Vitamin-D-Mangel in der Schwangerschaft 鈭?ein lebenslanges Gesundheitsrisiko f眉r die Kinder?

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• 作者：Prof. Dr. D. l鈥橝llemand
• 关键词：Kardiomyopathie ; Geburtsgewicht ; Kindliche muskuloskeletale Entwicklung ; Epigenetik ; Pr盲natale Programmierung ; Cardiomyopathy ; Epigenetics ; Pediatric musculoskeletal development ; Birth weight ; Prenatal programming
• 刊名：Der Gyn?kologe
• 出版年：2015
• 出版时间：May 2015
• 年：2015
• 卷：48
• 期：5
• 页码：372-376
• 全文大小：283 KB
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• 作者单位：Prof. Dr. D. l鈥橝llemand (1)
  
  1. P盲diatrische Endokrinologie/Diabetologie, Ostschweizer Kinderspital, St. Gallen, Claudiusstr. 6, 9006, St. Gallen, Schweiz
  
• 刊物主题：Gynecology; Obstetrics/Perinatology; Endocrinology;
• 出版者：Springer Berlin Heidelberg
• ISSN：1433-0393

文摘

Background Since the 1980s gynecologists and pediatricians have increasingly been confronted with vitamin D deficiency during pregnancy and its consequences for mother and child. In this article the short and long-term impacts on the health of children after a low maternal vitamin D status are considered. State of research and objectives Vitamin D deficiency is one of the causes of small for gestational age (SGA) births if an elevated parathyroid hormone indicates maternal calcium metabolic stress. Supplementation with up to 4000聽IU vitamin D daily during pregnancy was not accompanied by measurable side effects but the positive effects on birth weight were not conclusive. Severe maternal vitamin D deficiency and non-compliance with recommended vitamin D supplementation of infants can lead to life-threatening cardiomyopathy and hypocalcemic tetanus during the first year of life. This mostly affects risk groups with a migration background and lack of sun exposure. Long-term impairment of bone metabolism, muscle strength and obstructive lung diseases in children at the age of 3鈥? years has been observed after a low maternal vitamin D status during pregnancy. Conclusion As these observations on low vitamin D status during pregnancy support a prenatal programming of fetal metabolism, in particular of musculoskeletal development, an insufficient vitamin D status (<鈥?0聽nmol/l) has to be avoided during pregnancy and lactation. A supplementation with 600聽IU is recommended for all but it is of utmost importance to identify gravidae and lactating mothers at high risk, namely those with dark skin color or lack of sun exposure without sufficient vitamin D intake as well as the children and to diagnose a potentially severe vitamin D deficiency which has to be treated with adequately higher doses of vitamin D.