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High prevalence rates of suboptimal vitamin D levels have been observed in women who are not considered ‘at risk’.  A recent Australian study suggested that all pregnant women in Australia should take a daily vitamin D supplement.

Vitamin D deficiency is common in pregnant women and in breastfed infants, despite the widespread use of prenatal vitamins. Adverse health outcomes such as preeclampsia, low birthweight, neonatal hypocalcemia, poor postnatal growth, bone fragility, and increased incidence of autoimmune diseases have been linked to low vitamin D levels during pregnancy and infancy.

A cross-sectional study of pregnant women was performed to determine prevalence and predictive factors of suboptimal vitamin D levels in 2 antenatal clinics in Australia – Campbelltown, NSW and Canberra, ACT.

The researchers found behavioural factors, such as sun exposure, were not as predictive of suboptimal vitamin D levels as ethnicity, season and BMI among pregnant woman.  The prevalence of vitamin D deficiency and insufficiency was 35% in Canberra and 26% in Campbelltown.  Among the vitamin D-deficient women, 38% were Caucasian and all had a BMI of more than 30kg/m2. Vitamin D supplementation at 500 IU/day was inadequate to prevent insufficiency.

The study suggested routine supplementation for all pregnant women with a higher dose of vitamin D (1000 IU/day) regardless of their ethnicity or exposure to the sun.  Targeted screening of the women at highest risk of vitamin D deficiency should also be continued and supplemented if necessary.

Sumathy Perampalam et al. Australian and New Zealand Journal of Obstetrics and Gynaecology published online 18 May 2011

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