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[13] Physiological vitamin D sufficiency is vital for placental function, foetal bone accretion, and maternal skeletal health, yet professional bodies caution against parenteral megadose therapy during uncomplicated gestation, preferring daily or weekly oral regimens that allow tighter titration and minimise abrupt calcium flux

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ATP depletion secondary to mitochondrial dysfunction further limits PMCA turnover, establishing a reciprocal cycle in which impaired extrusion promotes mitochondrial Ca 2+ overload, which in turn worsens energetic insufficiency and ROS production (Millington-Burgess and Harper, 2021)