Vitamin D replacement in children, adolescents and pregnant women in the Middle East and North Africa: A systematic review and meta-analysis of randomized controlled trials.
Metabolism. 2017 May;70:160-176. doi: 10.1016/j.metabol.2017.02.009. Epub 2017 Feb 16.
Chakhtoura M1, El Ghandour S2, Shawwa K3, Akl EA4, Arabi A5, Mahfoud Z6, Habib R3, Hoballah H2, El Hajj Fuleihan G5.
- Overview Vitamin D Dose-Response
At least 9,600 IU is needed to get most pregnant women to a useful 40 ng
More could be needed if dark skin, obese, etc.
Different form is needed if poor digestion, etc,
Pregnancy category starts with
- see also
- Overview Pregnancy and vitamin D
- Healthy pregnancies need lots of vitamin D
- Dark skin births are much riskier due to lack of vitamin D,
- All items in category Infant/Child
- breastfed 887 items as of Jan 2018
- Preeclampsia 825 items as of Jan 2018
- Pre-term 2110 items as of Feb 2017
- "polycystic ovary syndrome" OR PCOS 303 items as of Jan 2018
- Gestational Diabetes
- c-section OR "caesarean section" (various spellings) 242 items as of Feb 2017
- postpartum depression 129 items as of Jan 2018
- Search VitaminDiiki for MISCARRIAGE OR "Spontaneous abortion" 339 items as of Jan 2018
- Search VitaminDWiki for "Assisted reproduction" 33 items as of Feb 2017
- Fertility and Sperm category listing has
83 items along with related searches
- (Stunting OR “low birth weight” OR LBW) 505 items as of Jan 2018
- Click on chart for details
Hypovitaminosis D affects one-third to two-thirds of children and pregnant women from the Middle East and North Africa (MENA) region.
To evaluate in infants, children, adolescents and pregnant women, from the MENA region, the effect of supplementation with different vitamin D doses on the change in 25-hydroxyvitamin D 25(OH)D level reached, and other skeletal and non-skeletal outcomes.
This is a systematic review of randomized controlled trials of vitamin D supplementation conducted in the MENA region. We conducted a comprehensive literature search in 7 databases, without language or time restriction, until November 2016. Two reviewers abstracted data from the included studies, independently and in duplicate. We calculated the mean difference (MD) and 95% CI of 25(OH)D level reached when at least 2 studies were eligible in each comparison (low (<800IU), intermediate (800-2000IU) or high (>2000IU) daily dose of vitamin D, or placebo). We pooled data using RevMan version 5.3.
We identified a total of 15 eligible trials: one in infants, 4 in children and adolescents and 10 in pregnant women. In children and adolescents, an intermediate vitamin D dose (1901IU/d), resulted in a mean difference in 25(OH)D level of 13.5 (95% confidence interval (CI) 8.1-18.8) ng/ml, compared to placebo, favoring the intermediate dose (p<0.001). The proportion of children and adolescents reaching a 25(OH)D level≥ 20ng/ml was 74% in the intermediate dose group. In pregnant women, four trials started supplementation at 12-16weeks of gestation and continued until delivery, and six trials started supplementation at 20-28weeks' gestation and stopped it at delivery. The MD in 25(OH)D level reached was 8.6 (95% CI 5.3-11.9) ng/ml (p<0.001) comparing the high dose (3662IU/d) to the intermediate dose (1836IU/d), and 12.3 (95% CI 6.4-18.2) ng/ml (p<0.001), comparing the high dose (3399IU/d) to the low dose (375IU/d). Comparing the intermediate (1832IU/d) to the low dose (301IU/d), the MD in 25(OH)D level achieved was 7.8 (95% CI 4.5-10.8) ng/ml (p<0.001).
The proportion of pregnant women reaching a 25(OH)D level≥20ng/ml was 80%-90%, 73% and 27%-43% in the high, intermediate, and low dose groups, respectively. The risk of bias in the included studies, for children, adolescents and pregnant women, ranged from low to high across all doamins.
In children, adolescents and pregnant women from the MENA, an intermediate vitamin D dose of 1000-2000IU daily may be necessary to allow for the majority of the population to reach a desirable 25(OH)D level of 20ng/ml. Further high quality RCTs are required to confirm/refute the beneficial impact of vitamin D supplementation on various clinically important outcomes.
PMID: 28403940 DOI: 10.1016/j.metabol.2017.02.009
217 visitors, last modified 22 Nov, 2017, URL: