Fw: Pregnancy and Vitamin D

[Guest guest]

----- Forwarded Message ----"John Cannell, M.D." <vitamindcouncilhughman73Sent: Wednesday, June 3, 2009 7:01:32 AMPregnancy and Vitamin D

The Vitamin D Newsletter

Pregnancy and Vitamin D

June, 2009

This is a periodic newsletter from the Vitamin D Council, a non-profit trying to end the epidemic of vitamin D deficiency. If you are not d, you can do so on the website. If you want to , go to the end of this newsletter.

This newsletter is not copyrighted. Please reproduce it, post it on Internet sites, and forward it to your friends and family. Dana Clark, our underpaid but superb webmaster, will post this newsletter on the website.

In the last 3 years, an increasing amount of research suggests that some of the damage done by Vitamin D deficiency is done in-utero, while the fetus is developing. Much of that damage may be permanent, that is, it can not be fully reversed by taking Vitamin D after birth. This research indicates Vitamin D deficiency during pregnancy endangers the mother’s life and health, and is the origin for a host of future perils for the child, especially for the child’s brain and immune system. Some of the damage done by maternal Vitamin D deficiency may not show up for 30 years. Let’s start with the mother.

Incidence of Gestational Vitamin D Deficiency:

Dr. Joyce Lee and her colleagues at the University of Michigan studied 40 pregnant women, the majority taking prenatal vitamins. Only two had levels of >50 ng/ml and only three had levels > 40 ng/ml. That is, 37 of 40 pregnant women had levels below 40 ng/ml and the majority had levels below 20 ng/ml. More than 25% had levels below 10 ng/ml.

Lee JM, Smith JR, Philipp BL, Chen TC, Mathieu J, Holick MF. Vitamin D deficiency in a healthy group of mothers and newborn infants. Clin Pediatr (Phila). 2007 Jan;46(1):42-4.

Dr. Lisa Bodnar, a prolific Vitamin D researcher, and her colleagues at the University of Pittsburg studied 400 pregnant Pennsylvania women; 63% had levels below 30 ng/ml and 44% of the black women in the study had levels below 15 ng/ml. Prenatal vitamins had little effect on the incidence of deficiency.

Bodnar LM, Simhan HN, Powers RW, Frank MP, Cooperstein E, Roberts JM. High prevalence of vitamin D insufficiency in black and white pregnant women residing in the northern United States and their neonates. J Nutr. 2007 Feb;137(2):447-52.

Dr. Dijkstra and colleagues studied 70 pregnant women in the Netherlands, none had levels above 40 ng/ml and 50% had levels below 10 ng/ml. Again, prenatal vitamins appeared to have little effect on 25(OH)D levels, as you might expect since prenatal vitamins only contain 400 IU of Vitamin D.

Dijkstra SH, van Beek A, Janssen JW, de Vleeschouwer LH, Huysman WA, van den Akker EL. High prevalence of vitamin D deficiency in newborns of high-risk mothers. Arch Dis Child Fetal Neonatal Ed. 2007 Apr 25.

Thus, more than 95% of pregnant women have 25(OH)D levels below 50 ng/ml, the level that may indicate chronic substrate starvation, that is, they are using up any Vitamin D they have very quickly and do not have enough to store for future use. Pretty scary.

Effects on the Mother:

Caesarean section:

The rate of Caesarean section in American women has increased from 5% in 1970 to 30% today. Dr. Anne Merewood and her colleagues at Boston University School of Medicine found women with levels below 15 ng/ml were four times more likely to have a Cesarean section than were women with higher levels. Among the few women with levels above 50 ng/ml, the Caesarean section rate was the same as it was in 1970, about 5%.

Merewood A, Mehta SD, Chen TC, Bauchner H, Holick MF. Association between vitamin D deficiency and primary cesarean section. J Clin Endocrinol Metab. 2009 Mar;94(3):940-5.

Preeclampsia:

Preeclampsia is a common obstetrical condition in which hypertension is combined with excess protein in the urine. It greatly increases the risk of the mother developing eclampsia and then dying from a stroke. Dr. Lisa Bodnar and her colleagues found women with 25(OH)D levels less than 15 ng/ml had a five-fold (5 fold) increase in the risk of preeclampsia.

Bodnar LM, Catov JM, Simhan HN, Holick MF, Powers RW, Roberts JM. Maternal vitamin D deficiency increases the risk of preeclampsia. J Clin Endocrinol Metab. 2007 Sep;92(9):3517-22.

Gestational Diabetes:

Diabetes during pregnancy affects about 5% of all pregnant women, is increasing in incidence, and may have deleterious effects on the fetus. Dr. Cuilin Zhang and colleagues at the NIH found women with low 25(OH)D levels were almost 3 times more likely to develop diabetes during pregnancy.

Zhang C, Qiu C, Hu FB, David RM, van Dam RM, Bralley A, Williams MA. Maternal plasma 25-hydroxyvitamin D concentrations and the risk for gestational diabetes mellitus. PLoS ONE. 2008;3(11):e3753.

Bacterial Vaginitis:

Dr. Lisa Bodnar and her colleagues found pregnant women with the lowest 25(OH)D level are almost twice as likely to get a bacterial vaginal infection during their pregnancy.

Bodnar LM, Krohn MA, Simhan HN. Maternal Vitamin D Deficiency Is Associated with Bacterial Vaginosis in the First Trimester of Pregnancy. J Nutr. 2009 Apr 8.

Effects on the child:

Before we talk about maternal Vitamin deficiency's effect on the fetus, remember that children need lots of Vitamin D. In fact, seventeen experts, many world-class experts, recently recommended:

"Until we have better information on doses of vitamin D that will reliably provide adequate blood levels of 25(OH)D without toxicity, treatment of vitamin D deficiency in otherwise healthy children should be individualized according to the numerous factors that affect 25(OH)D levels, such as body weight, percent body fat, skin melanin, latitude, season of the year, and sun exposure. The doses of sunshine or oral vitamin D3 used in healthy children should be designed to maintain 25(OH)D levels above 50 ng/mL. As a rule, in the absence of significant sun exposure, we believe that most healthy children need about 1,000 IU of vitamin D3 daily per 11 kg (25 lb) of body weight to obtain levels greater than 50 ng/mL. Some will need more, and others less. In our opinion, children with chronic illnesses such as autism, diabetes, and/or frequent infections should be supplemented with higher doses of sunshine or vitamin D3, doses adequate to maintain their 25(OH)D levels in the mid-normal of the reference range (65 ng/mL) — and should be so supplemented year round (p. 868)."

That's right. Healthy children need about 1,000 IU per 25 pounds of body weight and their 25(OH)D levels should be >50 ng/ml, year round.

Cannell JJ, Vieth R, Willett W, Zasloff M, Hathcock JN, White JH, TanumihardjoSA, Larson-Meyer DE, Bischoff-Ferrari HA, Lamberg-Allardt CJ, Lappe JM, NormanAW, Zittermann A, Whiting SJ, Grant WB, Hollis BW, Giovannucci E. Cod liver oil, vitamin A toxicity, frequent respiratory infections, and the vitamin D deficiency epidemic. Ann Otol Rhinol Laryngol. 2008 Nov;117(11):864-70.

What about fetuses, what happens to them later in life if their mother is deficient? Eight years before the above recommendations, Professor John McGrath of the Queensland Centre for Mental Health Research theorized that maternal Vitamin D deficiency adversely “imprinted†the fetus, making infants more liable for a host of adult disorders. Research since that time has supported McGrath’s theory. Consider, for a minute, what it must be like for John McGrath, to know that maternal Vitamin D deficiency is causing such widespread devastation, to know it could be so easily treated, but to also know he must wait the decades that will be required to deal with the problem.

McGrath J. Does 'imprinting' with low prenatal vitamin D contribute to the risk of various adult disorders? Med Hypotheses. 2001 Mar;56(3):367-71.

Schizophrenia:

Dr. Dennis Kinney and his colleagues at Harvard published a fascinating paper last month on the role of maternal Vitamin D deficiency in the development of schizophrenia, in support of Dr. McGrath’s theory. As they point out, the role of inadequate Vitamin D during brain development appears to “overwhelm†other effects, explaining why schizophrenia has so many of the footprints of a maternal Vitamin D deficiency disorder, such as strong latitudinal variation, excess winter births, and skin color