Vitamin D Efficiency in Pregnancy: Reporting an Updated Viewpoint in Indian Scenario

A decade ago identified as bone-building mineral improving calcium absorption, today new research opens potentials of Vitamin D in spectrum of diseases from diabetes, hypertension to cancer including special population like pregnancy & lactation. Vitamin D deficiency is recognized as the most untreated nutritional deficiency currently in the world. As calcium demands increase during pregnancy, Vitamin D status becomes crucial for optimal maternal & fetal outcomes. Adverse health outcomes such as preeclampsia, low birth weight, neonatal hypocalcemia, bone fragility & increased incidence of autoimmune diseases have been linked to low Vitamin D levels during pregnancy & infancy. Vitamin D deficiency is common during pregnancy & lactation despite wide-spread use of prenatal vitamins, because these are inadequate to maintain normal Vitamin D levels. The widespread Vitamin D deficiency in pregnant women and lactating mother’s calls for a view to define optimum level of Vitamin D and the adequate amount of Vitamin D intake required to maintain optimum levels in these populations. The current IOM (US) as well as ICMR (India) recommendations for Vitamin D supplementation is not sufficient to maintain the optimal levels of serum 25(OH) D above 30 ng/ml required during pregnancy. It may therefore be judicious to include screening of all pregnant women for Vitamin D levels as a part of routine antenatal care and supplementation should be considered if deficiency persists. Till date interventional trials in special population suggest that administration of Vitamin D during pregnancy & lactation is safe & beneficial for optimal maternal & fetal outcomes. When Vitamin D deficiency is identified during pregnancy, most experts agree that up to 2000 IU/day of Vitamin D is safe. This review elaborates Vitamin D deficiency in Indian scenario and the need for Vitamin D supplementation, expounds and exercises the facts for implementation of Vitamin D supplementation to be advised when planning for pregnancy, current recommendations and implications of Vitamin D deficiency during pregnancy and lactation.