Faculty of Medicine - Endocrinology, Health Sciences Centre, Memorial University of Newfoundland, 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada.
J Endocrinol Invest. 2021 Apr;44(4):643-659. doi: 10.1007/s40618-020-01387-2. Epub 2020 Aug 9.
During pregnancy, female physiology adapts to meet the additional mineral demands of the developing fetus. Meanwhile, the fetus actively transports minerals across the placenta and maintains high circulating levels to mineralize the rapidly developing skeleton. Most of this mineral is accreted during the last trimester, including 30 g of calcium, 20 g of phosphate and 0.8 g of magnesium. Given the dependence of calcium homeostasis on vitamin D and calcitriol in the adult and child, it may be expected that vitamin D sufficiency would be even more critical during pregnancy and fetal development. However, the pregnant mother and fetus appear to meet their mineral needs independent of vitamin D. Adaptations in maternal mineral and bone metabolism during pregnancy appear to be invoked independent of maternal vitamin D, while fetal mineral metabolism and skeletal development appear to be protected from vitamin D deficiency and genetic disorders of vitamin D physiology. This review discusses key data from both animal models and human studies to address our current knowledge on the role of vitamin D and calcitriol during pregnancy and fetal development.
在妊娠期间，女性的生理机能会发生适应性改变，以满足胎儿不断增长的矿物质需求。与此同时，胎儿会积极地将矿物质通过胎盘进行转运，并维持较高的循环水平，从而促进骨骼的快速发育和矿化。胎儿骨骼的矿化主要发生在妊娠晚期，在此期间，胎儿会积累 30 克钙、20 克磷酸盐和 0.8 克镁。鉴于成人和儿童的钙稳态依赖于维生素 D 和 1,25-二羟维生素 D3（calcitriol），因此可以推测，在妊娠和胎儿发育期间，维生素 D 充足可能更为关键。然而，孕妇和胎儿似乎可以独立于维生素 D 来满足矿物质需求。妊娠期间母体矿物质和骨代谢的适应性改变似乎独立于母体维生素 D，而胎儿矿物质代谢和骨骼发育似乎可以免受维生素 D 缺乏和维生素 D 生理学遗传障碍的影响。本文讨论了来自动物模型和人类研究的关键数据，以阐明我们目前对维生素 D 和 1,25-二羟维生素 D3 在妊娠和胎儿发育期间作用的认识。
