Current Recommended Vitamin D Prenatal Supplementation and Fetal Growth: Results From the China-Anhui Birth Cohort Study.
J Clin Endocrinol Metab. 2018 Jan 1;103(1):244-252. doi: 10.1210/jc.2017-00850.
Truly healthy pregnancies need much more Vitamin D
Healthy pregnancies need lots of vitamin D has the following summary
|0. Chance of not conceiving||3.4 times||Observe|
|1. Miscarriage||2.5 times||Observe|
|2. Pre-eclampsia||3.6 times||Randomized 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 times||Observe|
|Stillbirth - OMEGA-3||4 times||RCT - 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 times||Observe|
|13. Preeclampsia in young adult||3.5 times||Randomized Controlled Trial|
|14. Good motor skills @ age 3||1.4 times||Observe|
|15. Childhood Mite allergy||5 times||Randomized Controlled Trial|
|16. Childhood Respiratory Tract visits||2.5 times||Randomized Controlled Trial|
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 |
|< 750 mg||$3|
|6000||Probable: larger benefits for above items|
Just enough D for breastfed infant
More maternal and infant weight
|< 750 mg||$4|
- Small for gestational age birth was 6.5X more likely if mother was vitamin D deficient – March 2015
- Small for gestational age is 1.6 X more likely if mother was vitamin D deficient – meta-analysis Aug 2017
- Small for gestational age with low vitamin D – 3.6X higher for blacks than whites – April 2016
- Note: Black women typically have very low levels of Vitamin D
- Risk a small infant (SGA) increased by 9 percent for every ng lower vitamin D – Sept 2017
- Vitamin D is very important during pregnancy – 4,000 daily or 50,000 weekly - review Jan 2015
Tao RX1,2, Meng DH3, Li JJ3, Tong SL3,4, Hao JH3,5, Huang K3,5, Tao FB3,5, Zhu P3,5.
1 Department of Gynecology and Obstetrics, The Third Affiliated Hospital of Anhui Medical University, Hefei, China.
2 Hefei First People's Hospital, Hefei, China.
3 Department of Maternal, Child, and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.
4 School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
5 Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China.
Maternal vitamin D insufficiency has been associated with fetal growth restriction. However, the effect of maternal vitamin D supplementation on fetal growth has not been confirmed.
To assess the effect of maternal vitamin D supplementation recommended by the Institute of Medicine (IOM) during pregnancy on the neonatal vitamin D status and the risk of small for gestational age (SGA).
DESIGN AND PARTICIPANTS:
As part of the China-Anhui Birth Cohort study, maternal sociodemographic characteristics, food intake, lifestyle, information on vitamin D supplementation, and birth outcomes were prospectively collected. For participants, 600 IU/d of vitamin D3 was routinely advised to take during pregnancy. Cord blood levels of 25-hydroxyvitamin D [25(OH)D], calcium, and phosphorus were measured in 1491 neonates who were divided into three groups based on the duration of maternal vitamin D supplementation during pregnancy.
Mean cord blood concentrations of 25(OH)D were 3.5 nmol/L higher [95% confidence interval (CI), 0.8, 6.2] in neonates (median, 37.9 nmol/L) whose mother took vitamin D supplementation for >2 months during pregnancy compared with those (median, 34.3 nmol/L) whose mother did not take any supplement. These significant differences on cord blood concentrations of 25(OH)D occurred regardless of the season of birth. The adjusted risk of SGA in pregnant women with vitamin D supplementation for >2 months was significantly decreased than that in women without any vitamin D supplementation (11.8% vs 6.9%; adjusted odds ratio = 0.53; 95% CI, 0.32, 0.87).
The findings from China suggest that maternal vitamin D supplementation recommended by the IOM results in a slight but significantly higher fetal level of 25(OH)D and improves fetal growth.
PMID: 29096022 DOI: 10.1210/jc.2017-00850