Vitamin D In Pregnancy: Importance, Dosage And Supplements
You need to have optimum levels of the sunshine vitamin for a healthy pregnancy.
Specialty: Obstetrics and Gynecology, Minimally Invasive Surgery, UrogynecologyExperience: 12 yearsDr. Ng Kai Lyn is a Singapore-based obstetrician and gynecologist, specializing in urogynecology, minimally invasive surgery, and clinical interest in fertility. She has an experience of 12 years managing and treating benign gynecological conditions, including uterine fibroids, ovarian cysts, endometrial polyps, and endometriosis.
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In This Article
Maintaining optimum levels of vitamin D in pregnancy is crucial for pregnant women to stay healthy and support their baby’s growth and development. Vitamin D is fat-soluble, and most pregnant women meet their requirements through their diet, prenatal vitamins, and optimum sun exposure.
However, some women may develop vitamin D insufficiency or deficiency, leading to health issues such as preeclampsia and gestational diabetes (1). Furthermore, vitamin D deficiency in pregnancy may also cause hypocalcemia, poor bone growth, and eczema in neonates.
Read ahead to understand how much vitamin D is needed during pregnancy and how you can meet your needs effectively.
Why Is Vitamin D Important During Pregnancy?
Pregnant women need vitamin D (cholecalciferol) for optimum calcium and phosphorus absorption, which helps maintain their bone health, immunity, and mental health (2). For their infants, vitamin D facilitates healthy growth and development of bones, teeth, skin, and eyes (3).
Experts advise pregnant women and those planning to get pregnant to take prenatal vitamins and minerals to meet their daily nutritional needs for essential vitamins and minerals, such as folate and vitamin D (4). Typically, pregnant women need only one serving of prenatal supplement a day from the first trimester.
Talk to your doctor to know how many vitamin D tablets, soft gels, or powder sachets you need to consume to meet your requirements. Remember, maintaining optimal vitamin D levels during pregnancy is crucial for you and your baby’s health.
How Much Vitamin D Do Pregnant Women Need?
According to the Dietary Guidelines for Americans 2020-2025, pregnant women need 600 IU (15mcg) of vitamin D every day (4). You can meet your daily vitamin D requirement in the following ways.
1. Sun exposure
Experts advise spending five to ten minutes in the sun exposing your face, arms, hands, and legs two to three times per week (2). It is vital to trigger endogenous production of active vitamin D3, an inactive form of vitamin D that undergoes certain metabolic processes in the liver and kidneys to convert to active vitamin D(1,25-dihydroxycholecalciferol) (5).
The time you must spend in the sun depends on your skin type, time of the day, and the time of the year. Hence, seek your healthcare provider’s guidance if you have any doubts. Also, remember to wear sunscreen (SPF 15) if you are in the sun for several minutes.
2. Foods and beverages
Eating a well-balanced, healthy diet containing vitamin D-rich foods, such as low or reduced-fat milk, fortified cereal, and fatty fish, can help meet your vitamin D needs. In the next section, we present a list of some of the vitamin D-rich foods you can consume during pregnancy (6).
What Are The Best Foods With Vitamin D?
| Foods | Mcg (per serving) | IU (per serving) |
|---|---|---|
| Cod liver oil (1 tablespoon) | 34.0 | 1,360 |
| Trout (rainbow), farmed, cooked (3 ounces) | 16.2 | 645 |
| Salmon (sockeye), cooked (3 ounces) | 14.2 | 570 |
| Mushrooms, white, raw, sliced, exposed to UV light (½ cup) | 9.2 | 366 |
| Milk, 2% milkfat, vitamin D fortified (1 cup) | 2.9 | 120 |
| Soy, almond, and oat milk, vitamin D fortified, various brands (1 cup) | 2.5-3.6 | 100-144 |
| Ready-to-eat cereal, fortified with 10% of the DV for vitamin D (1 serving) | 2.0 | 80 |
| Atlantic sardines (2), canned in oil, drained | 1.2 | 46 |
| Egg (large), scrambled | 1.1 | 44 |
| Liver, beef, braised (3 ounces) | 1.0 | 42 |
| Tuna fish (light), canned in water, drained (3 ounces) | 1.0 | 40 |
| Cheese, cheddar (1 ounce) | 0.3 | 12 |
| Mushrooms, portabella, raw, diced ( ½ cup) | 0.1 | 4 |
| Chicken breast, roasted (3 ounces) | 0.1 | 4 |
Source: National Institute of Health
Mcg = Microgram
IU = International Unit
Note: Don’t take more than 4000 IU of vitamin D in a day as its excess can harm you and your unborn baby’s health (7).
If you suspect you aren’t meeting your daily vitamin D needs, talk to your doctor. They may get your vitamin D levels tested and advise vitamin D supplementation if required. Take your vitamin D supplement with food for better absorption.
Do Prenatal Vitamin Supplements Offer Enough Vitamin D?
Some studies indicate that prescribing a daily intake of 4000 IU of vitamin D is a good way to maintain sufficient amounts of vitamin D in maternal blood (8) . However, most prenatal vitamins contain around 400 IU of vitamin D (2). Since pregnant women are at risk of vitamin D deficiency, it’s best to keep their vitamin D intake to the maximum but no more than 4000 IU a day.
It’s crucial as a high amount of vitamin D can cause nausea/vomiting, muscle weakness, pain, loss of appetite, dehydration, excessive urination, and kidney stones. Surplus vitamin D may also cause serious complications such as kidney failure and irregular heartbeat (9).
What Causes Vitamin D Deficiency In Pregnancy?
Vitamin D deficiency is common during pregnancy, and the risk factors that increase a woman’s chances of having vitamin D insufficiency or deficiency are the following (10).
- Obesity: According to experts, obese women are more likely to develop vitamin D deficiency than their leaner counterparts. The reason is that vitamin D is a fat-soluble vitamin that gets trapped in subcutaneous fat, reducing its bioavailability. Thus, obese women require two to three times more vitamin D (11).
- Vegetarian or vegan dietary habit: Vitamin D is a crucial vitamin mainly found in animal-origin foods. Hence, if you are a vegetarian or vegan, your diet could likely contain no or fewer vitamin D-rich foods, raising your chances of developing vitamin D insufficiency or deficiency. Thus, you should include vitamin D fortified foods in your diet and consult your healthcare professional about vitamin D supplementation.
- Dark complexion: A 2017 single-center cohort study highlighted that “women with dark skin color were statistically significantly more often vitamin D deficient compared to women with light skin color (12).” It’s because of more melanin that acts as a natural sunscreen and blocks vitamin D production in the skin (13).
- Limited sun exposure: Sun exposure initiates endogenous production of vitamin D. If a pregnant woman has limited sun exposure or stays fully covered, she will not produce adequate vitamin D.
- Certain medications: Certain medications, such as steroids, antiseizure drugs, antacids, cholesterol-lowering medications, and some diuretics, reduce vitamin D absorption from the intestines (14). So, if you take any of these medications, you are at risk of vitamin D insufficiency or deficiency.
- Some health conditions: Certain health conditions, such as IBS, celiac, or Crohn’s disease, reduce the body’s ability to absorb dietary fat. It affects the absorption of vitamin D in the body.
If you have one or more of the risk factors for vitamin D deficiency, you will need extra vitamin D. So, talk to your doctor about vitamin D supplementation. They may recommend a standalone vitamin D supplement for you. Select a vitamin D supplement with vitamin D3 (cholecalciferol), as it’s more efficacious than vitamin D2 (ergocalciferol) (1) . However, if you are vegan, then a vitamin D2 supplement can be useful as it’s derived from plant sources.
Frequently Asked Questions
1. Can vitamin D deficiency cause miscarriage?
According to a 2018 study, insufficient intake of vitamin D during pregnancy is linked to miscarriage among women with a history of pregnancy loss (15). The researchers defined vitamin D levels below 30 nanograms per milliliter as insufficient.
2. Can vitamin D supplementation during early pregnancy cause birth defects?
No evidence exists that shows vitamin D supplementation during early pregnancy causes congenital disabilities in babies. Yet, if you have any doubts or queries, speak to your doctor for better understanding.
Getting enough vitamin D in pregnancy is essential as it aids in absorbing other vital nutrients and helps in the healthy growth of your baby and the overall pregnancy. Take the help of the above chart to know the foods rich in vitamin D and include them in your diet. Moreover, spend a sufficient amount of time under the sun for your daily dose of vitamin D. Staying healthy with wholesome meals and diet and following the necessary care can help you maintain a healthy pregnancy. If you lack adequate vitamin D, consult your doctor before resorting to supplements.
Key Pointers
- The intake of vitamin D in pregnancy is important for calcium and phosphorus absorption to maintain their mental health and boost immunity.
- You can benefit from exposure to sunlight and a balanced diet rich in foods that provide vitamin D.
- Consuming 4000 IU of vitamin D through a supplement is a good way to fulfill the requirement.
References
- Guideline: Vitamin D supplementation in pregnant women.
https://apps.who.int/iris/bitstream/handle/10665/85313/9789241504935_eng.pdf - Vitamin D and Pregnancy.
https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/vitamin-d-and-pregnancy/ - Nutrition During Pregnancy.
https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy#:~:text=Vitamin%20D%20works%20with%20calcium - Dietary Guidelines for Americans 2020-2025.
https://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pdf - Vitamin D (Calcitriol).
http://www.vivo.colostate.edu/hbooks/pathphys/endocrine/otherendo/vitamind.html - Vitamin D Fact Sheet for Health Professionals.
https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/ - Vitamins supplements and nutrition in pregnancy.
https://www.nhs.uk/pregnancy/keeping-well/vitamins-supplements-and-nutrition/ - Sanam Behjat Sasan et al (2017) The Effects of Vitamin D Supplement on Prevention of Recurrence of Preeclampsia in Pregnant Women with a History of Preeclampsia.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5585545/ - Vitamin D Fact Sheet for Consumers.
https://ods.od.nih.gov/factsheets/VitaminD-Consumer/ - Abdurrahman Avar Özdemir et al (2018) Vitamin D Deficiency in Pregnant Women and Their Infants.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5838372/ - Obesity and vitamin D in pregnancy.
https://www.hra.nhs.uk/planning-and-improving-research/application-summaries/research-summaries/obesity-and-vitamin-d-in-pregnancy-version-11/ - Aline Richard et al (2017) Prevalence of Vitamin D Deficiency and Its Associations with Skin Color in Pregnant Women in the First Trimester in a Sample from Switzerland.
https://pubmed.ncbi.nlm.nih.gov/28287422/ - Vitamin D and Skin Health.
https://lpi.oregonstate.edu/mic/health-disease/skin-health/vitamin-D - Vitamin D Supplementation in Pregnancy.
https://www.oxfordshireccg.nhs.uk/professional-resources/documents/clinical-guidelines/endocrinology/Vitamin-D-supplementation-in-pregnancy-guideline.pdf - Insufficient vitamin D linked to miscarriage among women with prior pregnancy loss.
https://www.nih.gov/news-events/news-releases/insufficient-vitamin-d-linked-miscarriage-among-women-prior-pregnancy-loss
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