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Study Title:

Hypovitaminosis D in pregnancy: can the Mediterranean paradox be explained? A systematic review.

Study Abstract

Introduction: Despite high levels of sunshine, maternal hypovitaminosis D during pregnancy is prevalent in the Mediterranean region, consisting a paradox. The aim of the study was to systematically review trials that investigated vitamin D concentrations during pregnancy in this region, in order to determine predictors of hypovitaminosis D and explain the paradox.
Methods: After applying inclusion/exclusion criteria, 15 studies were entered into the systematic review, involving 2649 pregnant women and 1820 neonates. The main outcome was maternal vitamin D concentration. Possible predictors of the outcome included study, maternal and neonatal characteristics (age, BMI, race, socioeconomic status, skin type, gestational age, sun exposure, calcium and vitamin D intake and supplementation, smoking status, parity, season of delivery, pregnancy complications).
Results: Studies differed widely in vitamin D deficiency criteria, methods of measurement and outcomes. However, prevalence of maternal and neonatal hypovitaminosis D was up to 90%. Predictors of maternal hypovitaminosis D were dark skin phototype, race and sartorial habits. Only a few pregnant women met the recommended dietary daily intake of calcium and vitamin D. Vitamin D supplementation was not a common practice.
Conclusions: Hypovitaminosis D during pregnancy is prevalent in the Mediterranean region. Racial, social and cultural habits, as well as the absence of preventive strategies seem to negate the benefits of sun exposure.

Study Information


Hypovitaminosis D in pregnancy: can the Mediterranean paradox be explained? A systematic review.
Endocrine Abstracts
1970 January
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