Calcium Plus Vitamin D Supplementation During the Third Trimester of Pregnancy in Adolescents Accustomed to Low Calcium Diets Does Not Affect Infant Bone Mass at Early Lactation in a Randomized Controlled Trial.
J Nutr. 2015 Jul;145(7):1515-23. doi: 10.3945/jn.114.208140. Epub 2015 May 27.
Diogenes ME1, Bezerra FF2, Rezende EP2, Donangelo CM3.
BACKGROUND:
Pregnancy and lactation in adolescents with low calcium intake may impair fetal growth and infant bone mass.
OBJECTIVE:
We investigated the effects of calcium plus vitamin D supplementation during pregnancy in Brazilian adolescent mothers consuming low calcium diets (∼600 mg/d) on fetal biometry and infant bone mass, and the relation between infant and maternal bone mass during early lactation.
METHODS:
Infants of mothers who received calcium (600 mg/d) plus cholecalciferol (200 IU/d) supplementation (n = 30) or placebo (n = 26) from 26 wk of gestation until parturition were studied. Fetal biometric measurements at 23 and 36 wk of gestation were obtained from medical records. Infant anthropometric and total body bone measurements bone mineral content (BMC), bone area (BA), and bone mineral density (BMD) at 5 wk postpartum were assessed by dual-energy X-ray absorptiometry. Maternal BMD z scores for total body, lumbar spine, total hip, and femoral neck at 5 wk postpartum were obtained. Group comparisons were adjusted for significant covariates.
RESULTS:
Maternal mean serum 25-hydroxyvitamin D was 59 nmol/L at baseline in both groups. No differences in fetal measurements at 36 wk of gestation were observed between the groups, except for body weight and its increment from 23 to 36 wk, which were higher in the supplemented group (6.8%, P = 0.014 and 10.5%, P = 0.07, respectively). Infant BMC (61.1 ± 21.7 g), BA (167 ± 79 cm(2)), and BMD (0.385 ± 0.069 g/cm(2)) did not significantly differ between the groups. In the placebo group, infant BMC and BA were negatively correlated with maternal BMD z scores for total body (r = -0.40 and r = -0.47; P < 0.05) and hip (r = -0.41 and r = -0.46; P < 0.05). In contrast, no correlations were observed in the supplemented group.
CONCLUSIONS:
Calcium and vitamin D supplementation of the adolescents studied resulted in higher fetal body weight at 36 wk of gestation and had no effect on infant bone mass at 5 wk postpartum. Because correlations between maternal and infant bone mass were evident only in the placebo group, infant bone mass appeared to be more dependent on maternal skeletal mass when calcium intake was low. This trial was registered at clinicaltrials.gov as NCT01732328.
PMID: 26019245
Most countries have known for decades that 400 IU is the very bare minimum dose of vitamin D which makes any difference at all
Overview Pregnancy and vitamin D has the following summary
| IU | Cumulative Benefit | Blood level | Cofactors | Calcium | $*/month |
| 200 | Better bones for mom with 600 mg of Calcium | 6 ng/ml increase | Not needed | No effect | $0.10 |
| 400 | Less Rickets (but not zero with 400 IU) 3X less adolescent Schizophrenia Fewer child seizures | 20-30 ng/ml | Not needed | No effect | $0.20 |
| 2000 | 2X More likely to get pregnant naturally/IVF 2X Fewer dental problems with pregnancy 8X less diabetes 4X fewer C-sections (>37 ng) 4X less preeclampsia (40 ng vs 10 ng) 5X less child asthma 2X fewer language problems age 5 | 42 ng/ml | Desirable | < 750 mg | $1 |
| 4000 | 2X fewer pregnancy complications 2X fewer pre-term births | 49 ng/ml | Should have cofactors | < 750 mg | $3 |
| 6000 | Probable: larger benefits for above items Just enough D for breastfed infant More maternal and infant weight | Should have cofactors | < 750 mg | $4 |