Obstetrics and GynecologyObstetrics and GynecologyАкушерство и гинекология0300-90922412-5679Bionika Media69598410.18565/aig.2025.124ReviewsОбзорыReview ArticleThe role of vitamin D in the prevention of pregnancy complicationsРоль витамина D в профилактике осложнений беременностиhttps://orcid.org/0000-0001-9053-9453LatfullinaRaina R.ЛатфуллинаРаина Радиковна
Russian Federation

PhD student, Department of Obstetrics and Gynecology, N.V. Sklifosovsky Institute of Clinical Medicine

аспирант кафедры акушерства и гинекологии Института клинической медицины им. Н.В. Склифосовского

latfullina1997@mail.ruSheshukovaNatalya A.ШешуковаНаталия Алексеевна
Russian Federation

Dr. Med. Sci., Professor at the Department of Obstetrics and Gynecology, N.V. Sklifosovsky Institute of Clinical Medicine

д.м.н., профессор кафедры акушерства и гинекологии Института клинической медицины им. Н.В. Склифосовского

shshukova_n_a@staff.sechenov.ruhttps://orcid.org/0000-0001-6104-9842GromovaTatiana A.ГромоваТатьяна Александровна
Russian Federation

PhD, Teaching Assistant at the Department of Obstetrics and Gynecology, N.V. Sklifosovsky Institute of Clinical Medicine

к.м.н., ассистент кафедры акушерства и гинекологии Института клинической медицины им. Н.В. Склифосовского

tgromova928@yandex.ruhttps://orcid.org/0009-0004-8536-650XPrudnikAleksandra V.ПрудникАлександра Вячеславовна
Russian Federation

student, N.V. Sklifosovsky Institute of Clinical Medicine

студентка Института клинической медицины им. Н.В.Склифосовского

prudnik-2014@mail.ruhttps://orcid.org/0009-0004-5595-8619YastrebAnna V.ЯстребАнна Валерьевна
Russian Federation

student, N.V. Sklifosovsky Institute of Clinical Medicine

студентка Института клинической медицины им. Н.В.Склифосовского

Yastrebanna1999@gmail.comhttps://orcid.org/0000-0002-4591-838XLevakovSergey A.ЛеваковСергей Александрович
Russian Federation

Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology, N.V. Sklifosovsky Institute of Clinical Medicine

д.м.н. профессор, заведующий кафедрой акушерства и гинекологии Института клинической медицины им. Н.В. Склифосовского

levakoff@yandex.ruI.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)ФГАОУ ВО «Первый Московский государственный медицинский университет имени И.М. Сеченова» Минздрава России (Сеченовский Университет)30112025105110911202509112025Copyright ©; 2025, Bionika MediaCopyright ©; 2025, ООО «Бионика Медиа»2025Bionika MediaООО «Бионика Медиа»https://journals.eco-vector.com/0300-9092/article/view/695984

Vitamin D deficiency is a serious problem affecting a significant part of the female population of reproductive age. Vitamin D acting through vitamin D receptors in the organs of the hypothalamic-ovarian-uteroplacental axis participates in the regulation of implantation, placentation, and organogenesis processes. The analysis of recent research data presented in the PubMed, Embase, eLibrary, and RSCI databases indicates a close relationship between vitamin D deficiency and an increased risk of gestational diabetes, preeclampsia, spontaneous miscarriages, preterm birth, and operative delivery. Optimization of the vitamin D level helps to normalize metabolic and immune processes, improve fertility and reduce the frequency of obstetric complications. A significant preventive effect is achieved by ensuring an adequate level of vitamin D at the preconception stage and in early pregnancy. Despite the proven efficacy and safety of vitamin D supplementation, there are still questions about the optimal dosage, the duration of treatment, and the need for regular screening. It is necessary to clarify the algorithms for the correction and prevention of vitamin D deficiency in women of reproductive age.

Conclusion: Vitamin D is an essential nutrient for the normal course of pregnancy and fetal development. Maintaining its adequate level should be considered as one of the key components of preconception care and management of pregnancy, aimed at reducing the risk of obstetric and perinatal complications.

Дефицит витамина D (ВД) представляет актуальную проблему, затрагивающую значительную часть женского населения репродуктивного возраста. ВД, действуя через рецепторы VDR в органах гипоталамо-яичниково-маточно-плацентарной оси, участвует в регуляции процессов имплантации, плацентации и органогенеза. Анализ данных современных исследований, представленных в базах PubMed, Embase, eLibrary и РИНЦ, свидетельствует о тесной связи между дефицитом ВД и повышенным риском гестационного диабета, преэклампсии, самопроизвольных выкидышей, преждевременных родов и оперативного родоразрешения. Оптимизация уровня ВД способствует нормализации метаболических и иммунных процессов, улучшению фертильности и снижению частоты акушерских осложнений. Значимый профилактический эффект достигается при обеспечении адекватного уровня ВД на этапе прегравидарной подготовки и в ранние сроки беременности. Несмотря на доказанную эффективность и безопасность применения ВД, остаются нерешенными вопросы о его оптимальной дозировке, длительности приема и целесообразности рутинного скрининга. Необходимо уточнение алгоритмов коррекции и профилактики гиповитаминоза D у женщин репродуктивного возраста.

Заключение: ВД является важным фактором, обеспечивающим нормальное течение беременности и развитие плода. Поддержание его адекватного уровня следует рассматривать, как один из ключевых компонентов прегравидарной подготовки и ведения беременности, направленный на снижение риска акушерских и перинатальных осложнений.

pregnancymiscarriagesgestational diabetesvitamin D deficiencycesarean sectionpregnancy complicationspreeclampsiapreterm birthбеременностьвыкидышигестационный диабетдефицит витамина Dкесарево сечениеосложнения беременностипреэклампсияпреждевременные родыMansur J.L., Oliveri B., Giacoia E., Fusaro D., Costanzo P.R. Vitamin D: before, during and after pregnancy: effect on neonates and children. Nutrients. 2022; 14(9): 1900. https://dx.doi.org/10.3390/nu14091900Guo J., Liu S., Wang P., Ren H., Li Y. Characterization of VDR and CYP27B1 expression in the endometrium during the menstrual cycle before embryo transfer: implications for endometrial receptivity. Reprod. Biol. Endocrinol. 2020; 18(1): 24. https://dx.doi.org/10.1186/s12958-020-00579-yArshad R., Sameen A., Murtaza M.A., Sharif H.R., Iahtisham-Ul-Haq, Dawood S. et al. Impact of vitamin D on maternal and fetal health: A review. Food Sci. Nutr. 2022; 10: 3230-40. https://dx.doi.org/10.1002/fsn3.2948Vestergaard A.L., Christensen M., Andreasen M.F., Larsen A., Bor P. Vitamin D in pregnancy (GRAVITD) - a randomised controlled trial identifying associations and mechanisms linking maternal vitamin D deficiency to placental dysfunction and adverse pregnancy outcomes - study protocol. BMC Pregnancy Childbirth. 2023; 23(1): 177. https://dx.doi.org/10.1186/s12884-023-05484-xGanguly A., Tamblyn J.A., Finn-Sell S., Chan S.Y., Westwood M., Gupta J. et al. Vitamin D, the placenta and early pregnancy: effects on trophoblast function. J. Endocrinol. 2018; 236(2): R93-R103. https://dx.doi.org/10.1530/JOE-17-0491Российская ассоциация эндокринологов. Клинические рекомендации. Дефицит витамина D. М.; 2021. 56 с. [Russian Association of Endocrinologists. Clinical guidelines. Vitamin D deficiency. Moscow; 2021. 56 p. (in Russian)].Heyden E.L., Wimalawansa S.J. Vitamin D: effects on human reproduction, pregnancy, and fetal well-being. J. Steroid Biochem. Mol. Biol. 2018; 180: 41-50. https://dx.doi.org/10.1016/j.jsbmb.2017.12.011Holick M.F., Binkley N.C., Bischoff-Ferrari H.A., Gordon C.M., Hanley D.A., Heaney R.P. et al. Evaluation, treatment, and prevention of vitamin D deficiency: an endocrine society clinical practice guideline. J. Clin. Endocrinol. Metab. 2011; 96(7): 1911-30. https://dx.doi.org/10.1210/jc.2011-0385McCartney C.R., McDonnell M.E., Corrigan M.D., Lash R.W. Vitamin D insufficiency and epistemic humility: an Endocrine Society guideline communication. J. Clin. Endocrinol. Metab. 2024; 109(8): 1948-54. https://dx.doi.org/10.1210/clinem/dgae322Министерство здравоохранения Российской Федерации. Клинические рекомендации. Нормальная беременность. М.; 2023. 58 с. [Ministry of Health of the Russian Federation. Clinical guidelines. Normal pregnancy. Moscow; 2023. 58 p. (in Russian)].Tamblyn J.A., Pilarski N.S.P., Markland A.D., Marson E.J., Devall A., Hewison M. et al. Vitamin D and miscarriage: a systematic review and metaanalysis. Fertil. Steril. 2022; 118(1): 111-22. https://dx.doi.org/10.1016/j.fertnstert.2022.04.017Hannan K., Sherer M.L., Osborne L.M. Vitamin D levels and anxiety symptomatology in pregnancy and the postpartum. Arch. Womens Ment. Health. 2023; 26(6): 857-61. https://dx.doi.org/10.1007/s00737-023-01358-5Lian R.H., Qi P.A., Yuan T., Yan P.J., Qiu W.W., Wei Y. et al. Systematic review and meta-analysis of vitamin D deficiency in different pregnancy on preterm birth: deficiency in middle pregnancy might be at risk. Medicine (Baltimore). 2021; 100(24): e26303. https://dx.doi.org/10.1097/MD.0000000000026303Kiely M.E., Wagner C.L., Roth D.E. Vitamin D in pregnancy: where we are and where we should go. J. Steroid Biochem. Mol. Biol. 2020; 201: 105669. https://dx.doi.org/10.1016/j.jsbmb.2020.105669Zahran A.M., Zharan K.M., Hetta H.F. Significant correlation between regulatory T cells and vitamin D status in term and preterm labor. J. Reprod. Immunol. 2018; 129: 15-22. https://dx.doi.org/10.1016/j.jri.2018.07.004Mohd Ghozali N., Giribabu N., Salleh N. Mechanisms linking vitamin D deficiency to impaired metabolism: an overview. Int. J. Endocrinol. 2022; 2022: 6453882. https://dx.doi.org/10.1155/2022/6453882Contreras-Bolívar V., García-Fontana B., García-Fontana C., Muñoz-Torres M. Mechanisms involved in the relationship between vitamin D and insulin resistance: impact on clinical practice. Nutrients. 2021; 13(10): 3491. https://dx.doi.org/10.3390/nu13103491Das B.P., Das S.K., Bhuyan A.K., Nandakumar A. Relationship between vitamin D level and gestational diabetes mellitus: A cross-sectional study. J. Obstet. Gynaecol. India. 2023; 73(Suppl 1): 83-7. https://dx.doi.org/10.1007/s13224-023-01832-1Zhang Q., Cheng Y., He M., Li T., Ma Z., Cheng H. Effect of various doses of vitamin D supplementation on pregnant women with gestational diabetes mellitus: A randomized controlled trial. Exp. Ther. Med. 2016; 12(3): 1889-95. https://dx.doi.org/10.3892/etm.2016.3515Mirzaei-Azandaryani Z., Mohammad-Alizadeh-Charandabi S., Shaseb E., Abbasalizadeh S., Mirghafourvand M. Effects of vitamin D on insulin resistance and fasting blood glucose in pregnant women with insufficient or deficient vitamin D: a randomized, placebo-controlled trial. BMC Endocr. Disord. 2022; 22: 254. https://dx.doi.org/10.1186/s12902-022-01159-4Akbari M., Moosazaheh M., Lankarani K.B., Tabrizi R., Samimi M., Karamali M. et al. The effects of vitamin D supplementation on glucose metabolism and lipid profiles in patients with gestational diabetes: A systematic review and meta-analysis of randomized controlled trials. Horm. Metab. Res. 2017; 49(9): 647-53. https://dx.doi.org/10.1055/s-0043-115225Мальцева Л.И., Васильева Э.Н., Денисова Т.Г., Кравцова О.А. Полиморфизм генов, регулирующих витамин D-гормональную систему, и оптимизация дозы витамина D у женщин с преэклампсией и высоким риском ее развития. Акушерство и гинекология. 2019; 9: 67-74. [Maltseva L.I., Vasilyeva E.N., Denisova T.G., Kravtsova O.A. Polymorphism of genes regulating the vitamin D hormonal system, and optimization of vitamin D intake in women with preeclampsia and a high risk for its development. Obstetrics and Gynecology. 2019; (9): 67-74 (in Russian)]. https://dx.doi.org/10.18565/aig.2019.9.67-74Zhang H., Wang S., Tuo L., Zhai Q., Cui J., Chen D., Xu D. Relationship between maternal vitamin D levels and adverse outcomes. Nutrients. 2022; 14(20): 4230. https://dx.doi.org/10.3390/nu14204230Woo J., Giurgescu C., Wagner C.L. Evidence of an association between vitamin D deficiency and preterm birth and preeclampsia: a critical review. J. Midwifery Womens Health. 2019; 64(5): 613-29. https://dx.doi.org/10.1111/jmwh.13014Xiaomang J., Yanling W. Effect of vitamin D3 supplementation during pregnancy on high risk factors - a randomized controlled trial. J. Perinat. Med. 2020; 49(4): 480-4. https://dx.doi.org/10.1515/jpm-2020-0318Kim S., Lim H.J., Kim J.R., Oh K.J., Hong J.S., Suh J.W. Longitudinal change in arterial stiffness after delivery in women with preeclampsia and normotension: a prospective cohort study. BMC Pregnancy Childbirth. 2020; 20: 685. https://dx.doi.org/10.1186/s12884-020-03374-0Министерство здравоохранения Российской Федерации. Клинические рекомендации. Привычный выкидыш. М.; 2022. 27 с. [Ministry of Health of the Russian Federation. Clinical guidelines. A habitual miscarriage. Moscow; 2022. 27 p. (in Russian)].Беспалова О.Н., Баклейчева М.О., Ковалева И.В., Толибова Г.Х., Траль Т.Г., Коган И.Ю. Экспрессия витамина D и его рецепторов в ворсинчатом хорионе.при неразвивающейся беременности. Акушерство и гинекология. 2019; 11: 89-96. [Bespalova O.N., Bakleicheva M.O., Kovaleva I.V., Tolibova G.Kh., Tral T.G., Kogan I.Yu. Expression of vitamin D and its receptors in the villous chorion in missed miscarriage. Obstetrics and Gynecology. 2019; (11): 89-96 (in Russian)]. https://dx.doi.org/10.18565/aig.2019.11.89-96Moradkhani A., Azami M., Assadi S., Ghaderi M., Azarnezhad A., Moradi Y. Association of vitamin D receptor genetic polymorphisms with the risk of infertility: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2024; 24(1): 398. https://dx.doi.org/10.1186/s12884-024-06590-0Chen Y., Zhi X. Roles of vitamin D in reproductive systems and assisted reproductive technology. Endocrinology. 2020; 161(4): bqaa023. https://dx.doi.org/10.1210/endocr/bqaa023Vivanti A.J., Monier I., Salakos E., Elie C., Tsatsaris V., Senat M.V. et al. Vitamin D and pregnancy outcomes: Overall results of the FEPED study. J. Gynecol. Obstet. Hum. Reprod. 2020; 49(8): 101883. https://dx.doi.org/10.1016/j.jogoh.2020.101883Subramanian A., Steiner A.Z., Weinberg C.R., Doss G.L., Jukic A.M.Z. Preconception vitamin D and miscarriage in a prospective cohort study. Hum. Reprod. 2022; 37(10): 2465-73. https://dx.doi.org/10.1093/humrep/deac155Bärebring L., Bullarbo M., Glantz A., Hulthén L., Ellis J., Jagner Å. et al. Trajectory of vitamin D status during pregnancy in relation to neonatal birth size and fetal survival: a prospective cohort study. BMC Pregnancy Childbirth. 2018; 18(1): 51. https://dx.doi.org/10.1186/s12884-018-1683-7Tikmani S.S., Brown N., Inayat A., Mårtensson A., Saleem S., Mårtensson T. Diagnostic accuracy of foot length measurement for identification of preterm newborn in rural Sindh, Pakistan. BMJ Paediatr. Open. 2024; 8(1): e002316. https://dx.doi.org/10.1136/bmjpo-2023-002316Bodnar L.M., Klebanoff M.A., Gernand A.D., Platt R.W., Parks W.T., Catov J.M. et al. Maternal vitamin D status and spontaneous preterm birth by placental histology in the US Collaborative Perinatal Project. Am. J. Epidemiol. 2014; 179(2): 168-76. https://dx.doi.org/10.1093/aje/kwt237Yoshikata H., Tsugawa N., Watanabe Y., Tsuburai T., Chaki O., Hirahara F. et al. 25-Hydroxyvitamin D profiles and maternal bone mass during pregnancy and lactation in Japanese women. J. Bone Miner. Metab. 2020; 38(1): 99-108. https://dx.doi.org/10.1007/s00774-019-01032-wАртымук Н.В., Тачкова О.А. Профилактика и лечение дефицита витамина D при беременности: позиция профессиональных медицинских сообществ. Акушерство и гинекология. 2025; 8: 5-14. [Artymuk N.V., Tachkova O.A. Prevention and treatment of vitamin D deficiency during pregnancy: the position of professional medical communities. Obstetrics and Gynecology. 2025; (8): 5-14 (in Russian)] https://dx.doi.org/10.18565/aig.2025.216Shahraki A.D., Hasanabadi M.S., Dehkordi A.F. The association of 25-hydroxy vitamin D level in mothers with term and preterm delivery and their neonates. J. Res. Med. Sci. 2020; 25: 21. https://dx.doi.org/10.4103/jrms.JRMS_633_19Chen Q., Chu Y., Liu R., Lin Y. Predictive value of vitamin D levels in pregnant women on gestational length and neonatal weight in China: a population-based retrospective study. Reprod. Biol. Endocrinol. 2024; 22(1): 102. https://dx.doi.org/10.1186/s12958-024-01276-wLuo T., Lin Y., Lu J., Lian X., Guo Y., Han L. et al. Effects of vitamin D supplementation during pregnancy on bone health and offspring growth: a systematic review and meta-analysis of randomized controlled trials. PLOS One. 2022; 17(10): e0276016. https://dx.doi.org/10.1371/journal.pone.0276016Yu L., Guo Y., Ke H.J., He Y.S., Che D., Wu J.L. Vitamin D status in pregnant women in Southern China and risk of preterm birth: A large-scale retrospective cohort study. Med. Sci. Monit. 2019; 25: 7755-62. https://dx.doi.org/10.12659/MSM.919307Zmijewski M.A. Vitamin D and human health. Int. J. Mol. Sci. 2019; 20(1): 145. https://dx.doi.org/10.3390/ijms20010145Zhang D., Cheng C., Wang Y., Sun H., Yu S., Xue Y. et al. Effect of vitamin D on blood pressure and hypertension in the general population: an update meta-analysis of cohort studies and randomized controlled trials. Prev. Chronic. Dis. 2020; 17: E03. https://dx.doi.org/10.5888/pcd17.190307Gilani S., Janssen P. Maternal vitamin D levels during pregnancy and their effects on maternal-fetal outcomes: a systematic review. J. Obstet. Gynaecol. Can. 2020; 42(9): 1129-37. https://dx.doi.org/10.1016/j.jogc.2019.09.013Hubeish M., Al Husari H., Itani S.E., El Tal R., Tamim H., Abou Saleh S. Maternal vitamin D level and rate of primary cesarean section. J. Clin. Gynecol. Obstet. 2019; 7(2): 43-51. https://dx.doi.org/10.14740/jcgo473wGómez-Carrascosa I., Sánchez-Ferrer M.L., Arense-Gonzalo J.J., Prieto-Sánchez M.T., Alfosea-Marhuenda E., Iniesta M.A. et al. Associations between maternal circulating 25-hydroxyvitamin D concentration and birth outcomes - Mode of delivery and episiotomy rate: a prospective cohort study. Nurs Open. 2021; 8(6): v3645-54. https://dx.doi.org/10.1002/nop2.915Sibtain S., Sinha P., Manoharan M., Azeez A. Controversies related to vitamin D deficiency effect on the maternal and feto-placental unit - an update. J. Obstet. Gynaecol. 2020; 40(6): 759-66. https://doi.org/10.1080/01443615.2019.1669012Hanson M.A., Bardsley A., De-Regil L.M., Moore S.E., Oken E., Poston L. et al. The International federation of gynecology and obstetrics (FIGO) recommendations on adolescent, preconception, and maternal nutrition: «Think nutrition first». Int. J. Gynaecol. Obstet. 2015; 131(S4): S213-53. https://dx.doi.org/10.1016/S0020-7292(15)30034-5Баранов И.И., Дорофейков В.В., Зазерская И.Е., Заплатников А.Л., Захарова И.Н., Каронова Т.Л., Климов Л.Я., Корсак В.С., Кузнецова Л.В., Курьянинова В.А., Лесняк О.М., Мальцев С.В., Мальцева Л.И., Никитина И.Л., Новикова Т.В., Первунина Т.М., Пигарова Е.А., Радзинский В.Е., Рожинская Л.Я., Серов В.Н., Сычев Д.А., Хазова Е.Л., Чернуха Г.Е., Шелепова Е.С., Юренева С.В., Ярмолинская М.И. Междисциплинарное руководство по профилактике и лечению дефицита витамина D в прегравидарном периоде, во время беременности и после родов. СПб: Эко-Вектор; 2020. 79 c. [Baranov I.I., Dorofeykov V.V., Zazerskaya I.E., Zaplatnikov A.L., Zakharova I.N., Karonova T.L., Klimov L.Ya., Korsak V.S., Kuznetsova L.V., Kuryaninova V.A., Lesnyak O.M., Maltsev S.V., Maltseva L.I., Nikitina I.L., Novikova T.V., Pervunina T.M., Pigarova E.A., Radzinsky V.E., Rozhinskaya L.Ya., Serov V.N., Sychev D.A., Khazova E.L., Chernukha G.E., Shelepova E.S., Yureneva S.V., Yarmolinskaya M.I. Interdisciplinary guide on prevention and treatment of vitamin D deficiency before conception, during pregnancy, and after childbirth. St. Petersburg: Eco-Vector, 2020. 79 p. (in Russian)].Мальцева Л.И., Гарифуллова Ю.В., Юпатов Е.Ю. Реалии и перспективы применения витамина D в сохранении репродуктивного здоровья женщин. Акушерство и гинекология. 2020; 10: 174-81. [Maltseva L.I., Garifullova Yu.V., Yupatov E.Yu. Use of vitamin D to maintain women’s reproductive health: realities and prospects. Obstetrics and Gynecology. 2020; (10): 174-81 (in Russian)]. https://dx.doi.org/10.18565/aig.2020.10.174-181