Vitamin D During Fetal Life and Bone Health in Children at Age 6 Interview with:
Audry H. Garcia PhD

Scientist Department of Epidemiology
Erasmus MC, University Medical Center Rotterdam
Rotterdam, the Netherlands What is the background for this study?

Response: Fetal bone mineralisation requires an adequate transfer of calcium to the fetus by the end of the pregnancy. Considering that vitamin D is required to maintain normal blood concentrations of calcium, adequate 25-hydroxyvitamin D (25[OH]D) concentrations in pregnant women seem to be crucial for bone development of the offspring. Maternal vitamin D deficiency during pregnancy has been associated with abnormal early skeletal growth in offspring and might be a risk factor for decreased bone mass in later life. Several studies have linked vitamin D deficiency in fetal life to congenital rickets, craniotabes, wide skull sutures and osteomalacia. However, the evidence of long-lasting effects of maternal vitamin D deficiency during pregnancy on offspring’s skeletal development is scarce and inconsistent, and has led to contradictory recommendations on vitamin D supplementation during pregnancy. What are the main findings?

Response: In a prospective multiethnic population-based cohort study of 5,294 children from the city of Rotterdam, the Netherlands, we found that decrease maternal or cord 25(OH)D concentrations were associated with increased offspring bone mineral content (BMC) and bone area at age 6 years. However, these associations were no longer significant after adjustment for the child’s own 25(OH)D concentrations at the time of bone assessment. No associations were seen for offspring bone mineral density or area-adjusted BMC, and the associations with skeletal parameters at 6 years did not differ by maternal BMI, maternal calcium intake during pregnancy, child sex, or weight status. What should readers take away from your report?

Response: The findings from our study provide more conclusive evidence, and do not support vitamin D supplementation as a routine antenatal care practice in pregnant women to improve offspring bone mass or bone density in childhood or in later life. Our data suggest that 25(OH)D concentrations during childhood might be more relevant for bone health than during fetal life. What recommendations do you have for future research as a result of this study?

Response: At present, no guidelines or clinical cutoffs are available to define vitamin D deficiency during pregnancy, and no studies have addressed if these might differ from non-pregnant individuals. Interventional research in large groups are needed to define vitamin D deficiency during pregnancy, and to explore whether vitamin D supplementation during pregnancy may be beneficial for other health outcomes. Thank you for your contribution to the community.

25-hydroxyvitamin D concentrations during fetal life and bone health in children aged 6 years: a population-based prospective cohort study
Garcia, Audry H et al.
The Lancet Diabetes & Endocrinology , Volume 0 , Issue 0 ,


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Last Updated on March 7, 2017 by Marie Benz MD FAAD