Vitamin D deficiency in pregnant women from a non-European ethnic minority population—an interventional study

Datta, Shraddha; Alfaham, Mazin; Davies, David; Dunstan, Frank David John; Woodhead, Stuart; Evans, Jane; Richards, Ben

doi:10.1016/s1470-0328(02)01171-0

Cited by 71 publications

(61 citation statements)

References 24 publications

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“…The authors speculated that the mothers developed hyperparathyroidism secondary to vitamin D deficiency leading to a transitory neonatal hypoparathyroidism and hypocalcaemia. This finding was reinforced by subsequent studies that reported that infants of mothers with low vitamin D intake during pregnancy had low serum Ca concentrations in cord blood or during the first week of life (9)(10)(11) .…”

Section: Effects Of Maternal Vitamin D Deficiency On the Neonatal Camentioning

confidence: 87%

Does vitamin D during pregnancy impact offspring growth and bone?

Specker

2011

Proc. Nutr. Soc.

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During pregnancy, maternal and fetal Ca demands are met through increased intestinal Ca absorption. Increased Ca absorption may be more dependent on oestrogen's up-regulation of Ca transport genes than on vitamin D status. Numerous studies, however, have found that severe vitamin D deficiency with secondary hyperparathyroidism during pregnancy leads to abnormal Ca homoeostasis in the neonate. Some, but not all, studies of maternal vitamin D supplementation during pregnancy find a greater birth weight among infants of mothers with adequate vitamin D status. Observational studies find a higher incidence of small-for-gestational age (SGA) infants among mothers who are vitamin D deficient, but this effect may be modified by genetics. In addition, the effect of vitamin D status on SGA may not be linear, with increased occurrence of SGA at high maternal 25-hydroxyvitamin D (25-OHD) concentrations. Some studies, but not all, also have found that maternal vitamin D status is associated with growth trajectory during the first year of life, although the findings are contradictory. There are recent studies that suggest maternal 25-OHD, or surrogates of vitamin D status, are associated with growth and bone mass later in childhood. These results are not consistent, and blinded randomised trials of vitamin D supplementation during pregnancy with long-term follow-up are needed to determine the benefits, and possible risks, of maternal vitamin D status on offspring growth and bone development. The possibility of adverse outcomes with higher maternal 25-OHD concentrations should be considered and investigated in all ongoing and future studies. (2) . The increase in 1,25-(OH) 2 D concentrations is accompanied by an increase in intestinal Ca absorption, and fractional Ca absorption is approximately 50-60 % greater than pre-pregnant levels during the second and third trimesters (3,4) . The increased Ca absorption is thought to be the reason for the hypercalciuria that is observed during pregnancy. Some investigators have suggested that Ca absorption during pregnancy is not dependent on vitamin D, since intestinal Ca transport genes are up regulated by oestrogens, which are increased SGA, small-for-gestational age; UVB, ultraviolet B.

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Section: Effects Of Maternal Vitamin D Deficiency On the Neonatal Camentioning

confidence: 87%

Does vitamin D during pregnancy impact offspring growth and bone?

Specker

2011

Proc. Nutr. Soc.

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“…6,12--15 For our local population, the This is in agreement with the ¢ndings of another UK study, which found 50% of pregnant women from ethnic minorities in South Wales were vitamin D de¢cient at their ¢rst antenatal visit. 23 The lower vitamin D levels found in Asian women compared with Asian men is unlikely to be dietary, and is probably due to their tendency to wear clothing that covers the skin, as studies have shown that dressing style contributes to vitamin D de¢ciency. 24,25 Since low maternal vitamin D can a¡ect the developing fetus and result in serious paediatric problems, these ¢nd-ings have serious implications, and could be a major contributor to the resurgence of rickets seen in Asian children in the UK.…”

Section: Discussionmentioning

confidence: 99%

Vitamin D concentrations in an UK inner-city multicultural outpatient population

et al. 2006

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Background Vitamin D deficiency is still thought to be widespread in the UK and in recent years the number of cases of rickets reported in children has increased. In this study, the distribution of vitamin D and the prevalence of vitamin D deficiency have been determined for a multi-ethnic population from the inner-city area of Birmingham, UK, where a vitamin D testing service has been readily available for over 10 years.Methods Serum 25-hydroxyvitamin D concentration was determined using an automated platform (Nichol's Advantage Speciality System) for 830 outpatient samples collected randomly at the end of summer (September).Results In our total study population, prevalence of vitamin D deficiency, defined as a 25-hydroxyvitamin D concentration o10 mg/L, was high (24%): one in eight Caucasians, one in four Black Afro-Caribbeans and one in three Asians were found to be deficient. Levels of deficiency were much higher in Asian women, with almost one in two individuals (43%) found to have a vitamin D level below 10 mg/L. ConclusionOur study has shown that widespread vitamin D deficiency in a UK inner-city population remains an issue. In concordance with other studies, we found a high prevalence of vitamin D deficiency in Afro-Caribbean and Asians, and, in particular, women. It is clear that more routine screening of vitamin D is needed.

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“…Data regarding appropriate doses of vitamin D during pregnancy are scant (Brooke et al, 1980;Marya et al, 1988;Madelenat et al, 2001;Datta et al, 2002). An exhaustive review of the topic (Hollis and Wagner, 2004) concluded that current national recommendations for vitamin D supplementation doses in pregnancy are grossly inadequate.…”

Section: Introductionmentioning

confidence: 99%

Vitamin D replacement in pregnant women in rural north India: a pilot study

et al. 2009

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Hypovitaminosis D is common in both urban and rural Indians. The dose of vitamin D needed for the treatment of its deficiency during pregnancy is not clear. We conducted a study in rural Indians to evaluate the effect of cholecalciferol supplementation during routine antenatal visits on maternal 25 hydroxyvitamin D (25OHD) at delivery. Pregnant women received either no cholecalciferol (Group A) or 60 000 U (Group B) in the fifth month of gestation or 120 000 U each in the fifth and seventh gestational months (Group C). Serum 25OHD was measured at baseline (n ¼ 139) and at delivery (n ¼ 84). Median (interquartile range) 25OHD

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Vitamin D deficiency in pregnant women from a non-European ethnic minority population—an interventional study

Cited by 71 publications

References 24 publications

Does vitamin D during pregnancy impact offspring growth and bone?

Does vitamin D during pregnancy impact offspring growth and bone?

Vitamin D concentrations in an UK inner-city multicultural outpatient population

Vitamin D replacement in pregnant women in rural north India: a pilot study

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