Vitamin D supplementation in pregnant women with diabetes in Far North Queensland

The need for routine antenatal vitamin D screening across Australia continues to be debated. In rural, tropical Far North Queensland (FNQ), while adequate concentrations have been reported in the general antenatal population, among pregnant women with diabetes (29%) there were found to be ‘insufficient’ or ‘deficient’ vitamin D levels and pregnant Indigenous women recorded slightly lower mean levels than non-Indigenous women.1 Maternal vitamin D status determines neonatal status; there is also growing evidence of an association between low maternal vitamin D in pregnancy and poor glycaemic control, although clinical significance remains uncertain.2 Some studies demonstrate an association with increased rates of pre-eclampsia and other pregnancy complications, while others have found no such association.2, 3 There is also evidence of associations between low neonatal vitamin D and extraskeletal adverse outcomes in childhood, including bronchiolitis, atopy and type 1 diabetes, in addition to the known skeletal complications, such as rickets.3, 4