Does vitamin D during pregnancy impact offspring growth andbone?

[摘要] During pregnancy, maternal and fetal Ca demands are met through increasedintestinal Ca absorption. Increased Ca absorption may be more dependent onoestrogen's up-regulation of Ca transport genes than on vitamin Dstatus. Numerous studies, however, have found that severe vitamin D deficiency with secondary hyperparathyroidism during pregnancy leads to abnormal Cahomoeostasis in the neonate. Some, but not all, studies of maternal vitamin Dsupplementation during pregnancy find a greater birth weight among infants ofmothers with adequate vitamin D status. Observational studies find a higherincidence of small-for-gestational age (SGA) infants amongmothers who are vitamin D deficient, but this effect may be modified bygenetics. In addition, the effect of vitamin D status on SGA may not be linear,with increased occurrence of SGA at high maternal 25-hydroxyvitamin D(25-OHD) concentrations. Some studies, but not all, alsohave found that maternal vitamin D status is associated with growth trajectoryduring the first year of life, although the findings are contradictory. Thereare recent studies that suggest maternal 25-OHD, or surrogates of vitamin Dstatus, are associated with growth and bone mass later in childhood. Theseresults are not consistent, and blinded randomised trials of vitamin Dsupplementation during pregnancy with long-term follow-up are needed todetermine the benefits, and possible risks, of maternal vitamin D status onoffspring growth and bone development. The possibility of adverse outcomes withhigher maternal 25-OHD concentrations should be considered and investigated inall ongoing and future studies.

[学科分类] 卫生学

[关键词] Bone;Growth;Adverse effects