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4,000 IU Vitamin D daily during pregnancy (Mongolia) was good – RCT Dec 2018

Randomized trial of three doses of vitamin D to reduce deficiency in pregnant Mongolian women

EBioMed - Lancet - DOI: https://doi.org/10.1016/j.ebiom.2018.11.060
D. Enkhmaa, L. Tanz, D. Ganmaa, Sh. Enkhtur, B. Oyun-Erdene, J. Stuart, G. Chen, A. Carr, E.W. Seely, G. Fitzmaurice, Yo. Buyandelger, B. Sarantsetseg, G. Gantsetseg, J. Rich-Edwards

VitaminDWiki

88% of the women got >80% of the vitamin D
Many other studies have found far higher compliance
  with weekly or bi-weekly doses instead of daily
Note: Very low levels to start with: 91% < 20 ng

 

4,000 IU of Vitamin D is OK - 19 organizations agree - 2018


Pregnancy category starts with

777 items in Pregnancy category

 - see also

The trial on this page started a Vitamin D maintenance dose at 12-16 weeks.
Far far better to fully restore the Vitamin D at 2 weeks,
or start maintenace dose before conception


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 timesRCT
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 timesObserve
     Stillbirth - OMEGA-3 4 timesRCT - 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 timesObserve
13. Preeclampsia in young adult 3.5 timesRCT
14. Good motor skills @ age 31.4 times Observe
15. Childhood Mite allergy 5 times RCT
16. Childhood Respiratory Tract visits 2.5 times RCT

RCT = Randomized Controlled Trial

 Download the PDF from VitaminDWiki
Mothers
Image

Umbilical Cord
Image

Background: In winter in Mongolia, 80% of adults have 25-hydroxyvitamin D (25(OH)D) concentrations <25 nmol/l (<10 ng/ml) and 99% have <50 nmol/l (<20 ng/ml). The vitamin D dose to avert deficiency during pregnancy in this population is unknown.

Methods
We conducted a randomized, controlled, double-blind trial of daily 600, 2000, or 4000 IU vitamin D3 for pregnant women in Mongolia (Clinicaltrials.gov #NCT02395081). We examined 25(OH)D concentrations at baseline (12–16 weeks' gestation), 36–40 weeks' gestation and in umbilical cord blood, using enzyme linked fluorescent assay. Sample size was determined to detect 0.4 standard deviation differences in 25(OH)D concentrations with 80% power.

Findings
119 pregnant women were assigned 600 IU, 121 assigned 2000 IU and 120 assigned 4000 IU from February 2015 through December 2016. Eighty-eight percent of participants took ≥80% of assigned supplements. At baseline, 25(OH)D concentrations were similar across arms; overall mean ± standard deviation concentration was 19 ± 22 nmol/l; 91% were < 50 nmol/l.
At 36–40 weeks, 25(OH)D concentrations increased to 46 ± 21, 70 ± 23, and 81 ± 29 nmol/l for women assigned 600, 2000, and 4000 IU, respectively (p < 0.0001 across arms; p = 0.002 for 2000 vs. 4000 IU). Mean umbilical cord 25(OH)D concentrations differed by study arm (p < 0.0001 across arms; p < 0.0001 for 2000 vs. 4000 IU) and were proportional to maternal concentrations. There were no adverse events, including hypercalcemia, attributable to vitamin D supplementation.

Interpretation
Daily supplementation of 4000 IU during pregnancy is safe and achieved higher maternal and neonatal 25(OH)D concentrations than 2000 IU. Daily 600 IU supplements are insufficient to prevent vitamin D deficiency in Mongolia.


Created by admin. Last Modification: Wednesday October 23, 2019 13:09:10 GMT-0000 by admin. (Version 10)

Attached files

ID Name Comment Uploaded Size Downloads
11035 Mongolian infant.jpg admin 13 Dec, 2018 20:34 18.42 Kb 246
11034 Mongolian mother.jpg admin 13 Dec, 2018 20:33 28.55 Kb 208
11033 Mongolian pregnancy RCT.pdf PDF 2018 admin 13 Dec, 2018 20:33 926.00 Kb 238
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