Whilst vitamin D levels are not routinely checked during pregnancy, a new study has shown that there is a link between vitamin D deficiency and preterm birth. In North America alone, every single day, 1000 babies are born prematurely. Looking into vitamin D deficiency and its role in this phenomenon is hence imperative.
Dreaming of Baby speaks with Dr. Kecia Gaither, MD, a double board-certified physician in OB-GYN and Maternal Fetal Medicine on the importance of adequate vitamin D levels in pregnancy.
Charles: Hello, and welcome to Dreaming of Baby; the source for answers to questions parents-to-be are asking. We have with us today Dr. Kecia Gaither, the Director of Perinatal Services at Lincoln Medical and Mental Health Center in the Bronx, New York! Today we will be focusing mainly on vitamin D and its importance before and after pregnancy. Dr. Gaither, would you be so kind as to tell our readers a little about yourself and why discussing vitamin D is so important.
Dr. Kecia Gaither: Good evening! Thank you for having me. Well, I’m a perinatologist, that’s fancy speak for a high-risk obstetrician. I’m the person the general Ob doc sends you to when there is an issue during pregnancy, such as if the mother has diabetes, HIV, hypertension, or preterm labor. Now for us perinatologists, we see a lot of preterm labor in our arena. The incidence of this entity appears to be rising. There are multifactorial proposed etiologies for its occurrence, among them infection, multiples— like twins, and there exists some research relating vitamin D deficiency as being an association.
What is vitamin D?
Charles: Thank you for explaining what you do in terms that we can understand; especially for parents-to-be that haven’t had their first child or are still trying. Trying to get a working knowledge of the different Doctors and titles can be a whole minefield in terms of knowing who is who and what is what! Ok, so in simple terms what is Vitamin D and how do we get it into the body; or on the flipside of that why would there be a vitamin D deficiency?
Dr. Kecia Gaither: Now, vitamin D is the only vitamin that humans can produce. We produce it in our skin, with the assistance of sunlight. For those people who live in urban areas, where skyscrapers, underground transportation, and long days at the office are the norm, well that can predispose you to having a deficiency of this vitamin. Vitamin D isn’t found in many foods. There are other factors which cause one to be low in vitamin D levels.
Supplementation is the answer, but it’s important to know your levels. There are two ways that can be attained: one is by simply asking your doctor, the other way is to assess it yourself with a self-test kit. There are websites that offer a lot of information about various vitamins and deficiencies. It’s also possible to purchase kits to check your vitamin levels, like vitamin D.
Dr. Kecia Gaither: “Vitamin D is the only vitamin that humans can produce. We produce it in our skin, with the assistance of sunlight.”
The link between vitamin D deficiency and preterm birth
Dr. Kecia Gaither: There has been some novel research that has come into the perinatal arena looking at vitamin D levels and preterm birth. Preliminarily, it appears that supplementation, with attainment of adequate levels of the vitamin, allows for a decreased incidence of preterm birth. This is, for me, really something to be looked into further. I am on a number of boards of companies which have a perinatal bent – I think there is something to be had with this research on vitamins, particularly vitamin D.
Charles: So, generally speaking, if we are not getting enough sun we are likely to be Vitamin D deficient and computer screens and office lighting doesn’t count as a great alternative to sunlight. Would a higher BMI and particular ethnicities make a vitamin D deficiency more likely?
Dr. Kecia Gaither: I think it’s best to find out what your level is, and go from there. ACOG, or the American Congress of Obstetricians and Gynecologists advise about 600 IU per day for a pregnant woman, but that might not be enough. That’s where the research that I spoke of earlier comes in. It’s best to have a certain level 40-60. Many pregnant women are below this level. Besides preterm labor, vitamin D is important in bone health, and cardiovascular health. Deficiencies have also been associated with depression and seasonal affective disorder or SAD for short, so it’s a pretty important vitamin.
Dr. Kecia Gaither: “Preliminarily, it appears that supplementation, with attainment of adequate levels of the vitamin, allows for a decreased incidence of preterm birth.”
Charles: Delving deeper into the study on vitamin D, what type of improvements have been seen by increasing Vitamin D levels in pregnant women?
Dr. Kecia Gaither: There is a marked decrease in the incidence of preterm labor with supplementation. it would be a great adjunct to see if there is a concurrent decrease in hypertensive disorders among pregnant women with supplementation.
Charles: Prior to our interview, I believe you mentioned that when women boosted their vitamin D intake to at least 40 nanograms per milliliter, they had a 62 percent lower rate of premature delivery. Am I quoting correctly from our conversation prior to the interview?
Dr. Kecia Gaither: In that particular study, yes, those were the preliminary findings. I’m actually initiating a research study on this at my institution. I have just applied for a grant, so we shall see how that goes.
Charles: Wow! How recent are these studies?
Dr. Kecia Gaither: Within the last 2 years…
Charles: So we are discussing cutting edge advancements. I want to make sure I am understanding correctly, what is definite at this point is that there is a reduction in premature births when vitamin D levels are boosted through supplementation and there are also overall health benefits including mental well-being?
Dr. Kecia Gaither: Preliminary results indicate that vitamin D supplementation leads to a decrease in preterm labor, and yes, definitely a boost to your mental health.
Dr. Kecia Gaither: “Preliminary results indicate that Vitamin D supplementation leads to a decrease in preterm labor, and yes, definitely a boost to your mental health.”
Charles: On the same note, can someone have too much vitamin D and can this have a negative impact on the body? Are there any conclusive studies on negative effects associated with vitamin D?
Dr. Kecia Gaither: The main consequence of vitamin D toxicity is calcium build up which can cause nausea, vomiting, muscle weakness, and renal dysfunction. Treatment would be to stop taking mega doses, and IV hydration. You may need to take corticosteroids, but overdosing would be like taking 50-60,000 IU every day for weeks to months.
Charles: Ok, so it is in fact important to test vitamin D levels, as opposed to just going out and taking supplements. Do people need a prescription, or can vitamin D be bought over the counter?
Dr. Kecia Gaither: Vitamin D can be obtained over the counter.
Charles: Thank you for your time today, Dr. Gaither, it’s been a pleasure speaking with you.