66%, 87%, 87%, P = .004), but only in the higher-dose group at age 6 months (74%, 82%, 89%, P = .07; higher dose versus placebo P = .03, lower dose versus placebo P = .21).

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Vitamin D deficiency and insufficiency in pregnant women: a longitudinal study

Cited by 211 publications

References 28 publications

Effects of 25OHD concentrations on chances of pregnancy and pregnancy outcomes: a cohort study in healthy Danish women

Effects of 25OHD concentrations on chances of pregnancy and pregnancy outcomes: a cohort study in healthy Danish women

Contribution of vitamin D insufficiency to the pathogenesis of multiple sclerosis

Vitamin D During Pregnancy and Infancy and Infant Serum 25-Hydroxyvitamin D Concentration

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