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Gesundheitswesen 2014; 76(05): 325-330
DOI: 10.1055/s-0033-1347223
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Medikamentöse Krankheitsprävention mit Vitamin D – Epidemiologische Evidenz am Beispiel von Komplika­tionen im Verlauf der Schwangerschaft und bei der Geburt

Pharmacological Prevention Disease with Vitamin D – Epidemiological Evidence using the Example of Complications during Pregnancy and Birth
W. Kirschner
1   Forschung, Beratung+Evaluation, Berlin c/o Charité Frauenklinik CVK
,
J. W. Dudenhausen
2   Professor of Obstetrics and Gynecology, Weill Cornell Medical College Medical Advisor and Head of Medical Staff Services; Professor Emeritus – Charité University Medicine Berlin, Editor in Chief – Journal of Perinatal Medicine
› Author Affiliations
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Publication History

Publication Date:
18 June 2013 (online)

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Zusammenfassung

Nationale und internationale epidemiologische Studien zeigen, dass v. a. im Winter große Teile der Bevölkerung einen Vitamin D Mangel aufweisen und die nutritive Vitamin D Aufnahme generell zu gering ist. Dies gilt auch für Schwangere. Im Januar 2012 hat die Deutsche Gesellschaft für Ernährung die Zufuhrempfehlungen bei Vitamin D um das Vierfache erhöht. Eine ausreichende Vitamin D Versorgung soll nicht nur auf zahlreiche chronische Krankheiten protektiv wirken, sondern z. B. auch Frühgeburten verringern. Der Beitrag untersucht die Evidenz zu Zusammenhängen zwischen einem Vitamin D Mangel und Komplikationen in der Schwangerschaft bzw. bei der Geburt. Bei der derzeitigen epidemiologischen Datenlage kann von einem gesicherten Risiko eines Vitamin D Mangels für Komplika­tionen in der Schwangerschaft und bei der Geburt nicht gesprochen werden. Umso schwieriger sind rationale Antworten auf die Frage zu finden, ob und in welcher Dosis supplementiert werden und ob eine Vitamin D Serumdiagnostik erfolgen soll. Eine Beobachtungsstudie an 2 oder 3 größeren Geburtskliniken könnte die zentrale Frage recht zeitnah klären.

Abstract

National and international epidemiological studies have shown that relevant segments of populations are – especially in the winter period – vitamin D deficient and for the entire year vitamin D intake is far too low. This also applies to pregnant women. In January 2012 the German Nutrition Society has increased the intake recommendations for vitamin D by a factor of 4. It is suggested that a sufficient supply with vitamin D has high preventive potentials with respect to several chronic diseases and will potentially reduce the incidence of preterm birth. This paper considers the evidence of associations between vitamin D deficiency and adverse pregnancy outcomes. Based on the current epidemiological knowledge which is, however, sparse there is very low evidence that vitamin D deficiency is a relevant risk factor for adverse pregnancy outcomes. This makes it even more difficult to give rationale answers to emerging questions with respect to supplementation, dosage and vitamin D diagnostic measures. An observational study with 2 or 3 large obstetric clinics should be undertaken to clarify the central question without delay.

Schlüsselwörter

Vitamin D Mangel - Schwangerschaft - Gesundheitsrisiken - Diagnostik - Ernährung - Supplementierung

Key words

vitamin D deficiency - pregnancy - health risks - diagnostic measures - nutrition - supplementation
 

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