Prenatal vitamin D3 supplementation: pharmacology and offspring health outcomes

Abstract

This thesis investigates how pregnancy alters vitamin D metabolism and how prenatal vitamin D exposure relates to maternal and child health. Pregnancy increases vitamin D requirements, affects conversion to active 1,25(OH)₂D, and changes the distribution of vitamin D metabolites across blood, placenta, kidneys, and fetal tissues. Using mouse data and clinical data from VDAART and COPSAC, higher maternal 25(OH)D exposure during pregnancy was associated with a lower risk of childhood asthma or wheeze and improved lung function. The findings support more personalised supplementation strategies that account for gestational age, maternal body weight, baseline 25(OH)D, and timing of supplementation initiation. The thesis also shows that perinatal factors such as preeclampsia, preterm birth, child growth, microbiome development, and maternal inflammation may have lasting effects on child health.