Abstract
Maternal vitamin D deficiency in pregnancy is a widespread public health concern. Race and ethnicity as biological and cultural factors, respectively, can affect vitamin D status through differences in skin color, sunlight exposure, and dietary intake. Low maternal vitamin D status in pregnancy may affect both mother and fetus adversely. Vitamin D deficiency and insufficiency are linked to a wide variety of adverse pregnancy outcomes such as gestational diabetes, preeclampsia, and preterm delivery. Furthermore, maternal vitamin D deficiency has been linked to several adverse health outcomes in infants and children. The examples include, but not limited to, impaired growth, skeletal problems, and autoimmune diseases such as type 1 diabetes and asthma. This chapter reviews the vitamin D status during pregnancy across different ethnic groups, looking into the adverse pregnancy and child outcomes, followed by a discussion on the association between maternal and child vitamin D status and successful interventions. Strong evidence exists about the association between vitamin D and some health outcomes during pregnancy, while more studies are needed to confirm the other claim. The existing body of evidence justifies the need for well-designed policies and systematic interventions to ensure optimal vitamin D status of pregnant women and their offsprings across different ethnic and racial groups.
Highlights
The calciotropic role of vitamin D is well known from the early twentieth century
Vitamin D deficiency is likely to be associated with preterm birth, to investigate the explicit relationship between vitamin D status and preterm delivery several factors should be noted including the timing of 25(OH)D assessment, ethnicity, precise definition of preterm birth, different study design such as human interventional and cohort studies
In a cohort multi-ethnic Asian study, vitamin D deficiency was related to a higher risk of C-sections in Chinese and Indian women compared to Malay women [86]
Summary
The recent advances in research opened a new perspective about vitamin D as prohormone with receptors in most tissues of the human body [1, 2]. This indicates additional non-calciotropic effects of vitamin D, such as its role in autoimmunity, chronic disease, infectious diseases, mental health issues, etc. Pregnancy is a unique stage of life for women when the normal physiology of mother is changing in order to provide the nutritional needs for the growing fetus [3]. Those changes influence the vitamin D hemostasis and availability for the mother and the fetus. We review the existing policies and practices to assure optimal vitamin status in pregnant women and their offsprings
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