Effects of vitamin D on pregnancy, fetal development and children’s health in the postnatal period

Abstract

A high prevalence of vitamin D insufficiency and deficiency and its negative consequences for health is identified as the area of primary concern for scientists and clinicians worldwide. Observational studies confirm that pregnant and lactating women, children and adolescents represent the high risk groups for developing vitamin D deficiency. Current evidence highlights a crucial role of vitamin D in maintaining the fetal life-support system and fetus development, including implantation, placental formation, intra- and postpartum periods. Hypovitaminosis D during pregnancy is associated with a higher incidence of placental insufficiency, spontaneous abortions and preterm birth, preeclampsia, gestational diabetes, impaired fetal and childhood growth, increased risk of autoimmune diseases. Potential mechanisms for the observed associations contain metabolic, immunomodulatory and antiinflammatory effects of vitamin D. Epigenetic modifications in vitamin D-associated genes and fetal programming are of particular interest. The concept of preventing vitamin D deficiency is actively discussed, including supplementation in different ethnic groups, required doses, time of initiation and therapy duration, influence on gestation and childbirth. An adequate supply of vitamin D during pregnancy improves the maternal and fetal outcomes, short- and long-term health of children. Still, current data on relationship between maternal vitamin D status and pregnancy outcomes remains controversial. The large observational and interventional randomized control trials are required to create evidence-based guidelines for the supplementation of vitamin D in pregnant and lactating women.