The Role of Vitamin D in Fertility and during Pregnancy and Lactation: A Review of Clinical Data.

Stefan Pilz, Armin Zittermann, Rima Obeid, Andreas Hahn, Pawel Pludowski, Christian Trummer, Elisabeth Lerchbaum, Faustino R Pérez-López, Spyridon N Karras, Winfried März

Journal: International journal of environmental research and public health 2019;15(10):2241

PMID: 30322097

Free Full Text on MDPI View on PubMed

Abstract

Vitamin D deficiency is common and there exists a huge gap between recommended dietary vitamin D intakes and the poor vitamin D supply in the general population. While vitamin D is important for musculoskeletal health, there are accumulating data suggesting that vitamin D may also be important for fertility, pregnancy outcomes and lactation. Significant changes in vitamin D metabolism during pregnancy such as increased production of the "active vitamin D hormone" calcitriol support the important role of vitamin D in this setting. Observational studies show that vitamin D deficiency is a risk marker for reduced fertility and various adverse pregnancy outcomes and is associated with a low vitamin D content of breast milk. Meta-analyses of randomized controlled trials (RCTs) document that physiological vitamin D supplementation during pregnancy is safe and improves vitamin D and calcium status, thereby protecting skeletal health. Although certain RCTs and/or meta-analyses reported some other beneficial effects, it is still not clear whether vitamin D supplementation improves fertility or decreases the risk of adverse pregnancy outcomes such as low birth weight, pre-eclampsia and neonatal mortality, or reduces wheeze/asthma in the infants. Nevertheless, vitamin D supplementation in pregnant women is frequently required to achieve a sufficient vitamin D status as recommended by nutritional vitamin D guidelines. In this review, we provide an overview of systematic reviews, meta-analyses and large trials reporting clinical data on the role of vitamin D for fertility, pregnancy and lactation.

Address: Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria. [email protected].; Clinic for Thoracic and Cardiovascular Surgery, Heart Center North Rhine-Westfalia, Ruhr University Bochum, Georgstraße 11, D-32545 Bad Oeynhausen, Germany. [email protected].; Department of Clinical Chemistry and Laboratory Medicine, University Hospital of the Saarland, Building 57, D-66421 Homburg/Saar, Germany. [email protected].; Institute of Food Science and Human Nutrition, Leibniz University Hannover, Am Kleinen Felde 30, D-30167 Hannover, Germany. [email protected].; Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children's Memorial Health Institute, Aleja Dzieci Polskich 20 Str, 04730 Warsaw, Poland. [email protected].; Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria. [email protected].; Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria. [email protected].; Department of Obstetrics and Gynecology, University of Zaragoza, Faculty of Medicine, Lozano-Blesa University Hospital, Domingo Miral s/n, 50009 Zaragoza, Spain. [email protected].; Division of Endocrinology and Metabolism, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, 55535 Thessaloniki, Greece. [email protected].; Medical Clinic V (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Diabetology), Medical Faculty Mannheim, University of Heidelberg, Theodor- Kutzer-Ufer 1-3, D-68167 Mannheim, Germany. [email protected].; Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria. [email protected].; SYNLAB Academy, SYNLAB Holding Deutschland GmbH, P5, 7, D-68161 Mannheim and Augsburg, Germany. [email protected].

DOI: 10.3390/ijerph15102241

Link outs

Free resources

Full Text Sources:

Medical:

https://medlineplus.gov/pregnancy.html

Miscellaneous:

https://assays.cancer.gov/CPTAC-1548

MeSH Terms: Female, Fertility, Humans, Lactation, Pregnancy, Vitamin D