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300,000 IU of Vitamin D is not enough during pregnancy – RCT May 2018

Effectiveness of prenatal vitamin D deficiency screening and treatment program: a stratified randomized field trial

The Journal of Clinical Endocrinology & Metabolism, jc.2018-00109, https://doi.org/10.1210/jc.2018-00109
Maryam Rostami, PhD Fahimeh Ramezani Tehrani, MD Masoumeh Simbar, PhD Razieh Bidhendi Yarandi, MS Sonia Minooee, MS Bruce W Hollis, PhD Farhad Hosseinpanah, MD

VitaminDWiki
  • 8 dosing branches this pregnancy RCT from Iran
  • Many of the branches included 50,000 IU of vitamin D during pregnancy
  • 50,000 IU weekly for 6 weeks or 300,000 IU injection resulted half getting> 20 ng, which other studies have found does not provide much benefit
  • However, all of the supplementation branches greatly reduced miscarriage rate

See also VitaminDWiki

Pregnancy trials getting most women above 40 ng used a total of > 1,300,000 IU (not just 300,000 IU total)
(6,400 IU/day for 30 weeks)
Healthy pregnancies need lots of vitamin D has the following summary

Problem
ReducesEvidence
0. Chance of not conceiving3.4 times Observe
1. Miscarriage 2.5 times Observe
2. Pre-eclampsia 3.6 timesRandomized Controlled Trial
3. Gestational Diabetes 3 times Randomized Controlled Trial
4. Good 2nd trimester sleep quality 3.5 times Observe
5. Premature birth 2 times Randomized Controlled Trial
6. C-section - unplanned 1.6 timesObserve
     Stillbirth - OMEGA-3 4 timesRCT - Omega-3
7. Depression AFTER pregnancy 1.4 times Randomized Controlled Trial
8. Small for Gestational Age 1.6 times meta-analysis
9. Infant height, weight, head size
     within normal limits
Randomized Controlled Trial
10. Childhood Wheezing 1.3 times Randomized Controlled Trial
11. Additional child is Autistic 4 times Intervention
12.Young adult Multiple Sclerosis 1.9 timesObserve
13. Preeclampsia in young adult 3.5 timesRandomized Controlled Trial
14. Good motor skills @ age 31.4 times Observe
15. Childhood Mite allergy 5 times Randomized Controlled Trial
16. Childhood Respiratory Tract visits 2.5 times Randomized Controlled Trial

PDF is available free at Sci-Hub   10.1210/jc.2018-00109

Objective
We aimed at determining the effectiveness of a prenatal screening program on optimizing 25-hydroxyvitamin D(25(OH)D) levels and preventing pregnancy complications. Also, to identify a safe regimen, we compared several regimens in a subgroup of vitamin D deficient pregnant women.

Design: Two cities of Masjed-Soleyman and Shushtar from Khuzestan province, Iran were selected as the screening and non-screening arms, respectively. Within the screening arm, a randomized controlled trial was conducted on 800 pregnant women.

Setting: Health centers of Masjed-Soleyman and Shushtar cities

Patients or Participants: Pregnant women aged 18-40 years

Intervention: Women with moderate(25(OH)D:10-20ng/ml) and severe(25(OH)D<10ng/ml) deficiency were randomly divided into 4 subgroups and received D3 until delivery.

Main Outcome Measure: Maternal concentration of 25(OH)D at delivery and rate of pregnancy complications

Results
After supplementation, only 2% of the women in the non-screening site met the sufficiency level(>20ng/ml), versus 53% of the women in the screening site. Adverse pregnancy outcomes including pre-eclampsia, gestational diabetes mellitus and preterm delivery were decreased by 60,50 and 40% in the screening site. A D3 injection in addition to monthly 50,000IU maintenance therapy contributed the most to achievement of sufficient levels at delivery.

Conclusions
Prenatal vitamin D screening and treatment program is an effective approach in detecting deficient women, improving 25(OH)D levels and decreasing pregnancy adverse outcomes.

Created by admin. Last Modification: Thursday August 23, 2018 00:43:34 GMT-0000 by admin. (Version 4)
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