Prenatal Vitamin D Deficiency - Wagner video June 2025

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Vitamin D Deficiency: The Indicator of Suboptimal Prenatal Health - video by Dr. Carol Wagner

YouTube 72 minutes

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GLASP AI summary

• (00:07–02:15)
  Dr. Carol Wagner is a professor of pediatrics and neonatology who has conducted multiple NIH-supported randomized controlled trials on vitamin D supplementation in pregnancy, including with Dr. Bruce Hollis.
• (03:02)
  Vitamin D deficiency is framed as a "canary in the coal mine"—a warning sign of suboptimal health in pregnant women.
    It affects maternal and fetal health profoundly, especially during the first 1,000 days (from preconception to age 2).
• (05:18–07:52)
  The U.S. has the highest maternal mortality rate among high-income countries.
    Black women experience three times the rate of maternal death compared to white women, reflecting severe health inequities.
• (11:35–14:14)
  Vitamin D undergoes complex placental and immune-modulatory transformations during pregnancy.
    It influences immune tolerance and fetal development via active hormone (calcitriol) and gene expression effects.
• (18:25–21:16)
  Over 50% of pregnant women are deficient (<20 ng/mL) in vitamin D;
  the rate is >75% among Black American women.
    Optimal levels are ≥40 ng/mL (100 nmol/L), which supports proper 25D to 1,25D conversion.
• (27:46–30:20)
  Deficiency is associated with:
  • Higher risk of preeclampsia
  • Preterm birth
  • Gingivitis
  • Impaired fetal growth and enamel development
  • Increased risk of RSV and neurodevelopmental issues
• (30:20–35:18)
  Supplementation of 4,000 IU/day (vs. 400 IU in prenatal vitamins) is safe and effective.
  Factors influencing deficiency:
  • BMI ≥30 (2× risk)
  • Black race (20× risk vs. white)
  • Hispanic ethnicity (2.4× risk)
• (45:51–50:46)
  Higher doses (2,000–4,400 IU/day) reduced maternal comorbidities and improved infant vitamin D status.
  ~hs` Preterm birth rates were significantly lower in women who achieved ≥40 ng/mL 25D.
• (52:34–57:22)
  Placental and immune biomarkers (e.g. IGF, VEGF, cytokines, vaginal microbiome) were favorably modulated by sufficient vitamin D levels. This suggests wide-reaching developmental and immune effects.
• (1:00:05–1:02:23)
  New studies (2025) confirm inverse relationship between 25D levels and risk of preterm birth. Women delivering before 37 weeks had significantly lower vitamin D levels.
• (1:06:17–1:08:30)
  Lifestyle factors like diet, stress, environment, physical activity, and sleep also influence pregnancy outcomes.
  A holistic approach including optimal vitamin D and healthy habits is advocated.

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YouTube entry points

(00:00

• 01:14 - Introduction & Dr. Wagner's Background Meet Dr. Carol Wagner and her pioneering work on vitamin D in pregnancy. 01:15
• 03:39 - Why Maternal Health Matters An overview of the maternal health crisis in the U.S. and globally. 03:40
• 04:59 - The First 1,000 Days of Life Why preconception to age 2 is critical for long-term health. 05:00
• 07:29 - Disparities in Maternal Outcomes Black maternal mortality and vitamin D deficiency risks. 07:30
• 09:59 - The Six Pillars of Health Modifiable lifestyle factors including stress, sleep, diet, and physical activity. 10:00
• 12:44 - What Is Vitamin D and How Do We Get It? Sunlight, skin pigmentation, and the vitamin D synthesis process. 12:45
• 13:49 - Beyond Bones: Vitamin D’s Immune Role How vitamin D supports immunity, especially during pregnancy. 13:50
• 15:09 - Vitamin D Transfer to the Fetus How vitamin D crosses the placenta and impacts fetal development. 15:10
• 16:54 - Deficiency and Pregnancy Risks Links between vitamin D deficiency and complications like preeclampsia, preterm birth, and more. 16:55
• 18:59 - A Potent Genetic Enabler Vitamin D’s influence on immune regulation and gene expression. 19:00
• 20:59 - Prevalence of Deficiency Global and U.S. statistics on vitamin D levels in pregnant women. 21:00
• 23:29 - Major Physiological Changes During Pregnancy How vitamin D metabolism shifts to meet pregnancy demands. 23:30
• 24:59 - Why Testing Matters The case for monitoring 25(OH)D levels in maternal care. 25:00
• 29:59 - RCT Findings: 400 vs. 4,000 IUs Results from key randomized controlled trials on supplementation. 30:00
• 33:59 - Dose-Response Effects Higher doses result in better maternal and neonatal vitamin D status. 34:00
• 35:59 - BMI, Skin Color, and Vitamin D Needs Why individualized dosing matters, especially for Black and Hispanic women. 36:00
• 38:59 - Hormonal Regulation During Pregnancy Vitamin D metabolism becomes independent of parathyroid hormone. 39:00
• 40:59 - The 40 ng/mL Threshold Why 40 ng/mL is the minimum level needed for optimal conversion. 41:00
• 43:59 - Is 4,000 IU Safe? Safety data from multiple clinical trials. 44:00
• 46:59 - Pregnancy Outcomes Improved by Supplementation Lower risks of preeclampsia, infection, and preterm birth. 44:00
• 50:59 - Vitamin D and Immune Gene Expression Findings from cytokine and placental gene studies. 51:00
• 54:59 - The Vaginal Microbiome and Vitamin D How vitamin D status influences microbial health. 55:00
• 56:59 - Summary of the Kellogg and Thrasher Studies Results from major vitamin D trials in pregnancy. 57:00
• 1:03:59 - Retrospective Study on Gestational Age Lower vitamin D = higher risk of early delivery. 1:04:00
• 1:06:00 - Final Takeaways on Risk and Prevention Vitamin D is essential, but not the only factor—lifestyle matters. 1:06:01
• 1:12:13 - Embracing a Holistic Approach

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Related studies, a table, and a chart in VitaminDWiki

• Prenatal VITAMIN D is more important than other prenatal vitamins
• Prenatal vitamins – including vitamin D – reduced autism by 7X in some cases – May 2011
• ALL of the top 10 health problems of women are associated with low vitamin D
• Overview Pregnancy and vitamin D has
  Healthy pregnancies need lots of vitamin D
  Most were taking 2,000 to 7,000 IU daily for >50% of pregnancy

   Click on hyperlinks for details

Problem	Vit. D Reduces	Evidence
0. Chance of not conceiving	3.4 times	Observe
1. Miscarriage	2.5 times	Observe
2. Pre-eclampsia	3.6 times	RCT
3. Gestational Diabetes	3 times	RCT
4. Good 2nd trimester sleep quality	3.5 times	Observe
5. Premature birth	2 times	RCT
6. C-section - unplanned	1.6 times	Observe
Stillbirth - OMEGA-3	4 times	RCT - Omega-3
7. Depression AFTER pregnancy	1.4 times	RCT
8. Small for Gestational Age	1.6 times	meta-analysis
9. Infant height, weight, head size      within normal limits		RCT
10. Childhood Wheezing	1.3 times	RCT
11. Additional child is Autistic	4 times	Intervention
12.Young adult Multiple Sclerosis	1.9 times	Observe
13. Preeclampsia in young adult	3.5 times	RCT
14. Good motor skills @ age 3	1.4 times	Observe
15. Childhood Mite allergy	5 times	RCT
16. Childhood Respiratory Tract visits	2.5 times	RCT

RCT = Randomized Controlled Trial

+Ensure a healthy pregnancy and baby - take Vitamin D BEFORE conception

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Additional benefits of higher levels of Vitamin D BEFORE conception

• Best fertility if high level of vitamin D 3 months before ejaculation - May 2025
• Birth rates doubled with Vitamin D - 300,000 IU for infertile men – RCT Nov 2017
• Vitamin D is needed for human fertility – goal is 50 ng – Sept 2018
• In-vitro Fertilization costs at least 10,000 dollars, Vitamin D costs 5 dollars
• Live birth 1.7 X more likely after IVF if good level of vitamin D – meta-analysis Aug 2020
• Conception was 3.7X more likely if the male had a good level of Vitamin D – July 2022
• Vitamin D improves Infertility in 9 ways (50 references, PDF behind paywall) – May 2023
• Pregnancy loss 9X more likely if male had less than 20 ng of Vitamin D – July 2021
• Preconception checkups being considered in Japan – recommends vitamin D above 30 ng (only 2% are above) – April 2024
• Ensure a healthy pregnancy and baby - take Vitamin D before conception

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Take prenatal Vitamins 1-3 months before conception, thru pregnancy, and then 6 months after birth

 Perplexity AI PDF
Note: Need 15X more vitamin D than in most prenatals (6,000 IU)