Editorials

Vitamin D sufficiency in pregnancy

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f1675 (Published 26 March 2013) Cite this as: BMJ 2013;346:f1675
  1. Robyn Lucas, associate professor1,
  2. Fan Xiang, research fellow1,
  3. Anne-Louise Ponsonby, professor2
  1. 1National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT 0200, Australia
  2. 2Murdoch Childrens Research Institute, Royal Children’s Hospital, Melbourne, Vic, Australia
  1. robyn.lucas{at}anu.edu.au

Better evidence is required to establish optimal levels and need for supplementation

One year ago, the chief medical officers of the United Kingdom recommended that “All pregnant and breastfeeding women should take a daily supplement containing 10 μg (400 IU) of vitamin D,” to counter the high prevalence of vitamin D deficiency in pregnant women. This was aimed at reducing the associated consequences of deficiency, such as rickets in children and osteomalacia in adults.1

In a linked meta-analysis (doi:10.1136/bmj.f1169), Aghajafari and colleagues look beyond bone health to other adverse health outcomes for mother and baby.2 Previous systematic reviews have highlighted challenges in combining data from different studies, including diverse definitions of vitamin D deficiency, variations in vitamin D assays used, use of non-representative samples, and varying study designs and study quality.3 4

A review published in 2011 found insufficient high quality studies to conduct quantitative meta-analysis3; in the qualitative review the evidence was inconsistent. In a subsequent review, rigorous assessment of study quality resulted in quantitative meta-analyses of only two observational studies and five randomised controlled trials, with additional studies reviewed qualitatively.4 Combined data from …

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