Vitamin D in the maternal-fetal-neonatal interface: clinical implications and requirements for supplementation

J Matern Fetal Neonatal Med. 2013 May;26(7):633-8. doi: 10.3109/14767058.2012.746306. Epub 2012 Dec 14.

Abstract

Identification of the current evidence regarding the pathophysiological and clinical facets of vitamin D in the maternal-fetal-neonatal interface is of value because of the significance of the vitamin D endocrine system in human health and high prevalence of vitamin D deficiency in mothers and their infants. Although many questions have still not been answered by the existing literature, we found evidence that: (i) during pregnancy vitamin D participates in fetal skeletal mineralization and growth, (ii) neonatal vitamin D levels are dependent on the maternal vitamin D status at delivery, (iii) a vitamin D sufficient status at birth may decrease the risk for the development of asthma and type 1 diabetes mellitus in later life, (iv) recommendations for maintaining serum 25-hydroxyvitamin D [25(OH)D] levels ≥32 ng/mL to avoid secondary hyperparathyroidism in adults have not been applied to mothers and their infants, (v) American Academy of Pediatrics recommended supplementation of 400 IU of vitamin D per day is sufficient only for infants who are born with normal vitamin D levels and (vii) supplementation of lactating mothers with high doses of vitamin D (4000 IU/d) allows the achievement of optimal 25(OH)D concentrations (>32 ng/mL) in the maternal and infant serum without any risk of hypervitaminosis D in the mother. We believe that inconsistency in the recognition of sufficient levels of vitamin D in mothers and their infants affects the identification of adequate doses for vitamin D supplementation during pregnancy, lactation and infancy.

Publication types

  • Review

MeSH terms

  • Dietary Supplements*
  • Female
  • Fetus / metabolism
  • Homeostasis
  • Humans
  • Infant, Newborn / metabolism*
  • Maternal-Fetal Exchange
  • Pregnancy
  • Pregnancy Complications / prevention & control*
  • Vitamin D / administration & dosage*
  • Vitamin D / metabolism
  • Vitamin D Deficiency / complications
  • Vitamin D Deficiency / prevention & control*
  • Vitamins / administration & dosage*
  • Vitamins / metabolism

Substances

  • Vitamins
  • Vitamin D