Vitamin D effects on pregnancy and the placenta

Abstract

Vitamin D is a pleiotropic secosteroid hormone important for health and disease prevention. The actions of vitamin D are mediated by the vitamin D receptor that binds the active form of vitamin D [1,25(OH) 2 D] to induce both transcriptional and non-genomic responses. Vitamin D has well known classical functions in calcium uptake and bone metabolism, but more recent work highlights the importance of the nonclassical actions of vitamin D in a variety of cell types. These actions include modulation of the innate and adaptive immune systems and regulation of cell proliferation. Adequate vitamin D intake is essential for maternal and fetal health during pregnancy, and epidemiological data indicate that many pregnant women have sub-optimal vitamin D levels. Notably, vitamin D deficiency correlates with preeclampsia, gestational diabetes mellitus, and bacterial vaginosis, and an increased risk for C-section delivery. Recent work emphasizes the importance of nonclassical roles of vitamin D in pregnancy and the placenta. The placenta produces and responds to vitamin D where vitamin D functions as a modulator of implantation, cytokine production and the immune response to infection. We describe vitamin D metabolism and the cellular responses to vitamin D, and then summarize the role of vitamin D in placental trophoblast, pregnancy and the fetus.

Correlation between maternal and neonatal blood vitamin D levels and its effect on the newborn anthropometry

“…Conversely, vitamin D deficiency results in proximal muscle weakness and decreased lower extremity muscle function, perhaps contributing to the risk for cesarean section. 23 The present study also revealed that type of delivery had significant association with vitamin D level.…”

Effect of vitamin D supplementation during pregnancy on maternal and neonatal outcomes: a systematic review and meta-analysis of randomized controlled trials

“…In any case, fetal growth is a complex process dependent on many factors, including genetic background, birth interval, trophoblast implantation, placental development, nutrition, and physical activity (29)(30)(31). Thus, vitamin D may play a minor role in fetal growth, compared with other factors.…”

Micronutrients in pregnancy: Current knowledge and unresolved questions

“…97 Vitamin D status may be critical with regards to pregnancy and fetal/infant outcomes. 113 Severe vitamin D deficiency causes modest hypocalcemia and secondary hyperparathyroidism and osteomalacia in non-pregnant adults, but no reports have documented worsening during pregnancy. 114 Despite the significantly higher needs of calcium to be passed on to the developing fetus, maternal adaptations provide the necessary calcium relatively independent of vitamin D status.…”