Curr Opin Obstet Gynecol. 2012 March; 24(2): 57–64. doi: 10.1097/GCO.0b013e3283505ab3
Rachel Peragallo Urrutia, M.D. rmpera@gmail.com and John M. Thorp, M.D.
University of North Carolina, Department of Obstetrics and Gynecology, Division of Women’s Primary Care
Introduction: Vitamin D (VD) is part of a complex steroid hormone system long known to be involved in bone metabolism. Recently, VD has been implicated physiologic processes as diverse as vascular health, immune function, metabolism and placental function. This review summarizes the current evidence for the role of VD in perinatal health.
Methods: A systematic review of articles published in PubMed between May 2010 and October 2011 was undertaken using key words for VD and pregnancy. Seventy-eight studies were reviewed.
Findings: The biologic evidence regarding a role for VD in reproductive outcomes is strong, and rates of VD deficiency may be high among pregnant women. However, no consensus exists regarding optimum VD levels in pregnancy or standard measurement of VD deficiency. Clinical studies establishing an association between VD levels and adverse pregnancy outcomes such as preeclampsia, gestational diabetes, low birthweight, preterm labor, cesarean delivery and infectious diseases have conflicting results. This is likely due to a paucity of randomized trials, heterogeneity of populations studied, and low sample size with poor adjustment for confounding among observational studies.
Conclusion: Further research should focus on defining optimum 25(OH)D levels in pregnancy as well as among various subgroups of the population. Randomized trials are needed to determine if VD supplementation can improve pregnancy outcomes. Currently, ACOG and IOM recommend 600 IU of daily VD supplementation during pregnancy to support maternal and fetal bone metabolism.
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