The role of vitamin D in pregnancy and lactation: emerging concepts

Abstract

Pregnancy is a critical time in the lifecycle of a woman where she is responsible not only for her own well-being, but also that of her developing fetus, a process that continues during lactation. Until recently, the impact of vitamin D status during this period had not been fully appreciated. Data regarding the importance of vitamin D in health have emerged to challenge traditional dogma, and suggest that vitamin D - through its effect on immune function and surveillance - plays a role beyond calcium and bone metabolism on the health status of both the mother and her fetus. Following birth, this process persists; the lactating mother continues to be the main source of vitamin D for her infant. Thus, during both pregnancy and lactation, maternal deficiency predicts fetal and infant deficiency; the significance of this is just beginning to be understood and will be highlighted in this review.

Figures

Figure 1. Vitamin D synthesis pathway

SPF: Sun protection factor. Reproduced with permission from [155].

Figure 2. Relationship of circulating 25-hydroxyvitamin D on circulating dihydroxyvitamin D during pregnancy

1,25(OH)2D: Dihydroxyvitamin D; 25(OH)D: 25-hydroxyvitamin D. Reproduced with permission from [4].

Figure 3. Milk antirachitic activity as a function of maternal vitamin D3 dose: 400 versus 6400 IU/day

SE: Standard error. Adapted with permission from [147].

Figure 4. Infant circulating 25-hydroxyvitamin D as a function of maternal supplementation (400 vs 6400 IU vitamin D3/day) and infant supplementation (300 vs 0 IU vitamin D3/day)

25(OH)D: 25-hydroxyvitamin D; SE: Standard error. Adapted with permission from [147].