Abstract
A decade ago identified as bone-building mineral improving calcium absorption, today new re-search opens potentials of Vitamin D in spectrum of diseases from diabetes, hypertension to cancer including special population like pregnancy & lactation. As calcium demands increase during pregnancy, Vitamin D status becomes crucial for optimal maternal & fetal outcomes. Adverse health outcomes such as preeclampsia, low birth weight, neonatal hypocalcemia, bone fragility & increased incidence of autoimmune diseases have been linked to low Vitamin D levels during pregnancy & infancy. Vitamin D deficiency is common during pregnancy & lactation despite widespread use of prenatal vitamins, because these are inadequate to maintain normal Vitamin D levels. The current IOM (US) as well as ICMR (India) recommendations for Vitamin D supplementation is not sufficient to maintain the optimal levels of serum 25(OH) D above 30 ng/ml required during pregnancy. It may therefore be judicious to include screening of all pregnant women for Vitamin D levels as a part of routine antenatal care and supplementation should be considered if deficiency persists. Till date interventional trials in special population suggest that administration of Vitamin D during pregnancy & lactation is safe & beneficial for optimal maternal & fetal outcomes. When Vitamin D deficiency is identified during pregnancy, most experts agree that up to 2000 IU/day of Vitamin D is safe. This review elaborates Vitamin D deficiency in Indian scenario and the need for Vitamin D supplementation, expounds and exercises the facts for implementation of Vitamin D supplementation to be advised when planning for pregnancy, current recommendations and implications of Vitamin D deficiency during pregnancy and lactation.
Highlights
As the statistics keep surfacing at the alarming pace, Vitamin D deficiency is recognized as the most un-treated nutritional deficiency currently in the world [1]-[3]
In a study from the United Arab Emirates, among pregnant Arab women with a high prevalence of Vitamin D deficiency suggested that Vitamin D supplementation of 2000 and 4000 International Unit (IU)/d appeared safe in pregnancy, and 4000 IU/d was most effective in optimizing serum 25(OH) D concentrations in mothers and their infants as compared to 400 IU/d [62]
As calcium demands increase in pregnancy, Vitamin D status becomes crucial for optimal maternal & fetal outcomes
Summary
As the statistics keep surfacing at the alarming pace, Vitamin D deficiency is recognized as the most un-treated nutritional deficiency currently in the world [1]-[3]. The aim of the paper is to provide a comprehensive picture of Vitamin D status among pregnant women and lactating mothers countrywide. It illustrates the summation of Indian studies projecting deficiency statistics across the country firmly establishing the grave need to tackle the issue. The review gives details of the benefits of Vitamin D supplementation in pregnancy and lactation and insights the current recommendations by different international organization for Vitamin D supplementation in pregnancy and lactation It discusses utility of Vitamin D as preconceptional nutrition as well as the possible benefits of Vitamin D supplementation in first trimester, a section less explored. Representation in single unit is aimed to allow easy comparison among studies This could enable physicians to optimally diagnose and treat the broader concern of Vitamin D deficiency among Indian population
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