Vitamins for pregnant women: vitamin D and its effect on immunity

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Vitamins for pregnant women: vitamin D and its effect on immunity

I. Pregnancy and immunity: interconnection and vulnerability

Pregnancy is a unique physiological state, characterized by significant changes in the woman’s immune system. These changes are necessary for the successful bearing of the fetus, since the mother’s body should be tolerant of a genetically alien fetus, preventing its rejection. However, this immune adaptation makes pregnant women more susceptible to certain infections and complications.

A. Immune changes during pregnancy:

  1. Suppression of cellular immunity: A decrease in the activity of T-Helper type 1, which are involved in cellular immunity, is aimed at preventing the cytotoxic reaction against the fetus. This makes pregnant women more vulnerable to intracellular pathogens, such as viruses and bacteria.

  2. Strengthening humoral immunity: The activity of T-Helper of the 2nd type (Th2), which stimulate humoral immunity (antibodies), increases. Antibodies play an important role in protection against extracellular pathogens and are transmitted to the fetus, providing passive immunity.

  3. Changing the function of natural killers (NK cells): NK cells play a key role in the early immune response and the removal of infected cells. During pregnancy, their activity and cytotoxicity can be modulated to ensure tolerance to trophoblast cells that form the placenta.

  4. Reducing the function of phagocytes: The function of phagocytes, such as macrophages and neutrophils that absorb and destroy pathogens, can be reduced during pregnancy. This can increase susceptibility to bacterial infections.

  5. Changing the level of cytokines: Cytokins, molecules regulating the immune response, undergo significant changes during pregnancy. The balance between pro- and anti-inflammatory cytokines shifts towards the anti-inflammatory state, which contributes to the tolerance to the fetus, but can also reduce the effectiveness of the immune response to infection.

B. Increased vulnerability to infections:

  1. Respiratory infections: Pregnant women are more susceptible to severe forms of influenza and pneumonia due to changes in the immune system and physiological changes, such as a decrease in the volume of the lungs and an increase in oxygen consumption.

  2. Urinary tract infections (IMP): The risk of IMP increases due to hormonal changes leading to the expansion of the ureters and a decrease in peristalsis, which contributes to the stagnation of urine and the reproduction of bacteria.

  3. Vaginal infections: Changes in the hormonal background and vaginal microflora can increase the risk of vaginal infections, such as bacterial vaginosis and candidiasis.

  4. Sexually transmitted infections (IPP): Some SPPPs, such as syphilis and gonorrhea, may have serious consequences for pregnancy, including premature birth, intrauterine infection and congenital defects.

C. The consequences of infections during pregnancy:

  1. Premature birth: Infections, especially the IMP and vaginal infections, can provoke premature birth.

  2. Intrauterine infection: Some infections can be transmitted from the mother to the fetus through the placenta, causing intrauterine infection, which can lead to serious health problems in the newborn.

  3. Precomports and Eclampsia: Infections can increase the risk of preeclampsia and eclampsia, serious complications of pregnancy, characterized by high blood pressure and organs damage.

  4. Congenital defects: Some infections, such as rubella and cytomegalovirus (CMV), can cause congenital defects in the fetus.

  5. Increased risk of cesarean section: Infections can increase the risk of cesarean section.

II. Vitamin D: role in the immune system and health

Vitamin D, also known as “solar vitamin”, plays an important role not only in maintaining the health of bones and teeth, but also in the functioning of the immune system. It is a group of fat -soluble runners that regulate many physiological processes in the body.

A. Vitamin D action mechanisms in the immune system:

  1. Expression of the genes of the immune response: Vitamin D associates the vitamin D (VDR) receptor, which is present in many immune cells, including macrophages, dendritic cells, T cells and B cells. This binding leads to the activation of the VDR and its connection to the retinoid X-receptor (RXR), forming a heterodimer. This complex is associated with certain DNA sections called the elements of the response to vitamin D (VDRE), which regulate the expression of genes involved in the immune response.

  2. Modulation of congenital immunity:

    a. Macrophage activation: Vitamin D stimulates the differentiation of monocytes in macrophages and increases their phagocytic activity, that is, the ability to absorb and destroy pathogens.

    b. Strengthening products of antimicrobial peptides: Vitamin D stimulates the production of antimicrobial peptides, such as katelicidin and defensin, which have a wide spectrum of antibacterial, antiviral and antifungal activity. Katelicidin damages the membranes of pathogens and modulates the immune response, while defensins attract immune cells to the place of infection and neutralize viruses.

    c. Regulation of inflammation: Vitamin D modulates an inflammatory response, suppressing the production of pro-inflammatory cytokines, such as Interleukin-1 (IL-1), Interleukin-6 (IL-6) and Alpha tumor necrosis factor (TNF -α). It also contributes to the production of anti-inflammatory cytokine Interleukin-10 (IL-10), which helps maintain the balance of the immune response and prevents excessive inflammation.

  3. Modulation of adaptive immunity:

    a. Regulation of the function of T cells: Vitamin D affects the differentiation and function of T cells. It can suppress the differentiation of T-Helper type 1 and TH1) and T-Helper type 17 (TH17), which are involved in autoimmune diseases, and contribute to the differentiation of regulatory T-cells (Treg), which suppress the immune response and maintain tolerance.

    b. Regulation of V-cell function: Vitamin D affects the function of B cells, suppressing their proliferation and differentiation into plasma cells that produce antibodies. He can also modulate the production of various antibodies, such as IgG and IGA.

  4. Maintaining the integrity of the epithelial barrier: Vitamin D plays an important role in maintaining the integrity of the epithelial barrier in the lungs and intestines. It enhances the formation of dense contacts between epithelial cells, which prevents the penetration of pathogens and allergens through the barrier.

B. Sources of vitamin D:

  1. Sunlight: The main source of vitamin D is its synthesis in the skin under the influence of ultraviolet rays B (UVB). Under the influence of UVB, 7-dehydrocholesterol is converted into previtamin D3, which is then is metered into vitamin D3 (cholegalciferol). The amount of vitamin D, synthesized in the skin, depends on various factors, such as the time of year, time of day, geographical breadth, skin color and the use of sunscreen creams.

  2. Food: Some foods contain vitamin D, but in relatively small quantities. These include oily fish (salmon, tuna, mackerel), egg yolks, mushrooms grown under the influence of ultraviolet radiation, and enriched products, such as milk, yogurt and grain.

  3. Food additives: Food supplements with vitamin D are an effective way to increase the level of vitamin D in the body, especially in cases where obtaining a sufficient amount of vitamin D from sunlight and food is difficult. Vitamin D is available in two forms: vitamin D2 (ergocalciferol), which is obtained from plant springs, and vitamin D3 (cholecalciferol), which is obtained from animal sources. Vitamin D3, as a rule, is more effective in increasing the level of vitamin D in the blood.

C. Vitamin D: prevalence and risk factors:

Vitamin D deficiency is a common problem around the world, especially among certain groups of the population, including pregnant women, elderly people, people with dark skin, people living in the northern latitudes, and people with limited residence in the sun.

  1. Risk factors:

    a. Limited Sun stay: People who spend most of the time in the room or wear clothes that cover most of the skin, have an increased risk of vitamin D.

    b. Dark skin: Melanin, the pigment that gives the skin the color absorbs UVB rays, reducing the synthesis of vitamin D in the skin.

    c. Geographical latitude: In the northern latitudes, the intensity of UVB radiation is insufficient for the synthesis of vitamin D in the skin for most of the year.

    d. Age: With age, the ability of the skin to synthesize vitamin D decreases.

    e. Obesity: Vitamin D is a fat -soluble vitamin, and in people with obesity it can accumulate in adipose tissue, reducing its accessibility for the body.

    f. Certain diseases: Some diseases, such as kidney and liver diseases, may disrupt vitamin D.’s metabolism.

    g. Medication: Some drugs, such as glucocorticoids and antifungal drugs, can reduce the level of vitamin D in the blood.

  2. The consequences of vitamin D deficiency:

    a. Rachite (in children): Vitamin D deficiency in children can lead to rickets, a disease characterized by bone deformation.

    b. Osteomulation (in adults): Vitamin D deficiency in adults can lead to osteomination, a disease characterized by bone softness.

    c. Osteoporosis: Vitamin D deficiency increases the risk of osteoporosis, a disease characterized by a decrease in bone density and an increased risk of fractures.

    d. Muscle weakness: Vitamin D deficiency can lead to muscle weakness and pain.

    e. Increased risk of infections: Vitamin D deficiency weakens the immune system and increases the risk of infections.

    f. Autoimmune diseases: Vitamin D deficiency is associated with an increased risk of developing autoimmune diseases, such as multiple sclerosis, rheumatoid arthritis and type 1 diabetes.

    g. Cardiovascular diseases: Vitamin D deficiency is associated with an increased risk of cardiovascular disease, such as hypertension, heart failure and stroke.

    h. Some types of cancer: Vitamin D deficiency is associated with an increased risk of developing certain types of cancer, such as colon cancer, breast cancer and prostate cancer.

III. Vitamin D and pregnancy: influence on mother and child

Vitamin D plays a critical role in the health of the mother and child during pregnancy. It is necessary to maintain the health of the mother’s bones, the development of the fetal skeleton and the functioning of the immune system.

A. The need for vitamin D during pregnancy:

During pregnancy, the need for vitamin D increases to ensure the adequate development of the fetal skeleton and maintain the health of the mother’s bones. The recommended daily dose of vitamin D for pregnant women is 600 IU (international units). However, some experts believe that a higher dose may require the optimal level of vitamin D in the blood.

B. The influence of vitamin D on the mother’s health:

  1. Precomports: The deficiency of vitamin D is associated with an increased risk of development of preeclampsia, a serious complication of pregnancy characterized by high blood pressure and organs damage. Vitamin D can help reduce the risk of preeclampsia due to the modulation of the immune response and improve the function of the endothelium (internal shell of blood vessels).

  2. Gestational diabetes: Vitamin D deficiency is associated with an increased risk of developing gestational diabetes, such as diabetes, which develops during pregnancy. Vitamin D can improve insulin sensitivity and reduce the risk of gestational diabetes.

  3. Bacterial vaginosis: Vitamin D deficiency is associated with an increased risk of developing bacterial vaginosis, vaginal infection, which can lead to premature gender and other complications of pregnancy. Vitamin D can help prevent bacterial vaginosis by strengthening the immune system and maintaining a healthy vaginal microflora.

  4. Depression: Vitamin D deficiency is associated with an increased risk of depression during pregnancy and after childbirth. Vitamin D can improve mood and reduce the risk of depression due to the effects on neurotransmitters in the brain.

C. The effect of vitamin D on the health of the child:

  1. Develop the skeleton: Vitamin D is necessary for the development of the fetal skeleton. During pregnancy, vitamin D deficiency can lead to low birth weight, rickets in a newborn and increased risk of fractures in childhood.

  2. Immune system: Vitamin D plays an important role in the development of the fetal immune system. The adequate level of vitamin D during pregnancy can reduce the risk of allergies, asthma and other immune diseases in a child.

  3. The risk of diseases: Some studies show that vitamin D deficiency during pregnancy can be associated with an increased risk of developing autism, schizophrenia and other neuropsychiatric disorders in a child.

D. Screening for vitamin D deficiency during pregnancy:

Many doctors recommend screening for vitamin D during pregnancy, especially in women with risk factors for vitamin D. The level of vitamin D is measured using a blood test that determines the level of 25-hydroxyvitamin D (25 (OH) D), the main form of vitamin D, circulating in the blood.

  1. Recommendations on the level of vitamin D:

    a. Deficiency: Level 25 (OH) D less than 20 ng/ml (50 nmol/l) is considered a deficiency of vitamin D.

    b. Failure: Level 25 (OH) D from 20 to 29 ng/ml (50-72.5 nmol/L) is considered the insufficiency of vitamin D.

    c. Adequacy: Level 25 (OH) D from 30 to 100 ng/ml (75-250 nmol/l) is considered a sufficient level of vitamin D.

E. Reception of vitamin D during pregnancy: dosage and safety:

If a pregnant woman has a deficiency of vitamin D, the doctor may prescribe the intake of vitamin D. The dosage of vitamin D will depend on the degree of deficiency and other factors.

  1. Dosage recommendations:

    a. Prevention: For the prevention of vitamin D deficiency, it is recommended to take 600 IU vitamin D per day.

    b. Treatment Deficit: For the treatment of vitamin D deficiency, a higher dose may be required, for example, 1000-2000 vitamin D per day or even higher, under the supervision of a doctor.

  2. Safety: Vitamin D is generally safe when receiving in recommended doses. However, taking too high doses of vitamin D can lead to hypervitaminosis D, a condition characterized by a high level of calcium in the blood, nausea, vomiting, weakness and damage to the kidneys.

F. The influence of vitamin D on the immunity of pregnant women:

Vitamin D plays an important role in maintaining the immune system of pregnant women, reducing the risk of infections and complications of pregnancy.

  1. Strengthening the immune system: Vitamin D strengthens the immune system, modulating the activity of immune cells and increasing the production of antimicrobial peptides.

  2. Reducing the risk of infections: The adequate level of vitamin D can reduce the risk of respiratory tract infections, ISP and other infections during pregnancy.

  3. Regulation of inflammation: Vitamin D regulates the inflammatory response, which can help prevent the development of preeclampsia and other inflammatory complications of pregnancy.

IV. The role of vitamin D in the prevention of infections during pregnancy: strategies and recommendations

The prevention of infections during pregnancy is crucial for the health of the mother and child. The adequate level of vitamin D is an important part of the strategy for the prevention of infections during pregnancy.

A. Strategies for maintaining the optimal level of vitamin D during pregnancy:

  1. Sunlight: Regular stay in the sun, especially in the summer months, can help maintain an adequate level of vitamin D. However, it is necessary to observe precautions to protect the skin from sunburn.

  2. Diet: Include products rich in vitamin D in your diet, such as oily fish, egg yolks and enriched products.

  3. Food additives: Take food additives with vitamin D if your vitamin D level is low or if you cannot get enough vitamin D from sunlight and food. Consult a doctor to determine the right dosage of vitamin D for you.

B. Recommendations for pregnant women:

  1. Screening: Take a screening for vitamin D during pregnancy, especially if you have risk factors for vitamin D.

  2. Dosage: Take a recommended dose of vitamin D if you have a deficiency of vitamin D.

  3. Healthy lifestyle: Maintain a healthy lifestyle, including a balanced diet, regular physical exercises and sufficient sleep.

  4. Prevention of infections: Take measures for the prevention of infections, such as regular hand washing, avoiding contact with sick people and vaccination against influenza and other infections.

C. Further research:

Further studies are needed to fully understand the role of vitamin D in the prevention of infections during pregnancy and to determine the optimal dosage of vitamin D for pregnant women.

V. Conclusion (this section will be excluded as indicated in the instructions)

VI. Recommendations (this section will be excluded as indicated in the instructions)

VII. References (this section will be excluded as indicated in the instructions)

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