Skip to main content
Log in

Low Vitamin D Status in Mother-Newborn Pairs in Greece

  • Clinical Investigations
  • Published:
Calcified Tissue International Aims and scope Submit manuscript

Abstract

Adequate vitamin D status during pregnancy is crucial to assure normal fetal skeletal growth and to provide the vitamin D needed for infants’ stores. To determine the actual situation in Greece, we evaluated serum 25-hydroxyvitamin D (25[OH]D), calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), parathyroid hormone (PTH), osteocalcin (OC), and calcitonin (CT) concentrations in 123 healthy mother-newborn pairs recruited from a public hospital of the sunny Athenian region. Blood samples were obtained from pregnant women at term and their neonates (cord blood). The study was conducted between June 2003 and May 2004. None of the mothers has been prescribed vitamin D supplements. Maternal 25(OH)D levels (16.4 [11-21.1] ng/mL) were significantly lower than umbilical venous blood concentrations (20.4 [13.9-30.4] ng/mL) (P < 0.001). A strong correlation was observed between maternal and infant 25(OH)D concentrations (r = 0.626, P < 0.001). Twenty-four (19.5%) mothers and 10 (8.1%) neonates had 25(OH)D <10 ng/mL. Pregnant women who delivered in summer and autumn reported higher levels of 25(OH)D (18.9 [12.9-23.3] ng/mL) than those who delivered in winter and spring (14.6 [10.1-18.5] ng/mL) (P = 0.006). Mothers with a darker phototype had lower levels of serum 25(OH) D than those with a fair phototype (P = 0.023). Umbilical venous blood Ca, P, OC, and CT levels were significantly higher than maternal venous blood levels (P < 0.001). PTH umbilical levels were lower than maternal levels (P < 0.001). Apparently, the abundant sunlight exposure in Athens is not sufficient to prevent hypovitaminosis D. Pregnant women should be prescribed vitamin D supplementations, and the scientific community should consider vitamin D supplementation of foods.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Van der Wielen RPJ, Lowik MRH, van der Berg H, de Groot LCPGM, Haller J, Moreiras O, van Staveren WA (1995) Serum vitamin D concentrations among elderly people in Europe. Lancet 346:207–210

    Article  PubMed  Google Scholar 

  2. Ginat-Israeli T, Dranitzki Z, Straus U (2003) Nutritional rickets in infants immigrating to Israel from Ethiopia. Isr Med Assoc J 5:289–290

    Google Scholar 

  3. Ward L (2005) Vitamin D deficiency in the 21st century: a persistent problem among Canadian infants and mothers. CMAJ 172:769–770

    PubMed  Google Scholar 

  4. Weisberg P, Scanlon KS, Li R, Cosgwell ME (2004) Nutritional rickets among children in the United States: review of cases reported between 1986 and 2003. Am J Clin Nutr 80:1697S–1705S

    PubMed  CAS  Google Scholar 

  5. Hanley DA, Davison KS (2005) Vitamin D insufficiency in North America. J Nutr 135:332–337

    PubMed  CAS  Google Scholar 

  6. Gannage-Yared MH, Chemali R, Yaacoub N, Halaby (2000) Hypovitaminosis D in a sunny country: relation to lifestyle and bone markers. J Bone Miner Res 15:1856–1862

    Article  PubMed  CAS  Google Scholar 

  7. DeLucia M, Carpenter T (2002) Rickets in the sunshine? Nutrition 8:97–98

    Article  Google Scholar 

  8. Hollick MF (1995) Environmental factors that influence the cutaneous production of vitamin D. Am J Clin Nutr 61(suppl):638–645

    Google Scholar 

  9. Lapatsanis D, Moulas A, Cholevas V, Soukakos P, Papadopoulou ZL, Challa A (2005) Vitamin D: a necessity for children and adolescents in Greece. Calif Tissue Int 77:348–355

    Article  CAS  Google Scholar 

  10. Bouillon R, Okamura WH, Norman AW (1995) Structure-function relationships in the vitamin D endocrine system. Endocr Rev 16:200–257

    Article  PubMed  CAS  Google Scholar 

  11. Haddad JG (1992) Vitamin D. Solar rays, the Milky Way or both. N Engl J Med 326:1213–1215

    Article  PubMed  CAS  Google Scholar 

  12. Holick MF (2003) Vitamin D: a millenium perspective. J Cell Bioch 88:296–307

    Article  CAS  Google Scholar 

  13. Ladhani S, Srinivasan L, Buchanan C, Allgrove J (2004) Presentation of vitamin D deficiency. Arch Dis Child 89:781–784

    Article  PubMed  CAS  Google Scholar 

  14. Sachan A, Gupta R, Das V, Agarwal A, Awasthi PK, Bhatia V (2005) High prevalence of vitamin D deficiency among pregnant women and their newborns in northern India. Am J Clin Nutr 81:1060–1064

    PubMed  CAS  Google Scholar 

  15. Care AD (1997) Vitamin D in pregnancy, the fetoplacental unit, and lactation. In: Feldman D, Glorieux FH, Wesley Pike J (eds). Vitamin D. New York: Academic Press, pp 437–443

    Google Scholar 

  16. Lawrence M, Garnter LM, Greer FR (2003) Section on Breastfeeding and Committee of Nutrition, American Academy of Pediatrics. Prevention of rickets and vitamin D deficiency: new guidelines for vitamin D intake. Pediatrics 111:908–910

    Article  Google Scholar 

  17. Hollis BW, Wagner C (2004) Assessment of dietary vitamin D requirements during pregnancy and lactation. Am J Clin Nutr 79:717-726

    PubMed  CAS  Google Scholar 

  18. Hill TR, O’Brien MM, Cashman KD, Flynn A, Kiely M (2004) Vitamin D intakes in 18?64-y-old Irish adults. Eur J Clin Nutr 58:1509-1517

    Article  PubMed  CAS  Google Scholar 

  19. Greer FR, Krebs NF, Committee on Nutrition (2006) Optimizing bone health and calcium intakes of infants, children, and adolescents. Pediatrics 117:578–585

    Article  PubMed  Google Scholar 

  20. Royal Society of Chemistry MAFF (1991) The Compositions of Foods, 5th ed. McCance and Widdowson, Turpin Distribution Services Ltd., Letchworth, Herts, SGG 1HN

  21. Fitzpatrick TB (1975) Soleil et peau. J Med Esthet 2:33–34

    Google Scholar 

  22. Allgrove J (2004) Is nutritional rickets returning? Arch Dis Child 89:699–701

    Article  PubMed  CAS  Google Scholar 

  23. Ward L (2005) Vitamin D deficiency in the 21st century: a persistant problem among Canadian infants and mothers. CMAJ 172:769–768

    PubMed  Google Scholar 

  24. Matsuoka LY, Worstman J, Haddad JG, Kolm P, Hollis BW (1991) Racial pigmentation and the cutaneous synthesis of vitamin D. Arch Dermatol 127:536–538

    Article  PubMed  CAS  Google Scholar 

  25. Lo C, Paris P, Holick M (1986) Indian and Pakistani immigrants have the same capacity as Caucasians to produce vitamin D in response to ultraviolet irradiation. Am J Clin Nutr 44:683–685

    PubMed  CAS  Google Scholar 

  26. Stamp TCB, Round JM (1974) Seasonal changes in human plasma levels of 25-hydroxyvitamin D. Nature 247:563–565

    Article  PubMed  CAS  Google Scholar 

  27. Institute of Medicine Food and Nutrition Board, Standing Committee on the Scientific Evaluation of Dietary Reference Intakes Vitamin D (1997) In: Dietary reference intakes for calcium, phosphorous, magnesium, vitamin D and fluoride. National Academy Press, Washington DC, pp 250–287

  28. Salle B, Delvin E, Lapillonne A, Bishop N, Glorieux F (2000) Perinatal metabolism of vitamin D. Am J Clin Nutr 71:1317S–1324S

    PubMed  CAS  Google Scholar 

  29. Stearns G, Jeans PC, Vandecar V (1936) The effect of vitamin D on linear growth in infancy. J Pediatr 9:1–10

    Article  Google Scholar 

  30. Thomson K. Morley R, Grover S, Zacharin M (2004) Postnatal evaluation of vitamin D and bone health in women who were vitamin D deficient in pregnancy and in their infants. MJA 181:486–488

    PubMed  Google Scholar 

  31. Anatoliotaki M, Tsilimigaki A, Tsekoura T, Schinaki A, Stefanaki S, Nikolaidou P (2003) Congenital rickets due to maternal vitamin D deficiency in a sunny island of Greece. Acta Paediatr 92:389–391

    Article  PubMed  CAS  Google Scholar 

  32. Dawodu A, Agarwal M, Hossain M, Kochiyil J, Zayed R (2003) Hypovitaminosis D and vitamin D deficiency in exclusively breast-feeding infants and their mothers in summer: a justification of breast-feeding infants. J Pediatr 142:169–173

    Article  PubMed  CAS  Google Scholar 

  33. Challa A, Ntourntoufi A, Cholevas V, Bistori M, Galanakis E, Andronikou S (2005) Breastfeeding and vitamin D status in Greece during the first 6 months of life. Eur J Pediatr 164:724–729

    Article  PubMed  CAS  Google Scholar 

  34. Craig M, Bowyer L, Doyle E, Catting-Paull C, Diamond T, Srinivasan S, Homer C (2005) Vitamin D and calcium status in a population of pregnant women and neonates. Horm Res 64(suppl 1):93

    Google Scholar 

  35. Hsu S, Levine M (2004) Perinatal calcium metabolism: physiology and pathophysiology. Semin Neonatol 9:23–36

    Article  PubMed  Google Scholar 

  36. Ardawi S, Nasrat H, BA’Aqueel H (1997) Calcium regulating hormones and parathyroid hormone related peptide in normal pregnancy and postpartum: a longitudinal study. Eur J Endocrinol 137:402–409

    Article  PubMed  CAS  Google Scholar 

  37. Wieland P, Fischer JA, Trechsel U, Roth HR, Vetter K, Schneider H, Huch A (1980) Perinatal parathyroid hormone, vitamin D metabolites, and calcitonin in man. Am J Physiol Endocrinol Metab 239:E385–E390

    CAS  Google Scholar 

  38. Kato T, Seki K, Matsui H, Sekiya S (1998) Monomeric calcitonin in pregnant women and in cord blood. Obstet Gynecol 92:241–244

    Article  PubMed  CAS  Google Scholar 

  39. Seki K, Makimura N, Mitsui C, Nagata I (1993) Osteocalcin levels in maternal and cord blood. Obstet Gynecol 81:189–190

    PubMed  CAS  Google Scholar 

  40. Alatas O, Colak O, Alatas E, Tekin B, Inal M, Ozalp S (1995) Osteocalcin metabolism in late fetal life: fetal and maternal osteocalcin levels. Clin Chim Acta 239:179–183

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgment

We are grateful to Nestle, Hellas SA, for the financial support of this study. We also thank Dr. Basil Psiloglou at the National Observatory of Athens for giving us the data on global radiation in Athens during the study period.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to P. Nicolaidou.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nicolaidou, P., Hatzistamatiou, Z., Papadopoulou, A. et al. Low Vitamin D Status in Mother-Newborn Pairs in Greece. Calcif Tissue Int 78, 337–342 (2006). https://doi.org/10.1007/s00223-006-0007-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00223-006-0007-5

Keywords

Navigation