Rickets risk due to lack of vitamin D in pregnant women

The NHS should consider checking pregnant women's vitamin D levels to protect babies from rickets, says an expert.

An article in the Journal of Medical Screening suggests the bone disease is returning because many women are not getting enough vitamin D.

The vitamin comes mainly from sunlight and the article highlights people with dark skin and women who cover up for cultural or religious reasons as the most at risk.

The Department of Health (DH) is reviewing the evidence on vitamin D screening.

The editorial, by Dr James Haddow, a US expert in pre-natal screening, describes cases of seizures, heart failure and rickets in children whose mothers were vitamin D deficient.

He argues it is time to look at screening pregnant women with a blood test, focusing initially on those most at risk. 

The article states: 'Any strategy aimed at avoiding symptomatic vitamin D deficiency in offspring would logically include assuring adequacy of maternal vitamin D during pregnancy.

‘Attending to this aspect of maternal and child health has added significance for mothers who breastfeed.’

A recent study in inner-city Birmingham found that almost one in two Asian women were vitamin D deficient.

The level was one in three in the wider Asian community, one in four in the black population and one in eight among Caucasians.

One of the authors, Dr Jonathan Berg, director of pathology at City Hospital, Birmingham, said some local GPs are already screening pregnant women from the Asian community, although there is no formal protocol.

Screening in selected populations is ‘currently the way forward’, he said.

A consultant paediatrician at Ealing's hospital, Dr Colin Michie, believes the increased use of high-factor sun-cream means a lot of women who are not in at-risk groups are also vitamin D deficient.

He argued that, rather than selected screening, providing free vitamin D supplements for all pregnant women would be the easier option and would save the NHS money.

A spokesman for the DH in England said all pregnant women are advised to take vitamin D supplements.

The spokesman added: ‘Our priority is to ensure health professionals provide consistent advice and implement the current recommendations.’

The department has asked the scientific advisory committee to review the evidence on vitamin D requirements for different population groups.