Vitamin D administration during pregnancy as prevention for pregnancy, neonatal and postnatal complications (original) (raw)
Related papers
Therapeutic advances in musculoskeletal disease, 2016
Low maternal vitamin D levels during pregnancy have been associated with a plethora of adverse neonatal outcomes, including small for gestational age and preterm births, detrimental effect on offspring bone and teeth development, and risk of infectious diseases. Although most observational studies indicate a significant linear relationship between maternal 25-hydroxyvitamin D and the above outcomes, some randomized controlled trials to date are inconclusive, mostly due to differences in study design and supplementation regimen. The currently available results indicate that vitamin D supplementation during pregnancy reduces the risk of preterm birth, low birth weight, dental caries of infancy, and neonatal infectious diseases such as respiratory infections and sepsis. This narrative review aims to summarize available trial results regarding the effect of low maternal vitamin D levels during pregnancy, in conjunction with neonatal outcomes on the field, with a discourse on the appropr...
Maternal–Fetal Impact of Vitamin D Deficiency: A Critical Review
Maternal and Child Health Journal, 2014
Research into the extra-skeletal functions of vitamin D has been expanding in recent years. During pregnancy, maternal vitamin D status may be of concern because of the key role of this vitamin in fetal skeletal development and due to the association between hypovitaminosis D and adverse maternal-fetal outcomes. Therefore, the objective of this manuscript was to review the maternal-fetal impact of gestational vitamin D deficiency and the benefits of vitamin D supplementation during pregnancy. A literature search was performed in PubMed and Embase employing the following keywords: vitamin D deficiency, pregnancy, 25-hydroxyvitamin D, and hypovitaminosis D. All relevant articles in English language published since 1980 were analysed by the two authors. Neonatal complications derived from vitamin D deficiency include low birth weight, growth restriction, and respiratory tract infection. In the mother, vitamin D deficiency has been associated with altered glucose homeostasis and increased incidence of gestational diabetes mellitus, preeclampsia, and bacterial vaginosis. However, the current state of the evidence is controversial for some other endpoints and the actual benefit of vitamin D supplementation in pregnancy remains unclear. Additional longitudinal studies may clarify the actual impact of vitamin D deficiency during pregnancy, and randomised trials are required to define the benefits of vitamin D supplementation in reducing the incidence of adverse outcomes in the mother and infant.
Presumed effects of Vitamin D during pregnancy on maternal and child outcomes
Drug Invention Today, 2019
Aim: Vitamin D has traditionally been viewed as a fundamental hormone in the regulation of phosphorus and calcium and bone metabolism. Recently, the discovery of a new world of extraskeletal and particularly immune modulator effects renewed the interest of research on Vitamin D in this light. Materials and Methods: Vitamin D status appears to be relevant to health at all ages, and even in prenatal life. In fact, maternal Vitamin D levels in pregnancy may have an impact on its course and on the health of the fetus, newborn, and even child in a longer term. Results and Discussion: Since Vitamin D deficiency is commonly observed in pregnant women around the world, there is a growing interest in the definition of Vitamin D health benefits and supplementation during pregnancy. In the present experiment, we are concentrating on Vitamin D during pregnancy on maternal and child Conclusion: In the present experiment, we had determined the role of Vitamin D and it is a role in the growth of the fetus and the child outcomes.
BMJ Open, 2016
Introduction: The vitamin D recommended doses during pregnancy differ between societies. The WHO guidelines do not recommend routine prenatal supplementation, but they underscore the fact that women with the lowest levels may benefit most. The effects of routine supplementation during pregnancy on maternal and neonatal clinical outcomes have not been investigated in the Middle East, where hypovitaminosis D is prevalent. Our hypothesis is that in Middle Eastern pregnant women, a vitamin D dose of 3000 IU/day is required to reach a desirable maternal 25-hydroxyvitamin D [25(OH)D] level, and to positively impact infant bone mineral content (BMC). Methods and analysis: This is a multicentre blinded randomised controlled trial. Pregnant women presenting to the Obstetrics and Gynaecology clinics will be approached. Eligible women will be randomised to daily equivalent doses of cholecalciferol, 600 IU or 3000 IU, from 15 to 18 weeks gestation until delivery. Maternal 25(OH)D and chemistries will be assessed at study entry, during the third trimester and at delivery. Neonatal anthropometric variables and 25(OH)D level will be measured at birth, and bone and fat mass assessment by dual-energy X-ray absorptiometry scan at 1 month. A sample size of 280 pregnant women is needed to demonstrate a statistically significant difference in the proportion of women reaching a 25 (OH)D level ≥50 nmol/L at delivery, and a difference in infant BMC of 6 (10)g, for a 90% power and a 2.5% level of significance. The proportions of women achieving a target 25(OH)D level will be compared between the two arms, using χ 2. An independent t test will be used to compare mean infant BMC between the two arms. The primary analysis is an intention-to-treat analysis of unadjusted results. Ethics and dissemination: The protocol has been approved by the Institutional Review Board at the American University of Beirut-Lebanon (IM.GEHF.22). The trial results will be published in peer-reviewed medical journals and presented at scientific conferences.
Indian Journal of Endocrinology and Metabolism, 2016
Introduction: Pregnant women represent a typical group susceptible to dietary and mineral deficiencies. This study was sought to assess the efficacy and safety of various doses of 25-hydroxyvitamin D (25[OH]D) supplementation during pregnancy and ratify the inadequacy of the recommended daily allowance for Vitamin D in vulnerable groups. Materials and Methods: A total of 100 pregnant women were included in this open-label, parallel group, prospective, randomized, and controlled trial. Study subjects were assigned to four treatment groups: Group 1 (n = 26), 1000 IU of Vitamin D daily; Group 2 (n = 21), 30,000 IU of Vitamin D monthly; Group 3 (n = 27), 2000 IU of Vitamin D daily; and Group 4 (n = 26), 60,000 IU Vitamin D monthly. Group 1 and 2 were further analyzed together as Group 1K (1000 IU daily and 30,000 IU monthly), and Group 3 and 4 as Group 2K (2000 IU daily and 60,000 IU monthly). The analysis was done on an intention to treat basis. Results: A total of 87 patients completed the study; 21 in Group 1, 25 in Group 2, 18 in Group 3, and 23 in Group 4. The levels of 25(OH)D at baseline ranged from 1.3 to 58.0 with a mean of 24.2 ± 15.1 ng/ml. Postsupplementation, 25(OH)D levels ranged from 11.5 to 70.3 with a mean of 40.2 ± 12.2 ng/ml. The postsupplementation levels of 25(OH)D were higher in Group 2K (42.86 ± 12.83) than in Group 1K (36.96 ± 10.56) with P value of 0.023. Conclusion: We concluded that Vitamin D supplementation with 2000 IU/day or 60,000 IU/month is very effective and safe in achieving Vitamin D sufficiency in pregnant women.
Fertility and sterility, 2015
Objective: To assess the effects of vitamin D supplementation during pregnancy on obstetric outcomes and birth variables. Design: Systematic review and meta-analysis of randomized controlled trials (RCTs). Setting: Not applicable. Patient(s): Pregnant women and neonates. Intervention(s): PubMed and 5 other research databases were searched through March 2014 for RCTs evaluating vitamin D supplementation AE calcium/vitamins/ferrous sulfate vs. a control (placebo or active) during pregnancy. Main Outcome Measure(s): Measures were: circulating 25-hydroxyvitamin D [25(OH)D] levels, preeclampsia, gestational diabetes mellitus (GDM), small for gestational age (SGA), low birth weight, preterm birth, birth weight, birth length, cesarean section.
Determinants of vitamin D status in pregnant women and neonates
Canadian journal of public health = Revue canadienne de sante publique, 2016
Evidence suggests a beneficial effect of vitamin D on perinatal health; however, low vitamin D status is prevalent in pregnant women and neonates. The objective was to determine factors that are associated with vitamin D status of mothers in early pregnancy and neonates. The study comprised 1,635 pregnant women from Quebec City and Halifax, Canada, 2002-2010. Vitamin D status was based on the concentration of 25-hydroxy-vitamin D [25(OH)D] determined with a chemiluminescence immunoassay in maternal sera collected at a median of 15 weeks' gestation and in neonatal cord sera at delivery. A questionnaire with information on potential determinants was completed midpregnancy. A total of 44.8% of mothers and 24.4% of neonates had 25(OH)D concentrations <50 nmol/L. Adjusted mean (95% confidence interval) maternal 25(OH)D levels were higher in summer than in winter by 16.1 nmol/L (13.6-18.7), and in those in the highest versus the lowest category of education by 6.1 nmol/L (0.5-11.8)...
Clinical endocrinology, 2015
To determine if maternal vitamin D supplementation, in the vitamin D deficient mother, prevents neonatal vitamin D deficiency. Open Label randomised controlled trial. Metropolitan Melbourne, Australia, tertiary hospital routine antenatal outpatient clinic. Seventy-eight women with singleton pregnancies with vitamin D deficiency/insufficiency (serum 25-OH Vit D less than 75 nmol/l) at their first antenatal appointment at 12 -16 weeks gestation were recruited. Participants were randomised to Vitamin D supplementation (2000-4000 IU cholecalciferol) orally daily until delivery or no supplementation. The primary outcome was neonatal 25-OH Vit D concentration at delivery. The secondary outcome was maternal 25-OH Vit D concentration at delivery. Baseline mean maternal 25-OH Vit D concentrations were similar (p=0.9) between treatment (32 nmol/L, 95% confidence interval 26 - 39nmol/L) and control groups (33nmol/L, 95% CI 26 - 39nmol/L). Umbilical cord 25-OH Vit D concentrations at delivery w...
Current view of vitamin D in pregnant women: a review
NASCER E CRESCER - BIRTH AND GROWTH MEDICAL JOURNAL, 2019
Hypovitaminosis D is a global health problem that affects all age groups. Pregnant women are considered a high-risk group and the condition has potentially associated maternal and fetal complications. The goal of the present review is to analyze the magnitude and consequences of hypovitaminosis D in pregnant women and the safety of vitamin D supplementation. Prevalence of hypovitaminosis D during pregnancy is very high, even in sunny countries. Maternal vitamin D deficiency has been associated with increased risk of specific hypertensive disease of pregnancy, bacterial vaginosis, prematurity, gestational diabetes mellitus, osteomalacia, and muscle weakness. It has also been linked to prematurity, low birth weight, and fetal infectious complications. Due to potential maternal and fetal complications, it is extremely important to achieve adequate vitamin D levels prior to pregnancy. During pregnancy, it would be prudent to monitor serum vitamin D levels and implement preventive measur...
Nutrition and Food Sciences Research, 2018
Background and Objectives: Vitamin D deficiency during pregnancy is prevalent throughout the world and has been associated with complications in mothers and infants. The aim of this study is to evaluate the efficacy of two doses of vitamin D supplementation (1000 IU/d versus 2000 IU/d) during pregnancy on maternal and cord blood vitamin D status, metabolic, inflammatory and oxidative stress biomarkers as well as maternal and neonatal outcomes (birth size and Apgar score). Methods: A total of 84 pregnant women with the eligible criteria are randomly allocated to one of the two supplementation groups: (a) 1000 IU/d vitamin D which is routinely given to pregnant women, and (b) 2000 IU/d. Biochemical assessments of mothers are performed at the beginning and 34 weeks of gestation. They include serum concentrations of 25-hydroxycalciferol (25(OH)D), calcium, phosphate, intact parathyroid hormone (iPTH), fasting serum glucose (FSG), insulin, lipid profile including triglycerides (TG), total cholesterol (TC), low-density lipoproteincholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL_C), as well as high sensitivity C-reactive protein (hs-CRP) and the maternal cell-culture supernatant concentrations of inflammatory cytokines IL-1β, IL-6 and TNF-α. Assessments of infants at delivery comprise cord blood serum concentrations of 25(OH)D, iPTH, hs-CRP, IL-1β, IL-6, TNF-α birth sizes and Apgar score. Discussion: The results obtained from the clinical efficacy trials on the appropriate dose for vitamin D supplementation during pregnancy are controversial. The current study could be a step to attenuate the existent controversy on evaluating the efficacy of two doses of vitamin D supplement on a wide spectrum of both mother and newborn outcomes. Meanwhile our study could give a clue to the policy-makers at MOH by revealing the efficacy of currently prescribed 1000 IU/d vitaminD3 versus 2000 IU/d.