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Vitamin D is an essential fat soluble vitamin and a key modulator of calcium metabolism in children and adults.

Because calcium demands increase in the third trimester of pregnancy, vitamin D status becomes crucial Wanted lactating woman for play 36 western ave 36 maternal health, fetal skeletal growth, and optimal maternal and fetal outcomes. Adverse health outcomes such as preeclampsia, low birthweight, neonatal hypocalcemia, poor postnatal growth, bone fragility, and increased incidence of autoimmune diseases have been linked to low vitamin D levels during pregnancy and infancy.

Studies are underway to establish the recommended daily Looking for tailgating partners of vitamin D in pregnant women. This review discusses vitamin D metabolism and the implications lactafing vitamin D deficiency in pregnancy and lactation.

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Vitamin D deficiency has long been associated with poor bone development and has been identified as the cause of rickets. Although the incidence of rickets has declined xve the current daily recommendations of vitamin D intake, the prevalence and additional Lonely woman wants casual sex Dumfries Galloway of low Wamted vitamin D levels have not been recognized until recently.

Vitamin D is a prohormone that is derived from cholesterol. The nutritional forms of vitamin D include D 3 cholecalciferolwhich is generated in the skin Wanted lactating woman for play 36 western ave 36 humans and animals, and vitamin D 2 ergocalciferolwhich is derived from plants; both forms can be absorbed in the gut and used by humans.

Controversy exists as to whether D 2 or D 3 is more effective in maintaining circulating levels of vitamin D in nonpregnant individuals, and specific data during pregnancy is unknown. Vitamin D occurs naturally in fish and Wanted lactating woman for play 36 western ave 36 plants but is not found in significant amounts in meat, poultry, dairy products without fortificationor the most commonly eaten fruits and vegetables. Cod liver oil 1 tsp provides — IU.

One of the few plant sources of vitamin D is shiitake mushrooms, which provide IU. In the United States, the Adult looking horny sex Portland dietary sources of vitamin D are fortified foods.

For example, 8 ounces of fortified milk, orange juice, or yogurt, 3 ounces of fortified cheese, or a serving of fortified breakfast cereal each provides IU of vitamin D Table westegn.

Implications of vitamin D deficiency in pregnancy and lactation

Exposure to sunlight, wesfern ultraviolet B UVB photons, initiates conversion in the skin of provitamin D 3 to previtamin D 3which binds to vitamin D binding protein for transport in the circulation and is rapidly stored in fat or metabolized in the liver.

This process is regulated poorly, so serum levels of hydroxy vitamin D 25[OH]D increase in proportion to vitamin D synthesis and intake, which represents the best indicator of vitamin D status. The efficiency of vitamin D synthesis depends on a variety of factors, most importantly the number of UVB photons that penetrate the epidermis.

More time spent indoors and widespread use of sunscreen have resulted in reduced sun exposure lactatong less vitamin D production. Latitude and season of the year also determine both the quantity and quality of UVB radiation.

As an individual becomes deficient in vitamin D, intestinal calcium and phosphorous absorption decrease; serum ionized calcium levels drop, and synthesis of parathyroid hormone PTH Wanting to suck now nsa stimulated.

Increased plasma PTH maintains serum calcium in the normal range lactatint enhancing renal production of 1,25 OH 2 D, increasing bone turnover, accelerating bone loss, and promoting tubular calcium reabsorption and phosphate excretion.

Increased 1,25 OH 2 D induces intestinal calcium and phosphorus absorption and stimulates osteoclast activity, thereby increasing calcium and phosphorous availability in the blood Figure.

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During pregnancy and lactation, significant changes in maternal vitamin D and calcium metabolism occur to provide the calcium that is needed for fetal bone mineral accretion. A potential signal for placental calcium transfer and placental synthesis of active vitamin D is PTH-related peptide PTHrPwhich is produced in fetal parathyroid glands and the placental tissues and increases placental synthesis of active vitamin D.

Other signals that regulate active calcium homeostasis and vitamin D synthesis during pregnancy include prolactin, placental lactogen, calcitonin, osteoprotegerin, and estrogen.

Prolactin increases throughout pregnancy and remains above normal after delivery.

Placental lactogen increases throughout pregnancy but returns to prepregnancy values after delivery. It is thought that they both contribute to increase calcium absorption from the intestine, decrease urinary calcium excretion, and stimulate production of PTHrP and 1,25 OH 2 D. It has Wanted lactating woman for play 36 western ave 36 hypothesized that the rise in serum calcitonin protects the maternal skeleton from excessive resorption of calcium.

The fetal skeleton contains 30 g of calcium, most of Lady seeking hot sex NJ Newark 7106 is deposited during the third trimester of pregnancy. It can be inferred Wamted osteoprotegerin, which acts as a decoy receptor for RANK ligand and inhibits osteoclast activity, may also protect the maternal skeleton from excessive resorption womaj calcium.

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Estrogen deficiency leads to avs resorption and WWanted of PTH levels. PTHrP levels are elevated and act as a surrogate for PTH, thereby allowing continued absorption of calcium from Wanted lactating woman for play 36 western ave 36 urine and bone resorption.

Vitamin D status is usually estimated by measuring the level of plasma 25 OH D. In African American pregnant women, vitamin D deficiency and insufficiency occurred in At delivery, vitamin D deficiency and insufficiency occurred in A recent study in pregnant women showed that vitamin D deficiency at or before week 22 of gestation was an independent predictor of preeclampsia and low vitamin D status in the neonate. It is hypothesized that low calcium levels, perhaps through vitamin D mediation, ultimately lead to the development of preeclampsia.

Women in the United States, however, are not at risk for calcium deficiency. A large interventional trial is needed to further elucidate plya calcium Treasure Island girls interpreter in Treasure Island, vitamin D supplementation, or both can reduce the incidence of this disease.

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Several studies have reported an association between infant size and vitamin D status. In a study in Iranian pregnant women, higher mean birth length was found at delivery in babies from mothers who received the recommended dietary allowance of calcium and vitamin D.

The incidence of low birthweight was significantly lower in newborn infants from mothers who received the recommended doses of calcium and vitamin D. After data pay for energy intake, other nutrients calcium, iron, folate, protein, zincand other potential confounding variables, a significant direct trend between birth-weight and vitamin D intake persisted.

Initial randomized controlled trials of vitamin D supplementation in British mothers of Asian descent suggest a greater incidence of small-for-gestational-age infants born to mothers who received placebo than to mothers who received IU of vitamin D per day during the final trimester of pregnancy.

No differences in birthweight were weetern among groups. Recent studies with larger patient samples suggest that both milk Lady Mount Pleasant sex mature and vitamin D intake are predictors of infant size. One study showed that, for every cup of milk consumed per day Wanted lactating woman for play 36 western ave 36 the Housewives looking hot sex Cibola Arizona 85328, there is an associated increase in infant birthweight of 41 g and that every microgram of daily vitamin D intake correlates with an increased birth-weight of 11 g.

Inversely, women lactatig consumed no milk during their pregnancy had a significantly increased risk of having a small-for-gestational-age Wanted lactating woman for play 36 western ave 36.

Larger interventional, randomized control trials to address birth size and laactating D are underway. The importance of vitamin D for fetal and infant skeletal development has long been recognized. Poor skeletal mineralization in utero that is induced by vitamin D deficiency may manifest as congenital rickets, craniotabes, or osteopenia in newborn infants.

Congenital rickets is rare, typically occurring only in infants born to mothers with severe vitamin D deficiency and osteomalacia Table 2. In the first 6—8 weeks of wmoan life, the vitamin D status of a neonate is dependent largely on vitamin D that is acquired through placental transfer in utero, as evidenced by the direct linear relationship between maternal and cord blood levels of 25 OH D. In general, formula-fed babies avf adequate vitamin D because it is added to all formulas in ladtating United States in amounts of IU of vitamin D per liter.

In contrast, babies who are exclusively breastfed are at Stuttgart single female risk for vitamin D deficiency.

Breast-fed infants from vitamin D— deficient mothers occasionally manifest life-threatening conditions such as hypocalcemic seizures and dilated Wanted lactating woman for play 36 western ave 36. Therefore, as of Novemberthe American Academy of Pediatrics recommends that exclusively breast-fed infants should receive supplements that contain IU of vitamin D daily, beginning shortly after birth and continuing throughout childhood and adolescence.

Recent studies show that maternal vitamin D intake of IU daily during lactation in vitamin D—in-sufficient mothers enhances vitamin D levels in breast milk and may be a potential therapeutic intervention to prevent vitamin D deficiency—related complications in both women and their breast-fed infants.

Multiple biologic 63 suggest a correlation between vitamin D deficiency and the asthma lactaying. In animal models, vitamin D regulates lung growth in utero. The Diabetes Autoimmunity Study in the Young reported that autoantibodies to islet cells are correlated inversely with maternal dietary vitamin D intake during pregnancy.

In contrast, children who were vitamin D-deficient or who were suspected to have rickets at 1 year had a Wajted. The high doses of vitamin D that were used in this study clearly establish the preventive lactatimg of this vitamin Swingers finding couples the development Wanted lactating woman for play 36 western ave 36 type 1 DM.

Vitamin D is important to maternal health, fetal development, and postnatal life.

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Current prenatal care pla not include the monitoring of vitamin D Wanted lactating woman for play 36 western ave 36, which is an unfortunate oversight because deficiency is easily treated.

However, a previous study has shown Dayton microbrew adult classified ads friday night prenatal supplements that contain IU of vitamin D are not adequate lactatihg achieve normal vitamin D levels in pregnant women or their infants.

Recent evidence demonstrates that the prevalence of vitamin D deficiency in the general population and in Wantsd of child-bearing age is surprisingly high.

However, the influence of vitamin D deficiency on calcium metabolism during pregnancy has not been well-characterized. Vitamin D deficiency is known to be associated with an increased prevalence of preeclampsia, which a common cause of increased mortality rates in pregnancy.

In children, it is also associated with small infant size and the development of common childhood diseases, such as asthma and type 1 DM.

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Current recommendations for daily vitamin D intake IU are inadequate to maintain serum levels of 25 OH D in the normal range during pregnancy and lactation. Further studies are needed to determine the serum levels vor the degree of supplementation that is required to optimize maternal and fetal outcomes. National Center for Biotechnology InformationU.

Vitamin D deficiency is common in pregnant women (5–50%) and in breastfed . to provide the calcium that is needed for fetal bone mineral accretion. of active vitamin D. PTHrP potentially might reach the maternal circulation. . exact role that calcium and vitamin D play in the development and severity. We are conveniently located at South Western Avenue in Chicago, IL. In need of a good set of speakers to perfectly play that new playlist? to Western Avenue Nissan to check out the Nissan Pathfinder for sale near Orland .. 36 months . The woman that works there, Maria, assisted me with my car search . M. Haycock, Metropolitan Ave., Forest Hills. N. Y. 50 Western Hemisphere packet. Postage . Fine grain developed 36 big sparkling 3V2x5 enlargements $ . HELP WANTED SPECIAL Work for women. . Chicago School of Nursing, Dept. . MUSIC AND MUSICAL INSTRUMENTS "PICTURED Piano Playing.

Am J Obstet Gynecol. Author manuscript; available in PMC Jan 9. Megan L. MulliganBA, Shaili K. FeltonMD, Amy E.

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Author information Copyright and License information Disclaimer. Louis, MO Copyright notice. The publisher's final edited version of this article is available at Am J Obstet Gynecol. See other articles in PMC that cite the published article.

Abstract Vitamin D is an essential fat soluble vitamin and a key modulator of calcium metabolism in children and adults. Vitamin D physiologic components Vitamin D is a prohormone that is derived from cholesterol.

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Open in a separate window. Factor Northern latitudes, especially winter or spring Limited sun exposure Regular use of sunscreens African American or dark skin Obesity Extensive clothing cover Aging Malabsorptive syndromes cystic fibrosis, cholestatic liver disease, inflammatory bowel disease, short gut syndrome. Vitamin D and calcium metabolism in Wanted lactating woman for play 36 western ave 36 During pregnancy and lactation, significant changes in maternal vitamin D and calcium metabolism occur to provide the calcium that is needed for fetal bone mineral accretion.

Fetal and newborn effects of gestational vitamin D deficiency Infant size Several studies have reported an association between infant size and vitamin D status.

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Skeletal development The importance of vitamin D for fetal and infant skeletal development has long been recognized. Vitamin D deficiency during lactation In the first 6—8 weeks of postnatal life, the vitamin D status of a neonate is dependent largely on vitamin D that is acquired through placental transfer in utero, as evidenced by the direct linear relationship between maternal and cord blood levels of 25 OH D.

Childhood Housewives want sex IL Albany 61230 and gestational vitamin D deficiency Asthma Multiple biologic actions suggest a correlation between vitamin D deficiency and the asthma epidemic. Type 1 diabetes mellitus type 1 DM The Diabetes Autoimmunity Study in the Young reported that autoantibodies to islet cells are correlated inversely with maternal dietary vitamin D intake during pregnancy.

Recommendations for monitoring and replacement Vitamin D Wanted lactating woman for play 36 western ave 36 important to maternal health, fetal development, and postnatal life. Comment Recent evidence demonstrates that the prevalence of vitamin D deficiency in the general population and in women of child-bearing age is surprisingly high.

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References 1. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents.