Keywords: Pregnancy, Vitamin D, Health Education

Background:

Vitamin D has effects on bone health, immune, musculoskeletal, and neurological systems.Maternal vitamin D status is critical for both maternal and fetal health. Deficiency has been associated with preeclampsia, preterm birth, and low birth weight. In Turkey, a national supplementation program recommends 1200 IU of vitamin D daily from12th gestational week until 6 months postpartum.

Research questions:

Rather than relying solely on vitamin D supplementation during pregnancy, could it be more effective to inform women of reproductive age about nutrition, sun exposure, and the use of sun barriers—considering that not all pregnancies are planned?

Method:

This is a cross-sectional,descriptive, preliminary analysis of an ongoing kohort study including 199 pregnant women at a university outpatient clinic in Ankara. A simple random sample of 40 participants was selected for this preliminary analysis. Serum 25(OH)D levels were measured in the first trimester before any supplementation. The second measurement is planned for the third trimester. A structured questionnaire collected data on sociodemographic characteristics, skin type, sun exposure, sunscreen use, multivitamin intake, and dietary habits (milk and fish consumption). Descriptive statistics were used.

Results:

Participants' ages ranged from 21–40 years (mean = 28.7, SD = 4.7). In the first trimester, 65% had serum 25(OH)D levels between 5–9.9 ng/ml, and 95% were below 20 ng/ml. About 45% reported less than 20 minutes of daily sun exposure. Most consumed ≤2 cups of dairy daily; 30% consumed fish less than once per month. Only 27.5% used multivitamin supplements.

Conclusions:

Most participants begin pregnancy with inadequate vitamin D levels. This raises the need to shift from a reactive model toward proactive strategies, including preconceptional education on sun exposure, diet, and sunscreen use. Since prenatal care in Turkey is delivered within primary care, such preventive efforts could be integrated effectively.
This project is supported by Ankara University Scientific Research Projects Coordination Unit (BAP).

Points for discussion:

Should vitamin D education start even before pregnancy is planned?

How can family physicians better address lifestyle factors affecting vitamin D status?

What is the role of dietitians in routine prenatal care for vitamin D optimization?