Mamas on Bedrest: Are You Vitamin D Deficient?

July 13th, 2011

Mamas on Bedrest, are you Vitamin D deficient? I am. Imagine my surprise when I learned that I was severely Vitamin D deficient and at risk for impaired calcium metabolism. Questions swirled through my head; Am I at increased risk for osteoporosis? Am I at increased risk of breaking my hip and lowering my mortality? Will I experience more dental cavities or worse, lose my teeth and need dentures? All of these health issues result from low calcium levels and calcium absorption is directly affected by the amount of Vitamin D present to aid in calcium metabolism. So it was a no brainer for me to add Vitamin D supplements to my multivitamin supplements. 

Unbeknownst to me at the time of my diagnosis (years after I had had my children) and to many pregnant women, adequate Vitamin D levels in pregnancy are essential for mamas health and proper develoment of a growing fetus.  According to a MedScape report, in recent years there is an increased understanding of the role that Vitamin D plays in regulation of cell growth, immunity, and cell metabolism. Vitamin D deficiency in pregnant women has been linked to:

  • Pre-Eclampsia
  • Insulin Resistance (Gestational Diabetes Mellitus)
  • Ricketts in the fetus (rare)
  • Impaired Bone Growth in the developing fetus and as it grows thru adulthood
  • Low Birth weight
  • Asthma in the children of mothers with low Vitamin D levels

More surprising to me, African American women are at least twice as likely to be Vitamin D deficient as white women. Vitamin D is absorbed through the skin from the sun and used to metabolize calcium. In African American women, especially dark skinned African American women, not as much Vitamin D is absorbed, partially due to repelling of the sun’s rays by their dark skin and partially because African American women are less likely to stay out in the sun. (At this time there is no indication that African American women absorb and process Vitamin D differently than their white counterparts.) The bottom line is that many pregnant women, and especially African American women, may be Vitamin D deficient and require supplementation.

So how much Vitamin D do pregnant women need? A recent article in the June 27, 2011 online Journal of Bone Mineral Research evaluated the Vitamin D needs of pregnant women, the current nutritional recommendations and based on their research, propose the following Vitamin D supplementation for pregnant women:

  • Vitamin D supplementation of 4000 IU/day for pregnant women was most effective in achieving Vitamin D level sufficiency in all women and their neonates, regardless of race 
  • Safety measures did not differ among groups, and no adverse event was thought to be caused by vitamin D supplementation or circulating Vitamin D levels
  • The study did not find any advantage of vitamin D supplementation on the risk of adverse pregnancy outcome, risk of cesarean section, or in respect to size of the newborn child

So Mamas on Bedrest, should you take Vitamin D supplements? Truthfully, there is no consensus on this. Many obstetricians refrain from Vitamin D (or any sort of) supplementation out of fear that excess may cause harm to the developing fetus. The current recommendations, 200 IU daily, were first proposed by Dr. Gilbert Forbes in 1963 with no scientific basis.  So while the current evidence would support supplementation up to 4000IU daily, many (most) women take far less.

Mamas on Bedrest, If you have concerns about your Vitamin D levels and how it may be affecting your pregnancy, discuss this with your doctor at your next prenatal visit and ask if you should supplement and by how much. Share the information in this blog with your OB and ask his/her opinion on Vitamin D supplementation. As always, If you have other questions or want more information e-mail us at info@mamasonbedrest.com. Please share your experiences and what you learn with our community in the comments section belwo!

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