Multifetal Pregnancy May Increase the Risk for Severe Maternal and Neonatal Vitamin D Deficiency

Benjamin U. Nwosu, University of Massachusetts Medical School
Leslie A. Soyka, University of Massachusetts Medical School
Amanda Angelescu, University of Massachusetts Medical School
Olga T. Hardy, University of Massachusetts Medical School
Mary M. Lee, University of Massachusetts Medical School

Abstract

Vitamin D deficiency is prevalent in pregnant women. This deficiency could be exaggerated in multifetal pregnancies by the increased demand on maternal stores of vitamin D. We present 2 cases in which hypocalcemia and secondary hyperparathyroidism occurred in 2 sets of twins from mothers with vitamin D deficiency. The first mother had gastric bypass surgery and Crohn disease. The second mother had no apparent cause of vitamin D deficiency. Both women had iron deficiency anemia and lived in Northeastern United States. We speculate that in twins, the demand for 25-hydroxyvitamin D by 2 fetuses could deplete the 25-hydroxyvitamin D stores in a mother.