Division of Nutritional Sciences, 225 Savage Hall, Cornell University, Ithaca, NY 14853, USA.
Proc Nutr Soc. 2012 May;71(2):205-12. doi: 10.1017/S0029665111003399. Epub 2012 Jan 20.
Concerns exist about adequacy of vitamin D in pregnant women relative to both maternal and fetal adverse health outcomes. Further contributing to these concerns is the prevalence of inadequate and deficient vitamin D status in pregnant women, which ranges from 5 to 84% globally. Although maternal vitamin D metabolism changes during pregnancy, the mechanisms underlying these changes and the role of vitamin D during development are not well understood. Observational evidence links low maternal vitamin D status with an increased risk of non-bone health outcome in the mother (pre-eclampsia, gestational diabetes, obstructed labour and infectious disease), the fetus (gestational duration) and the older offspring (developmental programming of type 1 diabetes, inflammatory and atopic disorders and schizophrenia); but the totality of the evidence is contradictory (except for maternal infectious disease and offspring inflammatory and atopic disorders), lacking causality and, thus, inconclusive. In addition, recent evidence links not only low but also high maternal vitamin D status with increased risk of small-for-gestational age and schizophrenia in the offspring. Rigorous and well-designed randomised clinical trials need to determine whether vitamin D has a causal role in non-bone health outcomes in pregnancy.
人们对孕妇的维生素 D 含量是否充足表示担忧，因为这可能会对母婴的健康产生不良影响。此外，孕妇普遍存在维生素 D 不足或缺乏的情况，全球范围内这一比例在 5%至 84%之间，这进一步加剧了人们的担忧。尽管孕妇在怀孕期间的维生素 D 代谢会发生变化，但这些变化的机制以及维生素 D 在发育过程中的作用尚不清楚。观察性证据表明，母体维生素 D 含量低与母亲（子痫前期、妊娠期糖尿病、产道阻塞和传染病）、胎儿（妊娠持续时间）和较年长的后代（1 型糖尿病、炎症和特应性疾病和精神分裂症的发育编程）非骨骼健康结果的风险增加有关；但总的来说，证据相互矛盾（除了母体传染病和后代炎症和特应性疾病），缺乏因果关系，因此结论不确定。此外，最近的证据表明，母体维生素 D 含量不仅低，而且高，也会增加胎儿的胎儿生长受限和精神分裂症的风险。需要进行严格和精心设计的随机临床试验来确定维生素 D 是否在妊娠的非骨骼健康结果中起因果作用。
