Abstract
Profound changes in calcium metabolism occur during pregnancy. The mother has to make available extra calcium for fetal requirements while ensuring that her plasma and bone calcium concentrations are satisfactorily maintained. In a cross-sectional study plasma concentrations of the major calcium-regulating hormones--namely, calcitonin, parathyroid hormone, 25-hydroxyvitamin D (25-OHD), and 1,25-dihydroxyvitamin D (1,25-(OH)2D)--were measured to establish their interrelations during normal pregnancy. The major changes observed were increases in the circulating concentrations of 1,25-(OH)2D and calcitonin. Concentrations of parathyroid hormone and 25-OHD remained within the normal range. The increased concentrations of 1,25-(OH)2D enable the increased physiological need for calcium to be met by enhancing intestinal absorption of this element. The simultaneous rise in calcitonin opposes the bone-resorbing activities of 1,25-(OH)2D, thereby protecting the integrity of the maternal skeleton. Maternal calcium homeostasis is thus maintained yet the requirements of the fetus are fulfilled.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bouillon R., de Moor P. Pathophysiological data obtained with a radioimmunoassay for human parathyroid hormone. Ann Endocrinol (Paris) 1973 Nov-Dec;34(6):657–668. [PubMed] [Google Scholar]
- Brodie M. J., Boobis A. R., Dollery C. T., Hillyard C. J., Brown D. J., MacIntyre I., Park B. K. Rifampicin and vitamin D metabolism. Clin Pharmacol Ther. 1980 Jun;27(6):810–814. doi: 10.1038/clpt.1980.115. [DOI] [PubMed] [Google Scholar]
- Brown D. J., Spanos E., MacIntyre I. Role of pituitary hormones in regulating renal vitamin D metabolism in man. Br Med J. 1980 Feb 2;280(6210):277–278. doi: 10.1136/bmj.280.6210.277. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cushard W. G., Jr, Creditor M. A., Canterbury J. M., Reiss E. Physiologic hyperparathyroidism in pregnancy. J Clin Endocrinol Metab. 1972 May;34(5):767–771. doi: 10.1210/jcem-34-5-767. [DOI] [PubMed] [Google Scholar]
- Drake T. S., Kaplan R. A., Lewis T. A. The physiologic hyperparathyroidism of pregnancy. Is it primary or secondary? Obstet Gynecol. 1979 Jun;53(6):746–749. [PubMed] [Google Scholar]
- Eisman J. A., Hamstra A. J., Kream B. E., DeLuca H. F. A sensitive, precise, and convenient method for determination of 1,25-dihydroxyvitamin D in human plasma. Arch Biochem Biophys. 1976 Sep;176(1):235–243. doi: 10.1016/0003-9861(76)90161-2. [DOI] [PubMed] [Google Scholar]
- Heaney R. P., Skillman T. G. Calcium metabolism in normal human pregnancy. J Clin Endocrinol Metab. 1971 Oct;33(4):661–670. doi: 10.1210/jcem-33-4-661. [DOI] [PubMed] [Google Scholar]
- Hillman L. S., Slatopolsky E., Haddad J. G. Perinatal vitamin D metabolism. IV. Maternal and cord serum 24,25-dihydroxyvitamin D concentrations. J Clin Endocrinol Metab. 1978 Nov;47(5):1073–1077. doi: 10.1210/jcem-47-5-1073. [DOI] [PubMed] [Google Scholar]
- Hillyard C. J., Cooke T. J., Coombes R. C., Evans I. M., Macintyre I. Normal plasma calcitonin: circadian variation and response to stimuli. Clin Endocrinol (Oxf) 1977 Apr;6(4):291–298. doi: 10.1111/j.1365-2265.1977.tb02014.x. [DOI] [PubMed] [Google Scholar]
- Hillyard C. J., Stevenson J. C., MacIntyre I. Relative deficiency of plasma-calcitonin in normal women. Lancet. 1978 May 6;1(8071):961–962. doi: 10.1016/s0140-6736(78)90249-0. [DOI] [PubMed] [Google Scholar]
- Kovarik J., Woloszczuk W., Linkesch W., Pavelka R. Calcitonin in pregnancy. Lancet. 1980 Jan 26;1(8161):199–200. doi: 10.1016/s0140-6736(80)90680-7. [DOI] [PubMed] [Google Scholar]
- Kumar R., Cohen W. R., Silva P., Epstein F. H. Elevated 1,25-dihydroxyvitamin D plasma levels in normal human pregnancy and lactation. J Clin Invest. 1979 Feb;63(2):342–344. doi: 10.1172/JCI109308. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lund B., Selnes A. Plasma 1,25-dihydroxyvitamin D levels in pregnancy and lactation. Acta Endocrinol (Copenh) 1979 Oct;92(2):330–335. doi: 10.1530/acta.0.0920330. [DOI] [PubMed] [Google Scholar]
- Nilsson B. E. Parity and osteoporosis. Surg Gynecol Obstet. 1969 Jul;129(1):27–28. [PubMed] [Google Scholar]
- Pitkin R. M., Reynolds W. A., Williams G. A., Hargis G. K. Calcium metabolism in normal pregnancy: a longitudinal study. Am J Obstet Gynecol. 1979 Apr 1;133(7):781–790. doi: 10.1016/0002-9378(79)90115-7. [DOI] [PubMed] [Google Scholar]
- Raisz L. G., Canalis E. M., Dietrich J. W., Kream B. E., Gworek S. C. Hormonal regulation of bone formation. Recent Prog Horm Res. 1978;34:335–356. doi: 10.1016/b978-0-12-571134-0.50013-2. [DOI] [PubMed] [Google Scholar]
- Reitz R. E., Daane T. A., Woods J. R., Weinstein R. L. Calcium, magnesium, phosphorus, and parathyroid hormone interrelationships in pregnancy and newborn infants. Obstet Gynecol. 1977 Dec;50(6):701–705. [PubMed] [Google Scholar]
- Samaan N. A., Anderson G. D., Adam-Mayne M. E. Immunoreactive calcitonin in the mother, neonate, child and adult. Am J Obstet Gynecol. 1975 Mar 1;121(5):622–625. doi: 10.1016/0002-9378(75)90462-7. [DOI] [PubMed] [Google Scholar]
- Shenolikar I. S. Absorption of dietary calcium in pregnancy. Am J Clin Nutr. 1970 Jan;23(1):63–67. doi: 10.1093/ajcn/23.1.63. [DOI] [PubMed] [Google Scholar]
- Spanos E., Brown D. J., Stevenson J. C., MacIntyre I. Stimulation of 1,25-dihydroxycholecalciferol production by prolactin and related peptides in intact renal cell preparations in vitro. Biochim Biophys Acta. 1981 Jan 7;672(1):7–15. doi: 10.1016/0304-4165(81)90273-7. [DOI] [PubMed] [Google Scholar]
- Steichen J. J., Tsang R. C., Gratton T. L., Hamstra A., DeLuca H. F. Vitamin D homeostasis in the perinatal period: 1,25-dihydroxyvitamin D in maternal, cord, and neonatal blood. N Engl J Med. 1980 Feb 7;302(6):315–319. doi: 10.1056/NEJM198002073020603. [DOI] [PubMed] [Google Scholar]
- Stevenson J. C., Hillyard C. J., MacIntyre I., Cooper H., Whitehead M. I. A physiological role for calcitonin: protection of the maternal skeleton. Lancet. 1979 Oct 13;2(8146):769–770. doi: 10.1016/s0140-6736(79)92117-2. [DOI] [PubMed] [Google Scholar]
- Wieland P., Fischer J. A., Trechsel U., Roth H. R., Vetter K., Schneider H., Huch A. Perinatal parathyroid hormone, vitamin D metabolites, and calcitonin in man. Am J Physiol. 1980 Nov;239(5):E385–E390. doi: 10.1152/ajpendo.1980.239.5.E385. [DOI] [PubMed] [Google Scholar]
- Wilmana P. F., Brodie M. J., Mucklow J. C., Fraser H. S., Toverud E. L., Davies D. S., Dollery C. T., Hillyard C. J., Macintyre I., Park B. K. Reduction of circulating 25-hydroxyvitamin D by antipyrine. Br J Clin Pharmacol. 1979 Dec;8(6):523–528. doi: 10.1111/j.1365-2125.1979.tb01039.x. [DOI] [PMC free article] [PubMed] [Google Scholar]