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South Australian Perinatal Practice Guideline
Vitamin D Status in
Pregnancy
Department for Health and Wellbeing, Government of South Australia. All rights reserved.
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Note:
This guideline provides advice of a general nature. This statewide guideline has been prepared to promote and facilitate
standardisation and consistency of practice, using a multidisciplinary approach. The guideline is based on a review of
published evidence and expert opinion.
Information in this statewide guideline is current at the time of publication.
SA Health does not accept responsibility for the quality or accuracy of material on websites linked from this site and does not
sponsor, approve or endorse materials on such links.
Health practitioners in the South Australian public health sector are expected to review specific details of each patient and
professionally assess the applicability of the relevant guideline to that clinical situation.
If for good clinical reasons, a decision is made to depart from the guideline, the responsible clinician must document in the
patient s medical record, the decision made, by whom, and detailed reasons for the departure from the guideline.
This statewide guideline does not address all the elements of clinical practice and assumes that the individual clinicians are
responsible for discussing care with consumers in an environment that is culturally appropriate and which enables respectful
confidential discussion. This includes:
The use of interpreter services where necessary,
Advising consumers of their choice and ensuring informed consent is obtained,
Providing care within scope of practice, meeting all legislative requirements and maintaining standards of
professional conduct, and
Documenting all care in accordance with mandatory and local requirements
Explanation of the aboriginal artwork:
The aboriginal artwork used symbolises the connection to country and the circle shape shows the strong relationships amongst families and the aboriginal culture. The horse shoe shape
design shown in front of the generic statement symbolises a woman and those enclosing a smaller horse shoe shape depicts a pregnant women. The smaller horse shoe shape in this
instance represents the unborn child. The artwork shown before the specific statements within the document symbolises a footprint and demonstrates the need to move forward together in
unison.
Purpose and Scope of Perinatal Practice Guideline (PPG)
To guide clinicians with the management of women and their newborns who are at risk of, or are
found to have, vitamin D insufficiency/deficiency in pregnancy.
Australian Aboriginal Culture is the oldest living culture in the world yet
Aboriginal people continue to experience the poorest health outcomes when
compared to non-Aboriginal Australians. In South Australia, Aboriginal women are
2-5 times more likely to die in childbirth and their babies are 2-3 times more likely to
be of low birth weight. The accumulative effects of stress, low socio economic
status, exposure to violence, historical trauma, culturally unsafe and discriminatory
health services and health systems are all major contributors to the disparities in
Aboriginal maternal and birthing outcomes. Despite these unacceptable statistics
the birth of an Aboriginal baby is a celebration of life and an important cultural
event bringing family together in celebration, obligation and responsibility. The
diversity between Aboriginal cultures, language and practices differ greatly and so
it is imperative that perinatal services prepare to respectively manage Aboriginal
protocol and provide a culturally positive health care experience for Aboriginal
people to ensure the best maternal, neonatal and child health outcomes.
Vitamin D Status in Pregnancy
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Flowchart 1: Management of Vitamin D Status in Pregnancy
Vitamin D Status in Pregnancy
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Flowchart 2: Newborn Management
Vitamin D Status in Pregnancy
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Table of Contents
Purpose and Scope of Perinatal Practice Guideline (PPG) ............................................................ 1
Flowchart 1: Management of Vitamin D Status in Pregnancy ......................................................... 2
Flowchart 2: Newborn Management ............................................................................................... 3
Abbreviations ................................................................................................................................... 5
Definitions ........................................................................................................................................ 5
Introduction ...................................................................................................................................... 5
Food sources of Vitamin D .......................................................................................................... 5
Other sources of Vitamin D ......................................................................................................... 5
Vitamin D content of multivitamins .............................................................................................. 6
Vitamin D status in pregnancy ......................................................................................................... 6
Antenatal screening and treatment ................................................................................................. 7
First appointment (booking) screening of at risk women ............................................................. 7
Vitamin D supplementation for ALL pregnant women ................................................................. 7
First follow-up of at risk women ................................................................................................... 7
Subsequent follow-up of at risk women ....................................................................................... 7
Discharge ..................................................................................................................................... 7
Neonatal management .................................................................................................................... 8
References ...................................................................................................................................... 9
Appendix I: Fact Sheet: Vitamin D Supplementation in Pregnancy .............................................. 10
Appendix 2: Fact Sheet: Vitamin D Insufficiency / Deficiency in Pregnancy ................................. 10
Appendix 2: Parent information: Vitamin D Deficiency in Babies .................................................. 12
Summary of Practice Recommendations
All women should be screened for risk factors at their first antenatal visit.
All women not at risk of vitamin D deficiency should commence colecalciferol 400 units daily as
part of routine supplementation.
Women at risk of vitamin D deficiency should have blood taken for 25-hydroxy vitamin D level
Women at risk of vitamin D deficiency should commence 1,000 units (25 micrograms) of
colecalciferol per day.
Subsequent management of women and their babies is dependent on 25-OHD levels at 28
weeks gestation.
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Abbreviations
AI Adequate intake
a.m. Ante meridiem (before noon)
BMI Body mass index (kg/m2)
e.g. For example
et al. And others
MED Minimal erythemal dose
mL Millilitre(s)
nmol/L Nanomoles per litre
25-OHD 25-hydroxy-vitamin D
PTH Parathyroid hormone
p.m. Post meridiem (after noon)
Vit Vitamin
Definitions
Vitamin D
sufficiency
Serum 25-OHD levels >50 nmol/L
Vitamin D
insufficiency
Serum 25-OHD levels of 30 to 50 nmol/L
Vitamin D
deficiency
Serum 25-OHD levels <30 nmol/L
Introduction
Vitamin D plays an essential role in calcium metabolism, bone growth and mineralisation
Around 90 % of our vitamin D requirement comes from exposure of the skin to sunlight. The
average diet contains only about 10 % of our requirements insufficient to prevent vitamin D
deficiency1.
The highest rates of vitamin D deficiency occur in dark-skinned, veiled, pregnant women (80%),
with similarly high rates found in mothers of infants treated for rickets2,3.
High rates of vitamin D deficiency have been found in low risk South Australian antenatal
populations, with risk-based screening failing to detect over half of deficient women4.
BMI is inversely proportional to serum vitamin D levels, with one study showing a BMI ?40 was
associated with a 24% lower serum 25-OHD (25-hydroxy-vitamin D) level compared to those with
BMI <255.
Women with darker skin produce less vitamin D for a given sunlight exposure6,7.
Neonatal vitamin D deficiency is always caused by maternal deficiency8.
Food sources of Vitamin D
Few foods contain significant amounts of vitamin D (e.g. fish with a high fat content such as
salmon, tuna, herring, mackerel and sardines). Other sources include meat, milk and eggs
In Australia, some margarine and milk and milk products are fortified with vitamin D2.
Breast milk is an inadequate source of vitamin D and exclusive breastfeeding is a risk factor for
neonatal rickets8.
Other sources of Vitamin D
The optimum route of vitamin D intake is via skin exposure.
However, deliberate sun exposure between 10.00 a.m. and 2.00 p.m. in summer (11.00 a.m. and
3:00 p.m. daylight saving time) is not advised3.
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It has been shown that whole body exposure to 10-15 minutes of midday sun in summer (about 1
minimal erythemal dose [MED] or the amount of sun exposure that just produces a faint redness
of skin) is comparable to taking 15,000units (375 micrograms) of vitamin D (colecalciferol) orally3.
On this basis, exposure of hands, face and arms (around 15 % of body surface) to around 1/3
MED should produce around 1,000units of vitamin D (colecalciferol) for people with moderately
fair skin3.
Exposure times for people with highly pigmented skin would be 3-4 times greater3.
Vitamin D content of multivitamins
A large proportion of women take multivitamins in pregnancy9.
The vitamin D content of commonly used pregnancy multivitamins are as follows:
> Blackmores Pregnancy & Breastfeeding Gold
o 500units per capsule = 1000units/day (i.e. 2 tablets)
> Elevit Pregnancy Multivitamin
o 200 units per tablet = 200units/day
> Swisse Pregnancy + Ultivite
o 600units per capsule = 600units/day
Vitamin D status in pregnancy
Recent consensus guidelines recommend the following classification of vitamin D status8. These
are in line with those already in use by The Royal Australian and New Zealand College of
Obstetricians and Gynaecologists10.
> Vitamin D sufficiency
o Serum 25-OHD levels >50 nmol/L
> Vitamin D insufficiency
o Serum 25-OHD levels of 30 to 50 nmol/L
> Vitamin D deficiency
o Serum 25-OHD levels <30 nmol/L
Women with vitamin D insufficiency/deficiency are at risk of:
> Osteomalacia
> Accelerated osteoporosis due to secondary hyperparathyroidism
> Muscle weakness
Vitamin D insufficiency/deficiency in pregnancy may be associated with:
> Hypertension
> Pre-eclampsia
> Increased primary Caesarean section rates11
Babies of women with vitamin D insufficiency/deficiency during pregnancy are at risk of:
> Hypocalcaemia and seizures
> Rickets
> Myopathy
> Reduced intrauterine long bone growth12
Although there is some evidence for risk reduction with vitamin D supplementation, further
randomised controlled trials are required to confirm the benefits13. Despite this, a strategy for
supplementation and treatment of maternal vitamin D deficiency is recommended10,11.
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Antenatal screening and treatment
First appointment (booking) screening of at risk women
Pregnant women at risk of vitamin D insufficiency/deficiency (see below) are to be offered vitamin
D screening at booking. They include:
> All veiled women e.g. Muslim, including those wearing headscarves
> Darker skinned women e.g. Aboriginal, North African, Indian and Sri Lankan
> Newly arrived refugees
> Women with limited sun exposure for any reason e.g. night shift or office workers
Vitamin D supplementation for ALL pregnant women
Pregnant women without known risk factors
Commence colecalciferol 400 units daily as part of routine supplementation e.g. 0.2ml Ostelin
Vitamin D Liquid (1,000 units/0.5ml) or half tablet of OsteVit-D (equivalent to 500 units) (which
may be purchased from a community pharmacy without a prescription). See appendix 1 for
information for women.
Note: Also consider the vitamin D content of the woman s pregnancy multivitamin, then
supplement if required.
Pregnant women with known risk factors
Request blood 25-hydroxy vitamin D (25-OHD) level
Commence 1,000 units (25 micrograms) of colecalciferol daily (e.g. one capsule of Ostelin , one
tablet of OsteVit-D or 0.5mL Ostelin Vitamin D Liquid (1,000 units/0.5ml) (which may be
purchased from a community pharmacy without a prescription). See appendix 2 for information
for women.
Note: Also consider the vitamin D content of the woman s pregnancy multivitamin and then adjust
the supplement if required.
First follow-up of at risk women
Check the report of the original 25-OHD assay at the next appointment:
Vitamin D ?50 nmol/L
> Continue vitamin D 1,000 units daily
> Repeat 25-OHD level at 28/40 to see if it has normalised
Vitamin D > 50 nmol/L
> Decrease vitamin D to 400 units daily
Subsequent follow-up of at risk women
Depending on the second 25-OHD assay:
If 25OHD > 50 nmol/L
> Continue vitamin D 1,000 units daily
If 25OHD ? 50 nmol/L
> Increase dose to vitamin D 2,000 units daily
Discharge
All at risk women require a follow-up letter to their General Practitioner with a recommendation
for a repeat 25-OHD assay at 6 weeks and vitamin D should be resumed then if indicated.
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Neonatal management
Universal supplementation of infants with vitamin D is recommended in global consensus
guidelines8. However, Australian and New Zealand guidelines recommend targeted
supplementation of infants with the following risk factors: maternal vitamin D deficiency, exclusive
breast feeding, and dark skin and/or social or cultural factors that could lead to lack of exposure
to sunlight14.
The following considerations are the basis for recommendations for neonatal supplementation,
taking into account published recommendations and an approach to protocol implementation that
optimises adherence and minimises harm. See appendix 3 for information for parents.
> In the absence of maternal risk factors (women not normally screened and are receiving
400units of colecalciferol), babies do not need routine vitamin D supplementation.
> Vitamin D supplementation at 400units daily is safe in babies. There is a wide therapeutic
safety window for 25-OHD in neonates, with toxicity unlikely below levels of 250nmol/L14.
> Breast milk vitamin D content approximates 4units per 100mL15, and term infant formula
(fortified with vitamin D) approximates 40units per 100mL (typical range 30-48units referenced
from manufacturer labelling). Daily intake from formula is unlikely to meet the recommended
adequate intake (AI is 400units assuming minimal sun exposure), whereas the addition of
400units daily supplement is unlikely to cause toxicity.
> Supplementation of both breast milk and formula fed babies with risk factors increases the
simplicity of the protocol, and may reduce a maternal perception that breast milk is inadequate.
> Even if maternal vitamin D sufficiency is assumed at full term on the basis of supplementation
and normal maternal 25-0HD levels, the lifestyle, social and cultural factors that affected the
mother may persist after the baby s birth and impact the baby. Supplementation based on risk
factors even if maternal supplementation has normalised maternal levels is reasonable.
> Serum 25-OHD levels are not generally measured in babies <3 months of age. However where
a clinician has measured 25-OHD levels, definitions of deficiency and treatment follow the SA
Paediatric Clinical Practice Guideline: Vitamin D Deficiency in Children (available
at www.sahealth.sa.gov.au/paediatric) and the SA Neonatal Medication Guidelines:
Colecalciferol and Multivitamins (available at www.sahealth.sa.gov.au/neonatal).
> Sunlight exposure in babies needs to balance risks of skin damage with the benefit of vitamin D
synthesis and no firm recommendations can be made. The following suggested advice to
parents is modified from the ANZ position statement14.
Light to olive skin Brown, dark brown and black skin
UV index ?3 Full protection advised sunscreen,
hat, clothing, shade
Hat, clothing, shade, intermittent sun
exposure of arms and legs without
sunscreen for approximately 10-15
minutes per day encouraged
UV index <3 Sunscreen not required. Intermittent
sun exposure of arms and legs for
10-15 minutes encouraged.
Encourage sun exposure of arms and
legs during outdoor activity
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References
1. Nozza JM, Rodda CP. Vitamin D deficiency in mothers of infants with rickets. MJA
2001; 175: 253-255. Available at
URL: http://www.mja.com.au/public/issues/175_05_030901/nozza/nozza.html
2. Nowson CA, Margerison C. Vitamin D intake and vitamin D status of Australians. MJA
2002; 177: 149-152. Available at
URL: http://www.mja.com.au/public/issues/177_03_050802/now10763_fm.html
3. Diamond TH, Eisman JA, Mason RS, Nowson CA, Pasco JA, et al. Working Group of
the Australian and New Zealand Bone and Mineral Society, Endocrine Society of Australia and
Osteoporosis Australia. Vitamin D and adult bone health in Australia and New Zealand: a
position statement. MJA 2005; 182: 281-285. Available at
URL: http://www.mja.com.au/public/issues/182_06_210305/dia10848_fm.html
4. De Laine KM, Matthews G, Grivell RM. Propspective audit of vitamin D levels of women
presenting for their first antenatal visit. Aust N Z J Obstet Gynaecol. 2013 Aug;53(4):353-7.
Available at URL:
https://doi.org/10.1111/ajo.12052
5. Konradsen S, Ah H, Lindberg F, Hexeberg S, R. J. Serum 1,25-dihydroxy vitamin D is
inversely associated with body mass index. Eur J Nutr. 2008;47(2). Available at URL:
http://www.ncbi.nlm.nih.gov/pubmed/18320256
6. Grover SR, Morley R. Vitamin D deficiency in veiled or dark-skinned pregnant women.
MJA 2001; 175: 251-252. Available at
URL: http://www.mja.com.au/public/issues/175_05_030901/grover/grover.html
7. McCullough ML. Vitamin D deficiency in pregnancy: Bringing the issues to light. J
Nutrition 2007; 137: 305-306.
8. Munns C, Shaw N, Kiely M, Specker B, Thacher T et al. Prevention and treatment of
infant and childhood vitamin D deficiency in Australia and New Zealand: a consensus statement.
JCEM 2016; 101(2): 394-415. Available at URL:
http://press.endocrine.org/doi/pdf/10.1210/jc.2015-2175
9. Sullivan KM, Ford ES, Fuad Azrak M, Mokdad AH. Multivitamin Use in Pregnant and
Nonpregnant Women: Results from the Behavioral Risk Factor Surveillance System. Public
Health Rep. 2009 May-Jun; 124(3): 384 390. Available at URL:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2663874/
10. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
Vitamin and mineral supplementation and pregnancy. RANZCOG 2015. Available at
URL: https://www.ranzcog.edu.au/RANZCOG_SITE/media/RANZCOG-
MEDIA/Women%27s%20Health/Statement%20and%20guidelines/Clinical-Obstetrics/Vitamin-
and-mineral-supplementation-in-pregnancy-(C-Obs-25)-Review-Nov-2014,-Amended-May-
2015.pdf?ext=.pdf
11. Royal College of Obstetricians and Gynaecologists. Vitamin D in Pregnancy (Scientific
Impact Paper No.43). 2014. Available at
URL: https://www.rcog.org.uk/globalassets/documents/guidelines/scientific-impact-
papers/vitamin_d_sip43_june14.pdf.
12. Morley R, Carlin JB, Pasco JA, Wark JD. Maternal 25-hydroxyvitamin D and parathyroid
hormone concentrations and offspring birth size. J Clin Endocrinol Metab 2006; 91: 906-912.
13. De-Regil LM, Palacios C, Lombardo LK, Pe a-Rosas JP. Vitamin D supplementation for
women during pregnancy. Cochrane Database of Systematic Reviews 2016, Issue 1. Art. No.:
CD008873. DOI: 10.1002/14651858.CD008873.pub3. Available at URL:
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008873.pub3/pdf
14. Paxton GA, Teale GR, Nowson CA, Mason RS, McGrath JJ, Thompson MJ, Siafarikas A,
Rodda CP and Munns CF. Vitamin D and health in pregnancy, infants, children and adolescents
in Australia and New Zealand: a position statement. MJA 2013; 198 (3): 142-143. Available at
URL:
https://www.mja.com.au/journal/2013/198/3/vitamin-d-and-health-pregnancy-infants-children-and-
adolescents-australia-and
15. National Health and Medical Research Council. Eat for Health Infant Feeding Guidelines
Information for health workers. Canberra: NHMRC, 2012. Available at URL:
https://nhmrc.gov.au/about-us/publications/infant-feeding-guidelines-information-health-workers
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Appendix I: Fact Sheet: Vitamin D Supplementation in Pregnancy
Fact Sheet
Routine Vitamin D Supplementation
in Pregnancy
About Vitamin D
Vitamin D is needed to keep bones healthy and strong.
> Most (90%) vitamin D comes from exposing your skin to the sun. A balance of sun
exposure and sun protection is needed to make enough Vitamin D.
> Some (10%) vitamin D comes from food such as oily fish, meat, milk and eggs.
What happens if you do not have enough vitamin D?
Many people with low vitamin D do not have symptoms.
Vitamin D deficiency can cause:
> Rickets (soft bones) in children
> Muscle cramps
> Seizures (fits) due to low calcium
Low vitamin D may be linked to other health problems such as: a higher risk of bowel
cancer, heart disease, problems with immunity (how the body fights infections) and
autoimmune diseases (e.g. diabetes).
Vitamin D supplementation
Routine supplementation with Vitamin D (400units daily) is recommended for all pregnant
women.
This can be achieved by a vitamin D supplement which may be purchased from a
community pharmacy without a prescription e.g.
> 0.2ml Ostelin Vitamin D Liquid (1,000 units/0.5ml) or
> half tablet of OsteVit-D (equivalent to 500 units)
You may be taking a pregnancy multivitamin already, however the vitamin D content varies
so you may need additional supplementation. The vitamin D content of commonly used
pregnancy multivitamins is as follows:
> Blackmores Pregnancy & Breastfeeding Gold
o 500units per capsule = 1000 units/day (i.e. 2 tablets)
> Elevit Pregnancy Multivitamin
o 200 units per tablet = 200 units/day
> Swisse Pregnancy + Ultivite
o 600units per capsule = 600 units/day
Further Information
1. Well for Life
https://www.betterhealth.vic.gov.au/health/HealthyLiving/vitamin-d
2. NHMRC Nutrient Reference Values for Australia and NZ Vitamin D
www.nrv.gov.au/nutrients/vitamin-d
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Appendix 2: Vitamin D Deficiency in Pregnancy
Fact Sheet
Vitamin D Insufficiency / Deficiency
in Pregnancy
About Vitamin D
Vitamin D is needed to keep bones healthy and strong.
> Most (90%) vitamin D comes from exposing your skin to the sun. A balance of sun
exposure and sun protection is needed to make enough Vitamin D.
> Some (10%) vitamin D comes from food such as oily fish, meat, milk and eggs.
What happens if you do not have enough vitamin D?
Many people with low vitamin D do not have symptoms.
Vitamin D deficiency can cause:
> Rickets (soft bones) in children
> Muscle cramps
> Seizures (fits) due to low calcium
Low vitamin D may be linked to other health problems such as: a higher risk of bowel
cancer, heart disease, problems with immunity (how the body fights infections) and
autoimmune diseases (e.g. diabetes).
Vitamin D supplementation
Supplementation with vitamin D (1000units) is recommended for women with risk factors or
whose vitamin D level is known to be low.
This can be achieved by a vitamin D supplement which may be purchased from a
community pharmacy without a prescription e.g.
> 0.5mL Ostelin Vitamin D Liquid (1,000 units/0.5mL) or
> One tablet of OsteVit-D (1,000 units) or
> One capsule of Ostelin Vitamin D (1,000 units)
You may be taking a pregnancy multivitamin already, however the vitamin D content varies
so you may need additional supplementation. The vitamin D content of commonly used
pregnancy multivitamins is as follows:
> Blackmores Pregnancy & Breastfeeding Gold
o 500units per capsule = 1000 units/day (i.e. 2 tablets)
> Elevit Pregnancy Multivitamin
o 200 units per tablet = 200 units/day
> Swisse Pregnancy + Ultivite
o 600units per capsule = 600 units/day
Further Information
1. Well for Life
https://www.betterhealth.vic.gov.au/health/HealthyLiving/vitamin-d
2. NHMRC Nutrient Reference Values for Australia and NZ Vitamin D
www.nrv.gov.au/nutrients/vitamin-d
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Appendix 2: Parent information: Vitamin D Deficiency in Babies
Parent Information
Vitamin D Deficiency in Babies
About Vitamin D
Vitamin D is needed to keep bones healthy and strong.
> Most (90%) vitamin D comes from exposing your skin to the sun. A balance of sun
exposure and sun protection is needed to make enough Vitamin D.
> Some (10%) vitamin D comes from food such as oily fish, meat, milk and eggs.
What happens if you do not have enough vitamin D?
Many people with low vitamin D do not have symptoms.
Vitamin D deficiency can cause:
> Rickets (soft bones) in children
> Muscle cramps
> Seizures (fits) due to low calcium
Low vitamin D may be linked to other health problems such as: a higher risk of bowel
cancer, heart disease, problems with immunity (how the body fights infections) and
autoimmune diseases (e.g. diabetes).
Breast Feeding
Breast feeding is the best way to feed your baby. Breast feeding is important for your
baby s health and wellbeing. You can still breast feed your baby if your Vitamin D level is
low.
Vitamin D Supplementation for Babies
All breastfed and formula fed babies born to mothers who have had persistently low vitamin
D levels in pregnancy or who are at risk of vitamin D deficiency (e.g. due to darker skin
colour, veiled), should be given a 400 units daily vitamin D supplement for the first 12
months of life. The preparations used in SA hospitals are Ostelin Vitamin D Liquid
(1,000units/0.5mL) and Penta-vite Infant Drops .
Ostelin Vitamin D Liquid (1,000units/0.5mL)
Ostelin Vitamin D Liquid contains vitamin D. The dose is 0.2mL daily, and it is the
preferred vitamin D liquid in term babies as it tastes better than Penta-vite Infant Drops .
You can buy a bottle of Ostelin Vitamin D Liquid from your local chemist.
Penta-vite Infant Drops
Penta-vite Infant Drops contain vitamins A, B1, B2, B3, B6, C and D. The dose is 0.45mL
daily. You can buy a bottle of Penta-vite Infant Drops from your local chemist.
Further Information
Speak with your GP (General Practitioner) if you have any questions about your or your
baby s Vitamin D levels.
1. Well for Life
https://www.betterhealth.vic.gov.au/health/HealthyLiving/vitamin-d
2. NHMRC Nutrient Reference Values for Australia and NZ Vitamin D
www.nrv.gov.au/nutrients/vitamin-d
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Acknowledgements
The South Australian Perinatal Practice Guidelines gratefully acknowledge the contribution of
clinicians and other stakeholders who participated throughout the guideline development process
particularly:
Write Group Lead
Dr Kate Gowling
Write Group Members
A/Prof Rosalie Grivell
Catherine Leggett
Dr Scott Morris
Rebecca Smith
Sheree Wynne
Other contributors
Dr Feisal Chenia
Cassandra Mosel
SAPPG Management Group Members 2018
SAPPG Management Group Members
Sonia Angus
Dr Kris Bascomb
Lyn Bastian
Elizabeth Bennett
Dr Feisal Chenia
John Coomblas
A/Prof Rosalie Grivell
Dr Sue Kennedy-Andrews
Jackie Kitschke
Catherine Leggett
Dr Anupam Parange
Dr Andrew McPhee
Rebecca Smith
A/Prof John Svigos
Dr Laura Willington
Vitamin D Status in Pregnancy
INFORMAL COPY WHEN PRINTED Page 14 of 14
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Document Ownership & History
Developed by: SA Maternal, Neonatal & Gynaecology Community of Practice
Contact: HealthCYWHSPerinatalProtocol@sa.gov.au
Endorsed by: SA Health Safety and Quality Strategic Governance Committee
Next review due: 10/05/2024
ISBN number: 978-1-76083-126-4
PDS reference: CG251
Policy history: Is this a new policy (V1)? N
Does this policy amend or update and existing policy? Y
If so, which version? 3
Does this policy replace another policy with a different title? Y
If so, which policy (title)? Vitamin D Deficiency
Approval
Date Version
Who approved New/Revised
Version Reason for Change
10/05/2019 V4 SA Health Safety and Quality Strategic Governance Committee Formally reviewed
24/12/2007 V3 SA Maternal & Neonatal Clinical Network Minor amendment
20/09/2007 V2 SA Maternal & Neonatal Clinical Network Minor amendment
18/09/2007 V1 SA Maternal & Neonatal Clinical Network
Original SA Maternal & Neonatal
Clinical Network approved version.
Purpose and Scope of Perinatal Practice Guideline (PPG)
Flowchart 1: Management of Vitamin D Status in Pregnancy
Flowchart 2: Newborn Management
Abbreviations
Definitions
Introduction
Food sources of Vitamin D
Other sources of Vitamin D
Vitamin D content of multivitamins
Vitamin D status in pregnancy
Antenatal screening and treatment
First appointment (booking) screening of at risk women
Vitamin D supplementation for ALL pregnant women
First follow-up of at risk women
Subsequent follow-up of at risk women
Discharge
Neonatal management
References
Appendix I: Fact Sheet: Vitamin D Supplementation in Pregnancy
Appendix 2: Vitamin D Deficiency in Pregnancy
Appendix 2: Parent information: Vitamin D Deficiency in Babies
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