Prenatal vitamin D supplementation and infant vitamin D status in Bangladesh.
Public Health Nutr. 2015 Nov 6:1-9. [Epub ahead of print]
Perumal N 1, Al Mahmud A 2, Baqui AH 2, Roth DE 1.
1 Centre for Global Child Health,The Hospital for Sick Children,686 Bay Street,Toronto,ON,Canada,M5G 0A4.
2 Centre for Child and Adolescent Health,International Centre for Diarrhoeal Disease Research,Bangladesh (icddr,b),Mohakhali,Dhaka,Bangladesh.
During pregnancy 35,000 IU weekly (5,000 IU daily average)
| Infant age | Vitamin D ng | Placebo ng | |||
| < 1 month | 32 | 9 | |||
| 2 months | 21 | 16 | |||
| 6 months | ~31 | ~31 | Formula and breast fed | ||
See also VitaminDWiki
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 |
Healthy pregnancies need lots of vitamin D has the following summary
Most were taking 2,000 to 7,000 IU daily for >50% of pregnancy
Click on hyperlinks for details
Problem | Vit. D Reduces | Evidence | |||
| 0. Chance of not conceiving | 3.4 times | Observe | |||
| 1. Miscarriage | 2.5 times | Observe | |||
| 2. Pre-eclampsia | 3.6 times | RCT | |||
| 3. Gestational Diabetes | 3 times | RCT | |||
| 4. Good 2nd trimester sleep quality | 3.5 times | Observe | |||
| 5. Premature birth | 2 times | RCT | |||
| 6. C-section - unplanned | 1.6 times | Observe | |||
| Stillbirth - OMEGA-3 | 4 times | RCT - Omega-3 | |||
| 7. Depression AFTER pregnancy | 1.4 times | RCT | |||
| 8. Small for Gestational Age | 1.6 times | meta-analysis | |||
| 9. Infant height, weight, head size within normal limits | RCT | ||||
| 10. Childhood Wheezing | 1.3 times | RCT | |||
| 11. Additional child is Autistic | 4 times | Intervention | |||
| 12.Young adult Multiple Sclerosis | 1.9 times | Observe | |||
| 13. Preeclampsia in young adult | 3.5 times | RCT | |||
| 14. Good motor skills @ age 3 | 1.4 times | Observe | |||
| 15. Childhood Mite allergy | 5 times | RCT | |||
| 16. Childhood Respiratory Tract visits | 2.5 times | RCT | |||
RCT = Randomized Controlled Trial
See also Web
OBJECTIVE:
To determine the effect of prenatal maternal vitamin D supplementation on infant vitamin D status in a tropical region where vitamin D supplementation is not routine.
DESIGN:
A prospective observational follow-up of a randomized trial.
SETTING:
Maternal-child health facility in Dhaka, Bangladesh (23°N).
SUBJECTS:
Infants born to pregnant women (n 160) randomized to receive 875 µg (35 000 IU) cholecalciferol (vitamin D3) per week (VD) or placebo (PL) during the third trimester were followed from birth until 6 months of age (n 115). Infant serum 25-hydroxyvitamin D concentration (25(OH)D) was measured at <1, 2, 4 and 6 months of age.
RESULTS:
Mean infant 25(OH)D was higher in the VD v. PL group at <1 month of age (mean (sd): 80 (20) nmol/l v. 22 (18) nmol/l; P<0·001), but the difference was attenuated by 2 months (52 (19) nmol/l v. 40 (23) nmol/l; P=0·05). Groups were similar at 4 months (P=0·40) and 6 months (n 72; P=0·26). In the PL group, mean infant 25(OH)D increased to 78 (95 % CI 67, 88) nmol/l by 6 months of age (n 34). 25(OH)D was higher with infant formula-feeding and higher in summer v. winter.
CONCLUSIONS:
Prenatal third-trimester vitamin D supplementation (875 µg (35 000 IU)/week) significantly ameliorated infant vitamin D status during the neonatal period when the risk of vitamin D deficiency is greatest. Further research is warranted to determine factors that contribute to the rise in 25(OH)D during the first 6 months of life among breast-fed infants in this setting.
PMID: 26541060