Vitamin D in pregnancy – what do you need to know?

Vitamin D in pregnancy has been a topic of much discussion in recent years. Vitamin D testing and supplementation has increased dramaticially.
WHAT DOES VIT D DO?
We know it is important for strong and healthy bones. The bone diseaes Ricketts is cause by lack of vitamin D, but Ricketts is rare in Australia.
It has been implicated in a wide range of other conditions but proof is lacking
WHAT DO WE KNOW ABOUT VIT D?
The main source of vitamin D is by sunlight exposure. Dietary consumption of vitamin D makes up only a small proportion of our daily requirement. The darker your skin colour is, the less efficient you are at making vitamin D from sunlight exposure. And conversely the lighter your skin pigment is, the less sun exposure you need to make the same amount of vitamin D. This makes sense in terms of people with darker skin pigmentation generally having their origins from countries nearer to the equator, ie lots of sun so no need to be efficient at making vitamin D, whilst those of pale skin and fair complexion generally originated from areas remote from the equator, less sunlight and therefore a greater need to be efficient at making vitamin D.
There are obviously some issues with lots of sun exposure (skin cancer and melanoma) and greater sun awareness is a really good thing, but has contributed to an increase in vitamin D deficiency.
VIT D IN PREGNANCY
It has been demonstrated in research studies in NSW that around a quarter to a half of all pregnant women are low in vitamin D. It appears that vitamin D supplementation during pregnancy and breastfeeding is safe. There are gradations of vitamin D deficiency with severe deficiency being less common but probably more significant than mild deficiency. Vitamin D deficiency is usually asymptomatic but it may be associated with bone pain, muscle aches and fatigue. It is not clear whether or not there is a strong association between maternal vitamin D levels in pregnancy and the levels in childhood.
RISK FACTORS FOR LOW VIT D LEVELS
Lack of sun exposure, dark skin pigmentation, obesity
SHOULD ALL PREGNANT WOMEN BE TESTED?
The answer at the moment is probably no. But women who have one or more of the above risks probably should be tested and if the level is low, give consideration to vitamin D supplementation.

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