Neonatal Hypocalcaemic Seizures Secondary to Maternal Vitamin D Deficiency: A Narrative Review

Abstract

Seizures in the first weeks of life have many causes, and low blood calcium is one that can be corrected quickly once it is recognised. When the mother was severely short of vitamin D during pregnancy, her infant may be born with small vitamin D stores and may become hypocalcaemic after birth, sometimes presenting with jitteriness, seizures or, less often, cardiac failure. This narrative review sets out what the published literature says about that chain of events. It covers the physiology of calcium supply before and after birth, the reasons maternal deficiency arises, the clinical picture and differential diagnosis, and the evidence for prevention through supplementation in pregnancy. It reports no patient data and no new measurements. The literature shows a plausible and well-described mechanism, but most direct evidence comes from case reports, small series and surveillance studies, and several features complicate causal interpretation: the fetus is protected from mild maternal deficiency, other causes of neonatal hypocalcaemia can coexist, and laboratory assays and diagnostic thresholds differ. Trials of supplementation in pregnancy support higher maternal vitamin D status, yet their effect on neonatal calcium outcomes is less clearly established than their effect on blood levels. The review closes with the gaps that matter most for future work.