Vitamin D in pregnancy: Where we are and where we should go

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dc.check.date2021-04-14
dc.check.infoAccess to this article is restricted until 12 months after publication by request of the publisher.en
dc.contributor.authorKiely, Mairead E.
dc.contributor.authorWagner, C. L.
dc.contributor.authorRoth, D. E.
dc.date.accessioned2020-07-27T13:17:55Z
dc.date.available2020-07-27T13:17:55Z
dc.date.issued2020-04-14
dc.date.updated2020-07-27T13:09:00Z
dc.description.abstractVitamin D deficiency has been widely reported among pregnant women and infants around the world. Women with low sun exposure, high BMI, low vitamin D intakes and socioeconomic disadvantage with poor quality diets are at greatest risk of vitamin D deficiency, leading to very low serum concentrations of 25-hydroxyvitamin D (25(OH)D) in their offspring and an increased risk of nutritional rickets. Many observational studies, supported by compelling in vitro and in vivo data, have generated evidence suggesting that low vitamin D status in pregnancy may also contribute to the risk of adverse perinatal outcomes including hypertensive disorders (e.g., preeclampsia), fetal growth restriction, and preterm birth. However, the few large randomized controlled trials (RCTs) conducted to date have generated conflicting evidence for a role of vitamin D supplementation in improving perinatal outcomes. Vitamin D supplementation policies during pregnancy and implementation of policies vary within and between jurisdictions. Regulatory authorities have cited insufficient evidence to establish pregnancy-specific targets for serum 25(OH)D concentrations or prenatal vitamin D intake that effectively reduce the risks of adverse perinatal and infant outcomes. This paper arises from a Debate on Vitamin D Requirements during Pregnancy, held at the 22nd Vitamin D Workshop, 2019. From varied perspectives, our objectives were to evaluate the evidence for: vitamin D metabolism in pregnancy and the prevalence of gestational vitamin D deficiency worldwide; the translation of laboratory research findings to clinical studies on the role of vitamin D in perinatal health; the challenges of designing and conducting clinical trials to establish prenatal vitamin D requirements; and results to date of major large RCTs of prenatal vitamin D supplementation. Lastly, we explored potential next steps towards generating robust clinical data in this field to address both public health protection and patient care.en
dc.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleid105669en
dc.identifier.citationKiely, M. E., Wagner, C. L. and Roth, D. E. (2020) 'Vitamin D in pregnancy: Where we are and where we should go', Journal of Steroid Biochemistry and Molecular Biology, 201, 105669 (9pp). doi: 10.1016/j.jsbmb.2020.105669en
dc.identifier.doi10.1016/j.jsbmb.2020.105669en
dc.identifier.eissn1879-1220
dc.identifier.endpage9en
dc.identifier.issn0960-0760
dc.identifier.journaltitleJournal of Steroid Biochemistry and Molecular Biologyen
dc.identifier.startpage1en
dc.identifier.urihttps://hdl.handle.net/10468/10311
dc.identifier.volume201en
dc.language.isoenen
dc.publisherElsevier Ltd.en
dc.rights© 2019, Elsevier Ltd. All rights reserved. This manuscript version is made available under the CC BY-NC-ND 4.0 license.en
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/en
dc.subjectPerinatal healthen
dc.subjectPregnancyen
dc.subjectVitamin Den
dc.subjectVitamin D requirementsen
dc.subjectVitamin D statusen
dc.titleVitamin D in pregnancy: Where we are and where we should goen
dc.typeArticle (peer-reviewed)en
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