ISSN 0300-9092 (Print)
ISSN 2412-5679 (Online)

Prevention and treatment of vitamin D deficiency during pregnancy: the position of professional medical communities

Artymuk N.V., Tachkova О.А.

Kemerovo State Medical University, Ministry of Health of Russia, Kemerovo, Russia

The review presents the analysis of 17 clinical recommendations and the position of 14 professional medical communities on the prevention and treatment of vitamin D deficiency in pregnant women. These recommendations are offered by the World Health Organization (WHO), the British Royal College of Obstetricians and Gynecologists (RCOG), the Institute of Obstetricians and Gynecologists of the Royal College of Physicians in Ireland, the American Pregnancy Association (APA), the American College of Obstetricians and Gynecologists (ACOG), the Society of Obstetricians and Gynecologists of Canada (SOGC), the Endocrine Society, the Royal Australian College of General Practitioners (RACGP), Health Canada, Académie de Médecine, the German Nutrition Society (Deutsche Gesellschaft für Ernährung e.V.), the Chinese Nutrition Society, the Institute of Medicine, the Russian Society of Obstetricians and Gynecologists (RSOG), the Russian Association of Endocrinologists (RAE), Health New Zealand - Te Whatu Ora and the nutrition societies of Germany, Austria, and Switzerland (D-A-CH).
Conclusion: All professional communities agree that pregnant women should receive adequate nutrition. This is best achieved by eating healthy, balanced foods, and ensuring that they get enough sunlight, which is a vital source of vitamin D. At the same time, the analysis reveals different positions among professional communities regarding vitamin D intake during pregnancy. Recommendations for vitamin D intake during pregnancy range from 200 to 4,000 IU/day. Most communities do not recommend regular prophylaxis with high doses of vitamin D for pregnant women, as the safety of this practice has not been proven. High-quality randomized controlled trials among populations with low vitamin D levels are necessary to assess the benefits of vitamin D during pregnancy, as these benefits remain uncertain and vary greatly.

Authors’ contributions: Artymuk N.V., Tachkova О.А. – developing the concept and design of the study; editing the article. 
Artymuk N.V. – search and analysis of the material, writing the text.
Conflicts of interest: Authors declare lack of the possible conflicts of interest.
Funding: The study was conducted without sponsorship.
For citation: Artymuk N.V., Tachkova О.А. Prevention and treatment of vitamin D deficiency during pregnancy: 
the position of professional medical communities.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (8): 5-14 (in Russian)
https://dx.doi.org/10.18565/aig.2025.216

Keywords

pregnancy
cholecalciferol
deficiency
vitamin D deficiency

References

  1. Varthaliti A., Rodolaki K., Lygizos V., Vlachos D.E., Thomakos N., Sioutis D. et al. Neurodevelopmental outcomes in the offspring of women with vitamin D deficiency and women who received vitamin D supplementation during pregnancy. Nutrients. 2025; 17(6): 978. https://dx.doi.org/10.3390/nu17060978
  2. Baqai S., Siraj A., Imran R. Association of vitamin-d insufficiency during pregnancy with maternal & perinatal morbidity and mortality. Pak. Armed. Forces Med. J. 2020; 70(2): 323-7.
  3. Thomas D.J., Khan H.U., Jaidev S.P., Hegde P. A study on vitamin D levels in preterm and term neonates and their mothers. Int. J. Contemp. Pediatrics. 2020; 7: 387-92. https://dx.doi.org/10.18203/2349-3291.ijcp20200115
  4. Wimalawansa S.J. Physiology of vitamin D – focusing on disease prevention. Nutrients. 2024; 16(11): 1666. https://dx.doi.org/10.3390/nu16111666
  5. da Silveira E.A., Moura L.A.N.E., Castro M.C.R., Kac G., Hadler M.C.C.M., Noll P.R.E.S. et al. Prevalence of vitamin D and calcium deficiency and insufficiency in women of childbearing age and associated risk factors: a systematic review and meta-analysis. Nutrients. 2022; 14(20): 4351. https://dx.doi.org/10.3390/nu14204351
  6. Chen B., Ji P., Wang Q., Qin W., Li Z. Vitamin D levels and its influencing factors in pregnant women in mainland China: a systematic review and meta-analysis. PLOS One. 2024; 19(5): e0297613. https://dx.doi.org/10.1371/journal.pone.0297613
  7. Wang Z., Ding R., Wang J. The association between vitamin D status and autism spectrum disorder (ASD): a systematic review and meta-analysis. Nutrients. 2020; 13(1): 86. https://dx.doi.org/10.3390/nu13010086
  8. Song S.J., Si S., Liu J., Chen X., Zhou L., Jia G. et al. Vitamin D status in Chinese pregnant women and their newborns in Beijing and their relationships to birth size. Public Health Nutr. 2013; 16(4): 687-92. https://dx.doi.org/10.1017/S1368980012003084
  9. Gur E.B., Gokduman A., Turan G.A., Tatar S., Hepyilmaz I., Zengin E.B. et al. Mid-pregnancy vitamin D levels and postpartum depression. Eur. J. Obstet. Gynecol. Reprod. Biol. 2014; 179: 110-6. http://dx.doi.org/10.1016/j.ejogrb.2014.05.017
  10. Мельниченко Г.А., Намазова-Баранова Л.С., Громова О.А., Драпкина О.М., Каронова Т.Л., Куликова К.С., Крупинова Ю.А., Лесняк О.М., Мазурина Н.В., Панов А.А., Пигарова Е.А., Рожинская Л.Я., Белая Ж.Е., Руяткина Л.А., Суплотова Л.А. Профилактика и лечение дефицита витамина D: выбор оптимального подхода. Вопросы современной педиатрии. 2021; 20(4): 338-45. [Melnichenko G.A., Namazova-Baranova L.S., Gromova O.A., Drapkina O.M., Karonova T.L., Kulikova K.S., Krupinova Yu.A., Lesnyak O.M., Mazurina N.V., Panov A.A., Pigarova E.A., Rozhinskaya L.Ya., Belaya Zh.E., Ruyatkina L.A., Suplotova L.A. Prevention and treatment of vitamin D deficiency: choosing the optimal approach. Current Pediatrics. 2021; 20(4): 338-45 (in Russian)]. https://doi.org/10.15690/vsp.v20i4.2246
  11. Суплотова Л.А., Авдеева В.А., Пигарова Е.А., Рожинская Л.Я., Трошина Е.А. Дефицит витамина D в России: первые результаты регистрового неинтервенционного исследования частоты дефицита и недостаточности витамина D в различных географических регионах страны. Проблемы эндокринологии. 2021; 67(2): 84-92. [Suplotova L.A., Avdeeva V.A., Pigarova E.A., Rozhinskaya L.Y., Troshina E.A. Vitamin D deficiency in Russia: the first results of a registered, non-interventional study of the frequency of vitamin D deficiency and insufficiency in various geographic regions of the country. Problems of Endocrinology. 2021; 67(2): 84-92 (in Russian)]. https://doi.org/10.14341/probl12736
  12. Мармалюк Д.А., Рунова Г.Е., Глинкина И.В., Фадеев В.В. Статус витамина D у жителей Российской Федерации, его возрастные особенности и взаимосвязь с уровнем паратиреоидного гормона. Архивъ внутренней медицины. 2024; 14(4): 276-83. [Marmalyuk D.A., Runova G.E., Glinkina I.V., Fadeyev I.M. Vitamin D status among residents of the Russian Federation and its relation with age and parathyroid hormone. The Russian Archives of Internal Medicine. 2024; 14(4): 276-83 (in Russian)]. https://doi.org/10.20514/2226-6704-2024-14-4-276-283
  13. Платонова Н.М., Рыбакова А.А., Никанкина Л.В., Малышева Н.М., Андреева Е.Н., Покусаева В.Н., Бойко Е.Л., Трошина Е.А. Витамин D и беременность: современное состояние проблемы в центральных регионах РФ. Проблемы эндокринологии. 2020; 66(6): 81-7. [Platonova N.M., Rybakova A.A., Nikankina L.V., Malysheva N.M., Andreeva E.N., Pokusaeva V.N., Boyko E.L., Troshina E.A. Vitamin D and pregnancy: current state of the problem in the central regions of the Russian Federation. Problems of Endocrinology. 2020; 66(6): 81-7 (in Russian)]. https://doi.org/10.14341/probl12693
  14. Артымук Н.В., Тачкова О.А. Дефицит витамина D и репродуктивное здоровье женщины. Акушерство и гинекология. 2021; 3: 189-95. [Artymuk N.V., Tachkova O.A. Vitamin D deficiency and women’s reproductive health.Obstetrics and Gynecology. 2021; (3): 189-95 (in Russian)]. https://dx.doi.org/10.18565/aig.2021.3.189-195
  15. Lima M.S., Pereira M., Castro C.T., Santos D.B. Vitamin D deficiency and anemia in pregnant women: a systematic review and meta-analysis. Nutr. Rev. 2022; 80(3): 428-38. https://dx.doi.org/10.1093/nutrit/nuab114
  16. Hu K.L., Zhang C.X., Chen P., Zhang D., Hunt S. Vitamin D levels in early and middle pregnancy and preeclampsia, a systematic review and meta-analysis. Nutrients. 2022; 14(5): 999. https://dx.doi.org/10.3390/nu14050999
  17. Saccone G., Buonomo G., Guerra S., Gentile D., Di Spiezio Sardo A. Prevalence of hypovitaminosis D in pregnancy and potential benefits of oral supplementation. Am. J. Perinatol. 2025; 42(11): 1421-4. https://dx.doi.org/10.1055/a-2502-7295
  18. Fatima K., Asif M., Nihal K., Hussain H.U., Hasan A.W., Zahid M. et al. Association between vitamin D levels in early pregnancy and gestational diabetes mellitus: a systematic review and meta-analysis. J. Family Med. Prim. Care. 2022; 11(9): 5569-80. https://dx.doi.org/10.4103/jfmpc.jfmpc_107_22
  19. Li W.J., Chen K.H., Huang L.W., Tsai Y.L., Seow K.M. Low maternal serum 25-hydroxyvitamin D concentration is associated with postpartum hemorrhage: a retrospective observational study. Front. Endocrinol. (Lausanne). 202; 13: 816480. https://dx.doi.org/10.3389/fendo.2022.816480
  20. Gerovasili E., Sarantaki A., Bothou A., Deltsidou A., Dimitrakopoulou A., Diamanti A. The role of vitamin D deficiency in placental dysfunction: a systematic review. Metabol. Open. 2025; 25: 100350. https://dx.doi.org/10.1016/j.metop.2025.100350
  21. Chien M.C., Huang C.Y., Wang J.H., Shih C.L., Wu P. Effects of vitamin D in pregnancy on maternal and offspring health-related outcomes: an umbrella review of systematic review and meta-analyses. Nutr. Diabetes. 2024; 14(1): 35. https://dx.doi.org/10.1038/s41387-024-00296-0
  22. Lian R.H., Qi P.A., Yuan T., Yan P.J., Qiu W.W., Wei Y. et al. Systematic review and meta-analysis of vitamin D deficiency in different pregnancy on preterm birth: Deficiency in middle pregnancy might be at risk. Medicine (Baltimore). 2021; 100(24): e26303. https://dx.doi.org/10.1097/MD.0000000000026303
  23. Wong R.S., Tung K.T.S., Mak R.T.W., Leung W.C., Yam J.C., Chua G.T. et al. Vitamin D concentrations during pregnancy and in cord blood: a systematic review and meta-analysis. Nutr. Rev. 2022; 80(12): 2225-36. https://dx.doi.org/10.1093/nutrit/nuac023
  24. Fang K., He Y., Mu M., Liu K. Maternal vitamin D deficiency during pregnancy and low birth weight: a systematic review and meta-analysis. J. Matern. Fetal Neonatal. Med. 2021; 34(7): 1167-73. https://dx.doi.org/10.1080/14767058.2019.1623780
  25. Keshavarz P., Jandaghi P., Shafiee M., Islam N., Vatanparast H. Maternal vitamin D status among different ethnic groups and its potential contribution to adverse pregnancy and child outcomes. In: Vitamin D deficiency. London, UK: IntechOpen; 2020. https://dx.doi.org/10.5772/intechopen.90766
  26. Upadhyaya S., Ståhlberg T., Silwal S., Arrhenius B., Sourander A. Maternal vitamin D levels during pregnancy and offspring psychiatric outcomes: a systematic review. Int. J. Mol. Sci. 2022; 24(1): 63. https://dx.doi.org/10.3390/ijms24010063
  27. You Z., Mei H., Zhang Y., Song D., Zhang Y., Liu C. The effect of vitamin D deficiency during pregnancy on adverse birth outcomes in neonates: a systematic review and meta-analysis. Front. Pediatr. 2024; 12: 1399615. https://dx.doi.org/10.3389/fped.2024.1399615
  28. Tamblyn J.A., Pilarski N.S.P., Markland A.D., Marson E.J., Devall A., Hewison M. et al. Vitamin D and miscarriage: a systematic review and meta-analysis. Fertil. Steril. 2022; 118(1): 111-22. https://dx.doi.org/10.1016/j.fertnstert.2022.04.017
  29. Chen C., Wang S., Zhang C., Wu X., Zhou L., Zou X. et al. Association between serum vitamin D level during pregnancy and recurrent spontaneous abortion: a systematic review and meta-analysis. Am. J. Reprod. Immunol. 2022; 88(3): e13582. https://dx.doi.org/10.1111/aji.13582
  30. Guideline: Vitamin D Supplementation in pregnant women. Geneva: World Health Organization; 2012.
  31. WHO antenatal care recommendations for a positive pregnancy experience: Nutritional interventions update: Vitamin D supplements during pregnancy [Internet]. Geneva: World Health Organization; 2020.
  32. RCOG. Vitamin D in pregnancy (Scientific Impact Paper 43). Available at: https://www.rcog.org.uk/guidance/browse-all-guidance/scientific-impact-papers/vitamin-d-in-pregnancy-scientific-impact-paper-43/
  33. RCOG. Healthy eating and vitamin supplements in pregnancy. Available at: https://www.rcog.org.uk/for-the-public/browse-our-patient-information/healthy-eating-and-vitamin-supplements-in-pregnancy/
  34. Institute of Obstetricians and Gynaecologists. Royal College of Physicians of Ireland. Directorate of Clinical Strategy and Programmes. Health Service Executive. Clinical Practice Guideline Guideline No. 27. Version 2.0. Nutrition during pregnancy. 2019. Available at: https://www.hse.ie/eng/about/who/acute-hospitals-division/woman-infants/clinical-guidelines/national-clinical-guidelines-nutrition-in-pregnancy-guideline.pdf
  35. American Pregnancy Association. Vitamin D and pregnancy. Available at: https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/vitamin-d-and-pregnancy/
  36. ACOG Committee Opinion No. 495: Vitamin D: Screening and supplementation during pregnancy. Obstet. Gynecol. 2011; 118(1): 197-8. https://dx.doi.org/10.1097/AOG.0b013e318227f06b
  37. Health Canada. Vitamin D and calcium: Updated dietary reference intakes. Available at: https://open.canada.ca/data/en/dataset/48eb23d1-954b-43a2-af71-2e361e74c188
  38. Magee L.A., Smith G.N., Bloch C., Côté A.M., Jain V., Nerenberg K. et al. Guideline № 426: hypertensive disorders of pregnancy: diagnosis, prediction, prevention, and management. J. Obstet. Gynaecol. Can. 2022; 44(5): 547-71.e1. https://dx.doi.org/10.1016/j.jogc.2022.03.002
  39. Demay M.B., Pittas A.G., Bikle D.D., Diab D.L., Kiely M.E., Lazaretti-Castro M. et al. Vitamin D for the prevention of disease: an endocrine society clinical practice guideline. J. Clin. Endocrinol. Metab. 2024; 109(8): 1907-47. https://dx.doi.org/10.1210/clinem/dgae290
  40. RACGP National Guide. Preconception care and pregnancy care. Chapter 5. Pregnancy care. Available at: https://www.racgp.org.au/clinical-resources/clinical-guidelines/key-racgp-guidelines/national-guide/preconception-and-pregnancy-care/pregnancy-care
  41. Ministry of Health. Companion statement on vitamin D and sun exposure in pregnancy and infancy in New Zealand: a supplement to the consensus statement on vitamin D and sun exposure in New Zealand. 2024. Available at: https://www.health.govt.nz/publication/companion-statement-vitamin-d-and-sun-exposure-pregnancy-and-infancy-new-zealand
  42. Salle B.L., Delvin E., Glorieux F.; Académie Nationale de Médecine. Vitamine D et grossesse. Available at: https://www.academie-medecine.fr/vitamine-d-et-grossesse/?lang=en
  43. Deutsche Gesellschaft für Ernährung e. V. Vitamin D. Available at: https://www.dge.de/wissenschaft/referenzwerte/vitamin-d/
  44. Referenzwerte für die Nährstoffzufuhr. Vitamin D (Calciferole). Available at: https://www.dge.de/fileadmin/dok/wissenschaft/referenzwerte/Vitamin-D-Aug-2016-2-Aufl-1-korr.Nachdruck-S1-S2.pdf
  45. Chinese Nutrition Society. China food guide. People's Health Press; 2022. Available at: https://www.cnsoc.org/latesachie/0522202020.html
  46. Министерство здравоохранения Российской Федерации. Клинические рекомендации. Нормальная беременность. М.; 2024. 58 с. [Ministry of Health of the Russian Federation. Clinical guidelines. Normal pregnancy. Moscow; 2024. 58 p. (in Russian)].
  47. Российская ассоциация эндокринологов. Клинические рекомендации. Дефицит витамина D. М.; 2021. 56 с. [Russian Association of Endocrinologists. Clinical guidelines. Vitamin D deficiency. Moscow; 2021. 56 p. (in Russian)].
  48. Saraf R., Morton S.M., Camargo C.A. Jr, Grant C.C. Global summary of maternal and newborn vitamin D status – a systematic review. Matern. Child Nutr. 2016; 12(4): 647-68. https://dx.doi.org/10.1111/mcn.12210
  49. Hynes C., Jesurasa A., Evans P., Mitchell C. Vitamin D supplementation for women before and during pregnancy: an update of the guidelines, evidence, and role of GPs and practice nurses. Br. J. Gen. Pract. 2017; 67(662): 423-4. https://dx.doi.org/10.3399/bjgp17X692489
  50. Wang H., Zhang F., Li B., Fu M., Shan X., Ma Y. Three-stage pattern of rapid increase, plateau, and subsequent decline in vitamin D concentration during pregnancy among Chinese women: a large-scale survey. Front. Nutr. 2023; 10: 1238389. https://dx.doi.org/10.3389/fnut.2023.1238389
  51. Hollis B.W., Wagner C.L., Howard C.R., Ebeling M., Shary J.R., Smith P.G. et al. Maternal versus infant vitamin D supplementation during lactation: a randomized controlled trial. Pediatrics. 2015; 136(4): 625-34. https://dx.doi.org/10.1542/peds.2015-1669
  52. Tuovinen S., Räikkönen K., Holmlund-Suila E., Hauta-alus H., Helve O., Rosendahl J. et al. Effect of high-dose vs standard-dose vitamin D supplementation on neurodevelopment of healthy term infants: a randomized clinical trial. JAMA Netw. Open. 2021; 4(9): e2124493. https://dx.doi.org/10.1001/jamanetworkopen.2021.24493
  53. Sass L., Vinding R.K., Stokholm J., Bjarnadóttir E., Noergaard S., Thorsen J. et al. High-dose vitamin D supplementation in pregnancy and neurodevelopment in childhood: a prespecified secondary analysis of a randomized clinical trial. JAMA Netw. Open. 2020; 3(12): e2026018. https://dx.doi.org/10.1001/jamanetworkopen.2020.26018
  54. Yang W.C., Chitale R., O'Callaghan K.M., Sudfeld C.R., Smith E.R. The effects of vitamin D supplementation during pregnancy on maternal, neonatal, and infant health: a systematic review and meta-analysis. Nutr. Rev. 2025; 83(3): e892-e903. https://dx.doi.org/10.1093/nutrit/nuae065
  55. Moghib K., Ghanm T.I., Abunamoos A., Rajabi M., Moawad S.M., Mohsen A. et al. Efficacy of vitamin D supplementation on the incidence of preeclampsia: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2024; 24(1): 852. https://dx.doi.org/10.1186/s12884-024-07081-y
  56. Kokkinari A., Antoniou E., Orovou E., Andronikidi P.E., Tzitiridou-Chatzopoulou M., Sarantaki A. et al. The role of vitamin D supplementation in preventing pre-eclampsia: a review of randomized controlled trials with meta-analysis. Healthcare (Basel). 2025; 13(11): 1221. https://dx.doi.org/10.3390/healthcare13111221
  57. Vestergaard A.L., Andersen M.K., Andersen H.H., Bossow K.A., Bor P., Larsen A. Effects of high-dose vitamin D supplementation on placental vitamin D metabolism and neonatal vitamin D status. Nutrients. 2024; 16(13): 2145. https://dx.doi.org/10.3390/nu16132145
  58. Shah V.P., Nayfeh T., Alsawaf Y., Saadi S., Farah M., Zhu Y. et al. A systematic review supporting the endocrine society clinical practice guidelines on vitamin D. J. Clin. Endocrinol. Metab. 2024; 109(8): 1961-74. https://dx.doi.org/10.1210/clinem/dgae312
  59. Grant W.B., Wimalawansa S.J., Pludowski P., Cheng R.Z. Vitamin D: evidence-based health benefits and recommendations for population guidelines. Nutrients. 2025; 17(2): 277. https://dx.doi.org/10.3390/nu17020277
  60. Solnier J., Chang C., Zhang Y., Kuo Y.C., Du M., Roh Y.S. et al. A comparison and safety evaluation of micellar versus standard vitamin D3 oral supplementation in a randomized, double-blind human pilot study. Nutrients. 2024; 16(11): 1573. https://dx.doi.org/10.3390/nu16111573
  61. Marwaha R.K., Verma M., Walekar A., Sonawane R., Trivedi C. An open-label, randomized, crossover study to evaluate the bioavailability of nanoemulsion versus conventional fat-soluble formulation of cholecalciferol in healthy participants. J. Orthop. 2022; 35: 64-8. https://dx.doi.org/10.1016/j.jor.2022.10.017
  62. Громова О.А., Торшин И.Ю., Пронин А.В. Особенности фармакологии водорастворимой формы витамина D на основе мицелл. Фарматека. 2015; 1(294): 28-35. [Gromova A., Torshin I.Yu., Pronin A.V. Features of the pharmacology of a water-soluble form of vitamin D based on micelles. Pharmateca. 2015; 1(294): 28-35 (in Russian)].
  63. Федеральный закон от 07.06.2025 № 150-ФЗ «О внесении изменений в отдельные законодательные акты Российской Федерации». Доступно по: http://www.kremlin.ru/acts/bank/51994 [Federal Law № 150-FZ of June 7, 2025 «On Amendments to Certain Legislative Acts of the Russian Federation». Available at: http://www.kremlin.ru/acts/bank/51994 (in Russian)].

Received 13.08.2025

Accepted 21.08.2025

About the Authors

Natalya V. Artymuk, Dr. Med. Sci., Professor, Head of the G.A. Ushakova Department of Obstetrics and Gynecology, Kemerovo State Medical University, Ministry of Health of Russia, 22a, Voroshilov str., Kemerovo, 650056, Russia, +7(3842)73-48-56, +7(960)923-33-55, artymuk@gmail.com, https://orcid.org/0000-0001-7014-6492
Olga A. Tachkova, PhD., Associate Professor, Department of Hospital Therapy and Clinical Pharmacology, Kemerovo State Medical University, Ministry of Health of Russia, 22a, Voroshilov str., Kemerovo, 650056, Russia, ol.an.t@yandex.ru, https://orcid.org/0000-0002-6537-3460
Corresponding author: Natalya V. Artymuk, artymuk@gmail.com

Similar Articles

By continuing to use our site, you consent to the processing of cookies that ensure the proper functioning of the site.