Page-84 JBUMDC 2020;10(1):84-85 They also plays a significant role in maternal as well as fetal blood glucose regulation. 6 The excess of adipose tissue in overweight and obese individuals causes sequestering of active form of vitamin D and stored it, in an inactive form in the body. 7 Thus and so, it has been noticed among pregnant women whose body mass index (BMI) >30 are at major risk of vitamin D insufficiency due to decrease insulin sensitivity. 8,9 Studies suggest that healthy, non-obese individuals had higher levels of circulating active metabolite of vitamin D as compare to the obese individuals. 10 Dark skin individuals and inadequate exposure to sunlight due to any reason is associated with reduction in the synthesis of cholecalciferol (D3) in skin through UV radiation from sunlight that is considered to be the significant source of vitamin D. 11 It might be the reason of vitamin D deficiency among obese individuals including obese pregnant women as they spend most of their time at home and not exposing themselves to sun. 12 Hence, pregnant woman who is vitamin deficient both due to sunlight exposure and due to insulin sensitivity must concerned their own health as well as their babies. Obese and women with dark pigmented skin or covered skin need to be careful regarding their vitamin D levels and consult to the health practitioner to rule out the cause and treatment if required. Public Health Concern: Being the public health issue, pregnancy related metabolic disorders and deregulations becoming challenge not only for the mother and its baby but also influence and burdened the entire family. Efficient and effective strategic interventions such as public awareness and professional educational programs at mass level regarding benefits of sun exposure at prescribed phase, physical activities, healthy and nutritional diet work as a helping hand and ultimately reduce the overall economic, social, emotional and health related burden. 13 In addition, family counselling also play a vital role to deal with the lethal scenario and to prevent the prenatal, intranatal and post natal life threatening conditions in mothers and adverse health consequences in the newborns. 14 Despite the recommendation in many documents of National Health Service guidance regarding the prevention and management of Prepregnancy condition such as obesity and diabetes but, unfortunately, there is limited provision so far for such service. Health promotion techniques helps to gain insight to improve general health and able to persuade them to adopt healthy lifestyle. Further, weight loss guidance prior to conceive the child would help to control the pregnancy related problems and able to cope the possible complications. Screening for the vitamin D status in child bearing age especially among the obese women who are planning to INTRODUCTION: Vitamin D and its active metabolite 1,25 - dihydrooxyvitamin D (1,25(OH) 2D) has been generally recognized as repertoire of many classical (calcium balance and bone metabolism) and non-classical effects (non-calcium actions) such as promotion of insulin secretion and its action, immunomodulation. Absorption of calcium and phosphorus depends on sufficient vitamin D levels. Its low level leads to demineralization of bone both in children and adults. Vitamin D has also a significant role and has potential to influence many factors in the developing fetus. Newborns are at high risk of developing hypocalcaemic tetany as a consequence of maternal deficiency of vitamin D. Pregnancy, Obesity and Vitamin D: Insufficiency of Vitamin D is an emerging public health concern across the globe especially among the women during their reproductive phases of life. Obesity in the reproductive phase of women’s life is another notable risk factor for vitamin D insufficiency that increases the risk of maternal and fetal complications. 1 The time after conceiving is crucial for women as they are more susceptible to vitamin D deficiency, as they sustain their own vitamin D reservoirs along with their babies. 2 Moreover, More than 14 million women suffer from maternal complication every year, especially in developing countries. 3 Maternal vitamin D levels directly linked to the fetal vitamin D levels and its insufficient level is a major cause of low gestational fetal weight, neonatal hypocalcaemia, reduced weight and size infant and juvenile rickets. 4,5 Prepregnancy obesity related adverse outcomes such as miscarriage, preeclampsia and gestational diabetes and its associated fetal overgrowth are mediated by the deficiency of active metabolite of vitamin D which has a significant role in the development and function of placenta, inflammation, angiogenesis, immunomodulation and insulin sensitivity. 2 The development and right progression of fetus and placenta depends on vitamin D receptors and an activating enzyme (1-a-hydroxylase) in placenta which acts as a modulators. Pre-Pregnancy Obesity: A friend or foe for Vitamin D Fareeha Shahid, Farhan Muhammad Qureshi Commentary DOI: https://doi.org/10.51985/JBUMDC2019136 Fareeha Shahid Assistant Professor Department of Community Health Sciences Bahria University Medical & Dental College Email: drfareeha@live.com Farhan Muhammad Qureshi Assistant Professor, Department of Community Health Sciences Karachi Institute of Medical Sciences Received: 16-12-2019 Accepted: 22-12-2019