Pregnancy and Vitamin D: What expectant and new mothers should know

Vitamin D plays an important role in the regulation of calcium in the blood as well as bone metabolism.¹ The recommended intake of vitamin D during pregnancy is 600 international units per day.¹ In pregnant women, vitamin D deficiency has been associated with an increased risk of gestational diabetes² and preeclampsia^3,4 for the mother and reduced bone mass,⁵ rickets⁶ and other complications⁷ in the child. Severe maternal vitamin D deficiency has also been associated with fractures in the newborn.¹ Here are some tips for making sure you, and your baby, are receiving adequate amounts of vitamin D.
1. Know your risk factors.
Risk factors for vitamin D deficiency include vegetarian diet, women with limited sun exposure, such as those who live in cool climates, and certain ethnicities, particularly those with darker skin.¹ If you feel you may be at risk, talk to your doctor.
2. Talk to your doctor about having your vitamin D levels checked.
The American College of Obstetrics and Gynecology recommends that pregnant women who are at risk for vitamin D deficiency should consider having their vitamin D levels tested.¹ Your doctor can use the results to help determine a plan of action.
3. Don’t rely solely on prenatal vitamins.
According to Mayo Clinic, most prenatal vitamins do not include optimal amounts of vitamin D. In addition to prenatal vitamins, talk to your doctor about other sources of vitamin D to boost your levels.⁸
4. Drink vitamin D-fortified low-fat milk or eat other calcium-rich foods containing vitamin D.
If you don’t drink milk or eat calcium-rich foods, talk to your physician about whether calcium and vitamin D supplements should be taken.⁸
5. Don’t discount salmon.
According to the Food and Drug Administration, women who are pregnant and women who are trying to become pregnant should consume no more than 12 oz. of low mercury fish weekly.⁹ Salmon is a low mercury fish¹⁴ and a good source of Vitamin D.¹⁵
6. Find other dietary sources.
Other foods, including fortified orange juice, eggs (yolks included), fortified cereals, liver and mushrooms are all sources of vitamin D.^6,10

7. Enjoy the sunshine.
Vitamin D is called “the sunshine vitamin” for a reason—your body processes vitamin D from sunlight.⁶ Studies suggest that 5–30 minutes of sun exposure midday, at least twice a week to the face, arms, legs, or back without sunscreen usually lead to sufficient vitamin D levels for most people.⁶
8. Consider supplements.
Supplements can be a good, easy source of vitamin D. However, be sure to talk to your healthcare provider before taking any supplements, particularly because too much vitamin D can result in toxicity.¹¹

David Spindell, MD is the DVP of Medical Affairs at Abbott Diagnostics.
Download these helpful charts about Vitamin D’s impact and the populations who are most at risk:

References
1. Vitamin D: Screening and Supplementation During Pregnancy, The American College of Obstetrics and Gynecology Committee Opinion July 2011
2. Maternal Plasma 25-Hyroxyvitamin D Concentrations and the Risk of Gestational Diabetes Mellitus, Zhang, et al. PLoS One, Nov 2008, Vol 3 Issue 11
3. Maternal Vitamin D deficiency increases the risk of preeclampsia, Bodnar, et al. J Clin Endcrinol Metab, 2007, Sep; 92(9): 3517-22
4. A Nested Case-Control Study of Midgestation Vitamin D Deficiency and Risk of Severe Preeclampsia. J Clin Endocrinol Metab. 2010 November ; 95(11) 5105-5109
5. Maternal vitamin D status during pregnancy and childhood bone mass at age 9 years; a longitudinal study. Javaid, et al. Lancet 2006 Jan 7: 367(9504) : 36-43
6. Dietary Supplement Fact Sheet: Vitamin D. Office of Dietary Supplements. http://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/. Last accessed 3/15/2012
7. Pregnancy and gestational vitamin D deficiency. Vitamin D Council. http://www.vitamindcouncil.org/news-archive/2009/pregnancy-and-gestation…. Last accessed 3/15/2012.
8. Pregnancy Week by Week. The Mayo Clinic. http://www.mayoclinic.com/health/prenatal-vitamins/PR00160. Last accessed 3/15/2012
9. Mercury Levels in Fish. American Pregnancy Association. http://www.americanpregnancy.org/pregnancyhealth/fishmercury.htm. Last accessed 3/15/2012
10. Vitamin D Content of Selected Foods per Common Measure. USDA. https://www.ars.usda.gov/SP2UserFiles/Place/12354500/Data/SR24/nutrlist/…. Last access 3/15/2012
11. Zeratsky,K. Nutrition and healthy eating. Mayo Clinic. http://www.mayoclinic.com/health/vitamin-d-toxicity/AN02008. Last accessed 3/15/2012
12. Vitamin D Supplementation. Centers for Disease Control and Prevention. http://www.cdc.gov/breastfeeding/recommendations/Vitamin_d.htm. Last accessed 2/28/2012
13. Dietary Reference Intakes for Calcium and Vitamin D, Institute of Medicine, March 2011.
14. FDA Website, Food Safety for Moms to be, March 16, 2011
15. Vitamin D. Medline Plus Encyclopedia. http://www.nlm.nih.gov/medlineplus/ency/article/002405.htm. Last accessed 3/19/12