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Review
. 2017 Sep 1:38:19.
doi: 10.1186/s40985-017-0066-3. eCollection 2017.

The importance of vitamin D in maternal and child health: a global perspective

M Fiscaletti  1 , P Stewart  1 , C F Munns  1   2
Affiliations
Review

The importance of vitamin D in maternal and child health: a global perspective

M Fiscaletti et al. Public Health Rev. .

Abstract

Vitamin D and calcium are important nutrients for skeletal growth and bone health. Children and pregnant women are particularly vulnerable to 25-hydroxy vitamin D deficiency (VDD). VDD, with or without dietary calcium deficiency, can lead to nutritional rickets (NR), osteomalacia, and disturbances in calcium homeostasis. Multiple studies have linked VDD to adverse health outcomes in both children and pregnant women that extend beyond bone health. VDD remains an important global public health concern, and an important differentiation must be made between the impact of VDD on children and adults. Reports of increased incidence of NR continue to emerge. NR is an entirely preventable condition, which could be eradicated in infants and children worldwide with adequate vitamin D and calcium supplementation. The desire and necessity to put in place systems for preventing this potentially devastating pediatric disease should not elicit dispute. VDD and NR are global public health issues that require a collaborative, multi-level approach for the implementation of feasible preventative strategies. This review highlights the history, risk factors, and controversies related to VDD during pregnancy and childhood with a particular focus on global NR prevention.

Keywords: 25-Hydroxycholecalciferol; Child health; Global public health; Maternal health; Nutritional rickets; Review; Vitamin D; Vitamin D deficiency.

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Conflict of interest statement

Not applicable.Not applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
X-ray of the lower extremities of a child with nutritional rickets. Classic radiological signs of rickets are seen including cupping, fraying, and widening of the growth plates and bowing of the diaphyses
Fig. 2
Fig. 2
Schematic representation of some maternal factors and physiological changes during pregnancy that optimize bone health in offspring. Increased calcium transport to fetus and sufficient maternal vitamin D status result in adequate skeletal maturation, decreased risk of neonatal hypocalcemia, and decreased risk of congenital and infantile NR. Maternal 25OHD likely crosses the placenta resulting in fetal levels that approximate maternal levels. 1,25(OH)2D, on the contrary, is not thought to cross the placenta. 1,25(OH)2D 1,25-dihydroxycholecalciferol, UVB ultraviolet B, NR nutritional rickets
See this image and copyright information in PMC

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