Most Pregnant Women in Mediterranean Are Vitamin D Deficient – May 2015

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.

 Download the PDF from VitaminDWiki


See also VitaminDWiki

IU Cumulative Benefit Blood level CofactorsCalcium $*/month
200 Better bones for mom
with 600 mg of Calcium
6 ng/ml increase Not needed No effect $0.10
400 Less Rickets (but not zero with 400 IU)
3X less adolescent Schizophrenia
Fewer child seizures
20-30 ng/ml Not needed No effect $0.20
2000 2X More likely to get pregnant naturally/IVF
2X Fewer dental problems with pregnancy
8X less diabetes
4X fewer C-sections (>37 ng)
4X less preeclampsia (40 ng vs 10 ng)
5X less child asthma
2X fewer language problems age 5
42 ng/ml Desirable < 750 mg $1
4000 2X fewer pregnancy complications
2X fewer pre-term births
49 ng/ml Should have
cofactors
< 750 mg $3
6000 Probable: larger benefits for above items
Just enough D for breastfed infant
More maternal and infant weight
Should have
cofactors
< 750 mg $4

And: Pregnancy problems vs Vitamin D level - GrassrootsHealth Feb 2015
Pregnancy GrassrootsHealth 2/15

From June 2014
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