Most Pregnant Women in Mediterranean Are Vitamin D Deficient

Title of Medscape Multispecialty

Reporting on Hypovitaminosis D in pregnancy: can the Mediterranean paradox be explained? A systematic review

Talk was presented at 17th European Congress of Endocrinology – May 2015

Spyridon Karras1, Stavroula A Paschou1, Eleni Kandaraki1, Panagiotis Anagnostis1, Cédric Annweiler 2,3, Basil C Tarlatzis1, Bruce W Hollis 4, William B Grant 5 & Dimitrios G Goulis1

1Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece;

2Department of Geriatric Medicine, University Hospital, Angers, France;

3Department of Medical Biophysics, Robarts Research Institute, Schulich School of Medicine and Dentistry, University of Western Ontario, Ontario, Canada;

4Medical University of South Carolina Children’s Hospital, Charleston, South Carolina, USA;

5Sunlight, Nutrition, and Health Research Center, San Francisco, California, USA.

Introduction: Despite high levels of sunshine, maternal hypovitaminosis D during pregnancy is prevalent in the Mediterranean region, consisting a paradox. The aim of the study was to systematically review trials that investigated vitamin D concentrations during pregnancy in this region, in order to determine predictors of hypovitaminosis D and explain the paradox.

Methods: After applying inclusion/exclusion criteria, 15 studies were entered into the systematic review, involving 2649 pregnant women and 1820 neonates. The main outcome was maternal vitamin D concentration. Possible predictors of the outcome included study, maternal and neonatal characteristics (

age,
BMI,
race,
socioeconomic status,
skin type,
gestational age,
sun exposure,
calcium and vitamin D intake and supplementation,
smoking status,
parity,
season of delivery,
pregnancy complications).

Results: Studies differed widely in vitamin D deficiency criteria, methods of measurement and outcomes.

However, prevalence of maternal and neonatal hypovitaminosis D was up to 90%.

Predictors of maternal hypovitaminosis D were

dark skin phototype
race and
sartorial habits

Only a few pregnant women met the recommended dietary daily intake of calcium and vitamin D. Vitamin D supplementation was not a common practice.

Conclusions: Hypovitaminosis D during pregnancy is prevalent in the Mediterranean region. Racial, social and cultural habits, as well as the absence of preventive strategies seem to negate the benefits of sun exposure.

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