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 is 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.
Current evidence from clinical studies indicates that vitamin D deficiency is very common in pregnant and
lactating women and is associated with a variety of adverse outcomes. By contrast, data from RCTs have
yielded inconsistent results. There may be some beneficial effects of vitamin D supplementation on clinical pregnancy outcomes, but it is premature to draw final conclusions and there is only insufficient RCT data on the potential effects of vitamin D in the first weeks of pregnancy. Importantly, it is clearly established that vitamin D supplementation at commonly used doses in pregnant and lactating women is safe and can effectively improve the vitamin D and calcium status of the fetus and infant, thereby protecting skeletal health. Current guidelines recommend a vitamin D intake of 400 to 800 IU per day for pregnant women. Our conclusion is that when a woman wants to ensure a sufficient vitamin D supply to their fetus or infant, an intake of a vitamin D supplement at a dose of 800 to 1000 IU per day during preconception or pregnancy is sufficient to achieve serum 25(OH)D target concentrations as recommended by vitamin D guidelines.
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