VITAMIN D BLOOD LEVEL IN PREGNANCY

Vitamin D Blood Level in Pregnancy



Table of Content

CHAPTER TWO: LITERATURE REVIEW3

Adaptations during Pregnancy4

Vitamin D Metabolism during Pregnancy9

Vitamin D and Maternal Outcomes from Pregnancy11

CHAPTER THREE: METHODOLOGY25

Materials and methods25

Instrumentation26

Materials and reagents27

Genotyping28

Haplotype inference30

Statistical analysis31

Prevalence of vitamin D deficiency in pregnancy49

Maternal effects of vitamin D deficiency50

Fetal and newborn effects of gestational vitamin D deficiency52

Vitamin D deficiency during pregnancy55

Classification of vitamin D status63

REFERENCES65

Chapter Two: Literature Review

Calcium and skeletal part metabolism in mature individuals count very powerfully on concentrations of vitamin D and its hardworking metabolite 1,25-dihydroxyvitamin D [1,25(OH)2D]. Without 1,25(OH)2D, the body will not soak up calcium and phosphorus amply, lesser hyperparathyroidism supervenes, the skeleton misplaces inorganic content (secondary osteoporosis), and new skeletal part is not amply mineralized (rickets or osteomalacia) (1). Hypocalcemia can happen, but lesser hyperparathyroidism carries body-fluid calcium through skeletal resorption. During pregnancy and lactation, mothers supply large allowances of calcium to the evolving fetus and suckling neonate, respectively. Given that mature individual calcium and skeletal part metabolism count on vitamin D sufficiency, vitamin D sufficiency would appear to be particularly critical throughout pregnancy. However, as this reconsider displays, maternal adaptations throughout pregnancy, lactation, and fetal development supply the essential calcium somewhat individually of vitamin D. It is only after birth that dependency on vitamin D becomes apparent, not less than with esteem to calcium metabolism and skeletal health.

            Due to the relation paucity of facts and numbers got throughout human pregnancy, this reconsider encompasses considerations of animal facts and numbers on vitamin D's function in mammalian calcium metabolism. Studies in humans should affirm all pertinent outcome from animal forms, but this might not ever be likely for certain facets of pregnancy and fetal development. To bypass an unduly long quotation register, I direct the book reader to a 1997 comprehensive reconsider by Kovacs and Kronenberg (2), with >550 prime quotations on the matters considered here, and some latest reconsiders that cite investigations released since 1997 (3-8).

Adaptations throughout Pregnancy

            During gestation, the human fetus accretes 30 g Ca on mean, of which 99% is comprised inside the skeleton. More than 150 mg/kg of this calcium is dynamically moved each day over the placenta throughout the third trimester.

            Serum calcium concentrations (which encompass ionized, protein-bound, and complexed fractions) drop early in pregnancy as a outcome of the fall in serum albumin. This artifact of pregnancy's hemodilution is physiologically insignificant and is not clues of factual hypocalcemia. Ionized calcium concentrations, the physiologically significant part, manage not change throughout pregnancy. Parathyroid hormone (PTH), as assessed by "intact" assays, declines to the smaller end of the usual variety and can become untraceable in North American and European women (no investigations have utilised the newer "bio-intact" PTH assays). In compare, investigations of women from Gambia, Asia, and other localities where calcium and vitamin D intake are reduced have discovered that PTH concentrations manage not fall throughout pregnancy. Levels of other hormones with promise calcium-regulating effects—including estradiol, prolactin, placental lactogen, and the calcium-regulating hormone parathyroid hormone-related protein (PTHrP)—increase throughout ...