The Role of Vitamin D Deficiency Prevention in Improving Obstetric, Perinatal and Long)Term Outcomes
DOI:
https://doi.org/10.15574/PP.2020.84.35Keywords:
vitamin D, deficiency, pregnancy, fetus, preventionAbstract
Much attention is paid to deficiencies prevention during pregnancy, since they negatively affect not only metabolic processes, including fetoplacental complex, but also the condition of the fetus, the newborn, and physical and mental development of the child in the future. Summarizing the recommendations for the use of vitamin D during pregnancy, it should be noted that the typical prophylactic dose is 400 IU/day starting from the first trimester. However, we should consider the use of corrective doses in the second and third trimesters when the fetal skeleton is growing and developing. A high dose of vitamin D (2000 IU/day) is recommended for women at high risk of developing hypertensive complications of pregnancy (a history of preeclampsia, in particular, arising before 28 weeks, arterial hypertension, chronic kidney disease), as well as pregnant women with comorbidity (systemic red lupus, rheumatoid arthritis, multiple sclerosis, cardiovascular disease, inflammatory bowel disease, oncological pathology). For women at risk of vitamin D deficiency, the recommended dose is less than 1000 IU/day. In case of confirmed vitamin D deficiency (<25-30 nmol/L), a correction dose of 2000-4000 IU/day is prescribed for 11 weeks to provide a cumulative dose of about 150,000 or 300,000 units in the second or third trimesters. Today, a sufficient number of vitamin D preparations are presented on the pharmaceutical market of Ukraine, among which one should pay attention to "Olidetrim" (Polpharma, Poland) in the form of oil solution in capsules ensuring its absorption and assimilation. Depending on the dosage, each capsule of the preparation contains 2000 IU or 4000 IU of vitamin D3 (cholecalciferol). In addition to the fat-soluble form, vitamin D preparation Aquadetrim® (Polpharma, Poland) is registered and successfully used in Ukraine. This is a unique form of vitamin D3 based on nanomycellae, which provides better absorption of vitamin D in the intestine.
References
American College of Obstetricians and Gynaecologists. (2011). Committee opinion. Committee on Obstetric Practice. Vitamin D: Screening and supplementation during pregnancy. Obstetrics&Gynecology. 118 (1): 197-198. https://doi.org/10.1097/AOG.0b013e318227f06b; PMid:21691184
Barrera D, Noyola-Martinez N, Avila E, Halhali A, Larrea F, Diaz L. (2012). Calcitriol inhibits interleukin-10 expression in cultured human trophoblasts under normal and inflammatory conditions. Cytokine. 57 (3): 316-321. https://doi.org/10.1016/j.cyto.2011.11.020; PMid:22182686
Bikle DD, Gee E, Halloran B, Haddad JG. (1984). Free 1,25-dihydroxyvitamin D levels in serum from normal subjects, pregnant subjects, and subjects with liver disease. J Clin Invest. 74 (6): 1966-1971. https://doi.org/10.1172/JCI111617; PMid:6549014 PMCid:PMC425383
Brustad N, Garland J, Thorsen J, Sevelsted A et al. (2020). Effect of High-Dose vs Standard-Dose Vitamin D Supplementation in Pregnancy on Bone Mineralization in Offspring Until Age 6 Years A Prespecified Secondary Analysis of a Double-Blinded, Randomized Clinical Trial. JAMA Pediatr. 174 (5): 419-427. https://doi.org/10.1001/jamapediatrics.2019.6083; PMid:32091548
Cleal JK, Day PE, Simner CL et al. (2015). Placental amino acid transport may be regulated by maternal vitamin D and vitamin D-binding protein: results from the Southampton Women's Survey. Br J Nutr. 113: 1903-1910. https://doi.org/10.1017/S0007114515001178; PMid:25940599 PMCid:PMC4498463
Cooper C, Harvey NC, Bishop NJ et al. (2016). Maternal gestational vitamin D supplementation and offspring bone health (MAVIDOS): a multicentre, double-blind, randomised placebo-controlledtrial. Lancet. 4 (5): 393-402.
Dror DK, Allen LH. (2010). Vitamin D inadequacy in pregnancy: biology, outcomes, and interventions. Nutrition Reviews. 68: 465-477. https://doi.org/10.1111/j.1753-4887.2010.00306.x; PMid:20646224
Harvey NC, Holroyd C, Ntani G et al. (2014). Vitamin D supplementation in pregnancy: a systematic review. Health Technol Assess. 18: 45. https://doi.org/10.3310/hta18450; PMCid:PMC4124722
Harvey NC, Moon RJ, Sayer AA et al. (2013). Southampton Women's Survey Study Group. Maternal antenatal vitamin D status and offspring muscle development: findings from the Southampton Women's Survey. J Clin Endocrinol Metab. 99: 330-337. https://doi.org/10.1210/jc.2013-3241; PMid:24178796 PMCid:PMC3880861
Holick MF. (2004). Vitamin D: importance in the prevention of cancers, Type 1 diabetes, heart disease, and osteoporosis. Am J Clin Nutr. 79: 362-371. https://doi.org/10.1093/ajcn/79.3.362; PMid:14985208
Holick MF. (2007). Vitamin D deficiency. New England Journal of Medicine. 357: 266-281. https://doi.org/10.1056/NEJMra070553; PMid:17634462
Holick MF. (2009). Vitamin D status: measurement, interpretation, and clinical application. Annals of Epidemiology. 19: 73-78. https://doi.org/10.1016/j.annepidem.2007.12.001; PMid:18329892 PMCid:PMC2665033
Javaid MK, Crozier SR, Harvey NC et al. (2006). Maternal vitamin D status during pregnancy and childhood bone mass at age 9 years: a longitudinal study. Lancet. 367: 36-43. https://doi.org/10.1016/S0140-6736(06)67922-1
Motamed S, Nikooyeh B, Kashanian M et al. (2020). Evaluation of the efficacy of two doses of vitamin D supplementation on glycemic, lipidemic and oxidative stress biomarkers during pregnancy: a randomized clinical trial. BMC Pregnancy Childbirth. 20: 619. https://doi.org/10.1186/s12884-020-03311-1; PMid:33054794 PMCid:PMC7556979
Ross C, Taylor CL, Yaktine AL, Del Valle HB. (2011). Institute of Medicine (US) Committee. Dietary reference intakes for calcium and vitamin D. Washington DC: National Academy Press. https://doi.org/10.17226/13050
SACN. (2016). Vitamin D and Health. Scientific Advisory Committee on Nutrition (SACN).
Thorne-Lyman A, Fawzi WW. (2012). Vitamin D during pregnancy and maternal, neonatal and infant health outcomes: a systematic review and meta-analysis. Paediatric and Perinatal Epidemiology. 26 (1): 75-90. https://doi.org/10.1111/j.1365-3016.2012.01283.x; PMid:22742603 PMCid:PMC3843348
Wagner CL, Greer FR. (2008). Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. American Academy of Pediatrics Section on Breastfeeding, American Academy of Pediatrics Committee on Nutrition. Pediatrics. 122: 1142-1152. https://doi.org/10.1542/peds.2008-1862; PMid:18977996
Wagner CL, Hollis BW, Kotsa K. (2017). Vitamin D administration during pregnancy as prevention for pregnancy, neonatal and postnatal complications. Reviews in Endocrine Metabolism Disorders. 18: 307-322. https://doi.org/10.1007/s11154-017-9414-3; PMid:28214921
Wei SQ et al. (2012). Longitudinal vitamin D status in pregnancy and the risk of pre-eclampsia. BJOG: International Journal of Obstetrics and Gynaecology. 119: 832-839. https://doi.org/10.1111/j.1471-0528.2012.03307.x; PMid:22462640
Wei SQ, Audibert F, Hidiroglou N, Sarafin K, Julien P, Wu Y, Luo ZC, Fraser WD. (2012). Longitudinal vitamin D status in pregnancy and the risk of pre-eclampsia. BJOG. 119 (7): 832-839. https://doi.org/10.1111/j.1471-0528.2012.03307.x; PMid:22462640
Wei S-Q, Qi H-P, Luo Z-C et al. (2013). Maternal vitamin D status and adverse pregnancy outcomes: a systematic review and meta-analysis. The Journal of Maternal-fetal&neonatal medicine. 26 (9): 889-899. https://doi.org/10.3109/14767058.2013.765849; PMid:23311886
Xu L, Lee M, Jeyabalan A, Roberts JM. (2014). The relationship of hypovitaminosis D and IL-6 in preeclampsia. Am J Obstet Gynecol. 210 (2):149. https://doi.org/10.1016/j.ajog.2013.09.037; PMid:24080305 PMCid:PMC4040267
Downloads
Published
Issue
Section
License
The policy of the Journal “Ukrainian Journal of Perinatology and Pediatrics” is compatible with the vast majority of funders' of open access and self-archiving policies. The journal provides immediate open access route being convinced that everyone – not only scientists - can benefit from research results, and publishes articles exclusively under open access distribution, with a Creative Commons Attribution-Noncommercial 4.0 international license(СС BY-NC).
Authors transfer the copyright to the Journal “MODERN PEDIATRICS. UKRAINE” when the manuscript is accepted for publication. Authors declare that this manuscript has not been published nor is under simultaneous consideration for publication elsewhere. After publication, the articles become freely available on-line to the public.
Readers have the right to use, distribute, and reproduce articles in any medium, provided the articles and the journal are properly cited.
The use of published materials for commercial purposes is strongly prohibited.
