Supplementation of vitamin D in pregnancy and its correlation with feto-maternal outcome.
Clin Endocrinol (Oxf). 2015 Feb 14. doi: 10.1111/cen.12751. [Epub ahead of print]
Sablok A1 aanchalsablok54 at gmail.com, Batra A, Thariani K, Batra A, Bharti R, Aggarwal AR, Kabi BC, Chellani H.
1Department of Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
| (A) | 60,000 IU Vitamin D (B) | ||||
| Women | 60 | 120 | |||
| Vitamin D Level mother | 18 ng | 32 ng | |||
| Cord blood level | 17 ng | 23 ng | |||
| Birthweight | 2,4 kg | 2.6 kg | |||
| preterm labour or pre-eclampsia or gestational diabetes. | 44% | 22% | |||
CONTEXT: Vitamin D deficiency is widely prevalent throughout the world. Pregnant women, neonates and infants form most vulnerable groups for vitamin D deficiency.
OBJECTIVE: (1) To find prevalence of vitamin D deficiency in pregnant women. (2) To evaluate the effect of supplementation with cholecalciferol in improving vitamin D levels in pregnant women and evaluate its correlation with feto-maternal outcome.
DESIGN: Randomized control trial from years 2010 to 2012.
SETTING: Tertiary care centre, Delhi, India.
PARTICIPANTS: One-hundred and eighty pregnant women. Study population divided randomly into two groups: group A: nonintervention (60 women) and group B: intervention (120 women).
INTERVENTION: The intervention group received supplementation of vitamin D in dosages depending upon 25(OH)-D levels.
MAIN OUTCOME MEASURES: Risk of maternal complications such as preterm labour, pre-eclampsia and gestational diabetes associated with vitamin D deficiency and risk of low birthweight and poor Apgar score in infants of mothers with vitamin D deficiency.
RESULTS: Adjusted serum 25(OH)-D concentration was lower in group A as compared to group B (mean 46·11 ± 74·21 nmol/l vs 80 ± 51·53 nmol/l). Forty-four percent patients in group A and 20·3% patients in group B developed preterm labour/pre-eclampsia/gestational diabetes. Newborns of mothers in group A had lower cord blood levels of 25(OH)-D levels as compared to group B (mean 43·11 ± 81·32 nmol/l vs 56·8 ± 47·52 nmol/l). They also had lower birthweight of mean 2·4 ± 0·38 kg as compared to group B 2·6 ± 0·33 kg.
CONCLUSIONS: Vitamin D supplementation reduces risk of maternal comorbidities and helps improve neonatal outcomes.
PMID 25683660
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RCT: Are vitamin D levels associated with pregnancy outcomes? Report on study at Vitamin D Council
Given large doses of vitamin D ( not daily) depending on deficiency level
Sufficient (> 20 ng) 60,000 IU vitamin D at 20 weeks - not much left after 19 weeks!!
Insufficient: 120,000 IU at 20 and 24 weeks
Deficient:120,000 IU of vitamin D at 20, 24, 28, and 32 weeks.(about only half had > 20 ng at birth)
| Vitamin D | None | ||||
| Complications | 20% | 44% | |||
| Small for gestational age | 8% | 19% | |||
| Pre-eclampsia | 11% | 21% (p = 0.08). | |||
See also VitaminDWiki
The articles in Pregnancy AND Intervention are here:
- 3X reduction in preemie Bronchopulmonary Dysplasia if add tiny amount of Vitamin D – meta-analysis June 2024
- 4,000 IU of daily Vitamin D during pregnancy is good (Mongolia this time) – RCT Oct 2023
- Resulting childhood Asthma cut in half if 4,400 IU Vitamin D daily while pregnant - RCT April 2023
- 6,400 IU of Vitamin D is safe and effective during breastfeeding – RCT Dec, 2020
- Vitamin D during pregnancy – single 200,000 IU similar to daily 5,000 IU – April 2020
- Massive improvement in vaginal microbiome during pregnancy with Vitamin D – March 2019
- Autism risk reduced 2X by prenatal vitamins (Vitamin D or Folic) – Feb 2019
- Fetal bones helped a bit by 1,000 IU of vitamin D – RCT Feb 2019
- Adding 1,000 IU vitamin D while pregnant did not help much (no surprise) – RCT Jan 2019
- Pregnancies helped a lot by Vitamin D (injection then 50,000 IU monthly) – RCT May 2018
- 430 genes changed when 3,800 IU Vitamin D added in late second trimester – RCT May 2018
- 300,000 IU of Vitamin D is not enough during pregnancy – RCT May 2018
- Preeclampsia risk reduced 7X by 4,000 IU of Vitamin D daily – RCT March 2018
- Risk of infant Asthma cut in half if mother supplemented Vitamin D to get more than 30 ng – RCT Oct 2017
- Gestational diabetes 30 percent less likely if consumed more than 400 IU of vitamin D daily – Oct 2017
- Monthly 120,000 IU Vitamin D plus daily Calcium was great during pregnancies – RCT Sept 2017
- Preterm birth rate reduced by vitamin D – 78 percent if non-white, 39 percent if white – July 2017
- 1,000 IU of Vitamin D while pregnant helped a little bit (4,000 IU helps a lot) – RCT Dec 2016
- Preeclampsia recurrence reduced 2 X by 50,000 IU of vitamin D every two weeks – RCT July 2017
- Only a select group of women will get a modest benefit from 800 IU of vitamin D – Jan 2017
- Reduction of infant asthma may require good vitamin D when lung development starts (4 weeks) – March 2017
- Gestational diabetes treated by Vitamin D plus Omega-3 – RCT Feb 2017
- 3,800 IU Vitamin D during pregnancy did not help much – RCT Jan 2017
- 50,000 IU of vitamin D for 8 weeks of pregnancy raised most above 30 nanograms - RCT Jan 2017
- Gestational Diabetes reduce 3 times by 5,000 IU of Vitamin D – RCT Jan 2016
- Preeclampsia risk reduced by higher levels of vitamin D (VDAART 4,400 IU) - RCT Nov 2016
- Gestational Diabetes treated with 50,000 IU every two weeks – RCT Sept 2016
- Perinatal depression decreased 40 percent with just a few weeks of 2,000 IU of vitamin D – RCT Aug 2016
- Pregnancy – adding 35,000 IU Vitamin D weekly was nice, but not enough – RCT April 2016
- Vitamin D once during pregnancy reduced infant health care costs (300 times ROI) – RCT Dec 2015
- Autism rate in siblings reduced 4X by vitamin D: 5,000 IU during pregnancy, 1,000 IU to infants – Feb 2016
- Preterm birth rate reduced 57 percent by Vitamin D – Nov 2015
- Pregnancy supplemented with 2,000 IU vitamin D got most infants to more than 12 nanograms – Aug 2015
- Preeclampsia reduced by Vitamin D (50,000 IU bi-weekly) and Calcium – Oct 2015
- Clinical trials for pregnancy with Vitamin D intervention – 51 as of Sept 2015
- No multiple sclerosis relapses during pregnancy if 50,000 IU of Vitamin D weekly – RCT April 2015
- Wheezing reduced 35 percent if vitamin D added during pregnancy – April 2015
- 4,000 IU raised vitamin D levels during pregnancy – July 2014
- Pregnant mothers in Quatar needed more than weekly 50,000 IU Vitamin D – Nov 2013
- Gestational diabetes – Vitamin D and Calcium provided huge benefits – RCT March 2015
- Pregnancy helped by single dose of 60,000 IU of Vitamin D – RCT March 2015
- Gestational diabetes reduced by just two 50,000 IU doses of vitamin D – RCT Nov 2014
- Improved births with 2,000 IU vitamin D during pregnancy in India - RCT Feb 2015
- 50,000 IU of Vitamin D every 2 weeks reduced gestational diabetes – RCT Feb 2015
- Infant much healthier if Gestational Diabetic mother got 2 doses of vitamin D – RCT Nov 2014
- 2000 IU vitamin D during pregnancy and 800 IU to infant resulted in less use of antibiotics – RCT April 2014
- Gestational Diabetes reduced with 50,000 IU of vitamin D every 3 weeks and daily Calcium – RCT June 2014
- Gestational Diabetes reduced 40 percent by 5,000 IU of vitamin D – RCT April 2014
- 5,000 IU Vitamin D was not enough to reduce preeclampsia but did help future infant – RCT April 2014
- Breast milk resulted in 20 ng of vitamin D for infant if mother had taken 5,000 IU daily – RCT Dec 2013
- 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 |