Rickets was a global problem in the early 20th century. The main risk factor for vitamin-D deficiency in neonates is maternal vitamin-D deficiency. Vitamin-D status in the fetus and newborn infant is largely determined by maternal vitamin-D status. During pregnancy it crosses the placenta through passive or facilitated transport according to a concentration gradient. It is the best estimator of human body vitamin D stores. Serum 25-hydroxycholecalciferol (25D) is the main circulating metabolite of vitamin D with a reported half-life of approximately three weeks.

Vitamin-D deficiency in neonates has been linked to higher risk of respiratory distress syndrome, lower respiratory infections, food sensitivities, asthma, type I diabetes, autism and schizophrenia.

Vitamin D deficiency is a worldwide health issue that affects more than one billion children and adults globally. Vitamin-D is not only an essential element in bone health, but it is also a pro-hormone that plays a well-recognized role in other organs of body. It is a prohormone that can be ingested or derived from body sterols by the photolytic activity of ultraviolet rays on human skin. The chapter also describes evidence-based recommendations to prevent vitamin D deficiency in these vulnerable population. The chapter will review the prevalence of vitamin D deficiency in pregnant women and newborn population and its adverse effects on pregnancy and infant’s health. Vitamin D deficiency is prevalent in both developed and developing countries. Surprisingly, rickets is re-emerging per recent evidence. It has nearly disappeared in developed countries after its causal pathway was understood and fortification of milk with the hormone vitamin D was introduced at the population level. Rickets was a global disease in the early twentieth century. Rickets in children is caused by severe, chronic vitamin D deficiency with apparent skeletal abnormalities, but neonates with vitamin D insufficiency have no overt skeletal or calcium metabolism defects. Low maternal vitamin D status during pregnancy is a major risk factor for rickets in infants. Vitamin D status in newborns is entirely dependent on maternal supply during pregnancy. Vitamin D deficiency limits the effective absorption of dietary calcium and phosphorus. Deficiency of vitamin D is the most common cause of rickets and is also known to increase the risk of respiratory distress syndrome, lower respiratory infections, food sensitivities, asthma, type I diabetes, autism and schizophrenia. Vitamin-D is not only an essential element in bone health, but it is also a pro-hormone.

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