Maternal Vitamin D Status: Implications for the Development of Infantile Nutritional Rickets
Section snippets
Cause and epidemiology of infantile nutritional rickets
The clinical picture of nutritional rickets was first described by Whistler (1645) and Glisson (1650), who reported that the disease rarely occurred before 6 months of age and was most prevalent between 6 months and 2.5 years of age.6 Although the classic features of vitamin D deficiency rickets are most commonly seen during this period, studies have shown that symptomatic vitamin D deficiency can develop early in infancy.7, 8, 9, 10, 11, 12 In Turkey, for example, in a 2-year period, 42
Vitamin D and calcium homeostasis in the mother-infant pair during pregnancy and lactation
Major changes in maternal calcium homeostasis take place during pregnancy and lactation, as the mother must provide enough calcium for fetal development during pregnancy and to meet breast milk calcium concentrations during lactation. In the nonpregnant and nonlactating woman, vitamin D sufficiency is essential to maintain normal calcium and bone homeostasis. However, during pregnancy and lactation, the vitamin D endocrine system probably plays little role in the physiologic alterations in
Consequences of vitamin D deficiency in mother-infant pairs
Besides the increased incidence of infantile rickets, neonatal hypocalcaemia, and the rare entity of congenital rickets, there is new evidence to suggest that there may be other consequences of maternal and infant vitamin D deficiency on the growing infant, child, and adolescent.
Intrauterine programming is important for neonatal and adult health, including bone health, and is determined by among other factors, adequate maternal nutritional and mineral homeostasis and the fetal hormonal milieu.69
Recommendations for the prevention of vitamin D deficiency in mother and child
Vitamin D deficiency in the neonate and infant can be prevented by supplementing all at-risk pregnant and lactating women with vitamin D, by exposing pregnant and lactating women and their infants to sufficient sunlight, or by supplementing exclusively breastfed infants with vitamin D.
There are obstacles to the implementation of each of these preventive strategies. The lack of adequate training of physicians in a supposedly rickets-free era coupled with the lack of adequate recommendations
Summary
The mother is the major source of circulating 25-OHD concentrations in the young infant. Thus maternal vitamin D status is an important factor in determining the vitamin D status of the infant and their risk of developing vitamin D deficiency and infantile nutritional rickets. As a result, breastfed infants of mothers with vitamin D deficiency who are unsupplemented and who receive little sunlight exposure are at high risk of developing vitamin D deficiency or rickets. Despite food
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Cited by (59)
A joint medico-historical and paleopathological perspective on vitamin D deficiency prevalence in post-Medieval Netherlands
2021, International Journal of PaleopathologyCitation Excerpt :In addition, the study by Veselka et al. (2019) has identified perinatal/fetal vitamin D deficiency via micro-CT assessment of teeth in a subsample of 15 individuals from Hattem (6.7 %; 1/15) and 15 from Beemster (13.3 %; 2/15). Since the fetus is dependent on maternal vitamin D levels (Dror and Allen, 2010; Thandrayen and Pettifor, 2010), vitamin D deficiency in fetal/perinatal individuals suggests that mothers were vitamin D deficient (Brickley et al., 2019). Mothers of the perinates/fetuses from Rhenen and Gouda 2 may have had a higher risk of adult vitamin D deficiency than mothers from other sites (e.g. Hattem and Beemster).
An Overview of Rickets in Children
2020, Kidney International ReportsCitation Excerpt :Infancy is another age group quite vulnerable to 25-hydroxy vitamin D deficiencies. During pregnancy, there is a transfer of vitamin D between the mother and fetus and hence if the mother has low vitamin D level storage then so does the fetus.31 Even if the mother’s vitamin D level is adequate, infants get a maximum of approximately 40 IU of vitamin D per 750 ml of the breast milk.
Vitamin D deficiency and the ancient city: Skeletal evidence across the life course from the Roman period site of Isola Sacra, Italy
2019, Journal of Anthropological ArchaeologyCitation Excerpt :As newborn vitamin D status has been found to correlate strongly with maternal vitamin D status (Sachan et al., 2005; Karatekin et al., 2009), mothers of rachitic young infants may have been deficient during pregnancy. Maternal vitamin D deficiency can lead to overt bone disease in the fetus as early as 30 weeks’ gestation (Paterson and Ayoub, 2014), and the newborn is dependent on the maternal supply of vitamin D transferred through the placenta to ensure adequate vitamin D status in early infancy (Thandrayen and Pettifor, 2010). In modern populations globally, nutritional rickets in infants has been linked to low birth weight (Agarwal et al., 2012; Thacher et al., 2013) and low vitamin D status in mothers (Kim et al., 2010; Soliman et al., 2010; El Koumi et al., 2013).
Is there a potential link between vitamin D and pulmonary morbidities in preterm infants?
2018, Journal of the Chinese Medical AssociationCitation Excerpt :Vitamin D deficiency is common among infants, and pregnant and lactating mothers in the worldwide.8,9 Among the population of newborns, preterm babies often have less vitamin D stores due to less sunlight exposure and decreased trans-placental transfer from deficient mothers, and consequently have a higher requirement.10,11 Animal and laboratory studies have showed substantial positive effects of vitamin D on the alveolar type II cell (ATII), fibroblast proliferation, surfactant synthesis, and alveolarization.3,12,13
The IOM-Endocrine Society Controversy on Recommended Vitamin D Targets: In Support of the IOM Position
2018, Vitamin D: Fourth EditionRadiology of Rickets and Osteomalacia
2018, Vitamin D: Fourth Edition