Vitamin D and pregnancy: An old problem revisited

Area of Science:

• Endocrinology
• Maternal-Fetal Medicine
• Public Health

Background:

• Vitamin D was traditionally linked only to bone and calcium metabolism.
• Emerging evidence suggests vitamin D deficiency is associated with various adverse health outcomes, including cardiovascular disease, immune function, and glucose metabolism.
• Low maternal vitamin D levels during pregnancy are linked to negative outcomes for both mother and child.

Purpose of the Study:

• To review the current understanding of vitamin D's role in health beyond bone metabolism.
• To highlight the associations between vitamin D deficiency and adverse maternal and child health outcomes.
• To emphasize the need for further research, particularly randomized controlled trials, to establish causality and optimal vitamin D concentrations.

Main Methods:

• Review of human disease associations and basic physiological studies.
• Examination of evidence linking maternal and child health outcomes to vitamin D levels.
• Identification of research gaps and the need for randomized controlled trials.

Main Results:

• Vitamin D deficiency is plausibly implicated in mortality, malignancy, cardiovascular disease, immune function, and glucose metabolism.
• Low maternal 25-hydroxyvitamin D levels are associated with infertility, preeclampsia, gestational diabetes, cesarean section, fetal growth restriction, neonatal hypocalcemia, and seizures.
• Childhood associations include type 1 diabetes, impaired immune tolerance, and increased HIV transmission risk.

Conclusions:

• Vitamin D deficiency may play a significant role in a wide range of adverse health outcomes.
• The precise role of vitamin D in these conditions requires further investigation through rigorous clinical trials.
• Optimal 25-hydroxyvitamin D concentrations and the causal relationship between deficiency and disease remain unclear.