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Half as many tooth enamel defects in child if 2400 IU Vitamin D in late pregnancy – RCT Aug 2019

Association of High-Dose Vitamin D Supplementation During Pregnancy With the Risk of Enamel Defects in Offspring:
A 6-Year Follow-up of a Randomized Clinical Trial.

JAMA Pediatr. 2019 Aug 5. doi: 10.1001/jamapediatrics.2019.2545

Nørrisgaard PE1, Haubek D2, Kühnisch J3, Chawes BL1, Stokholm J1,4, Bønnelykke K1, Bisgaard H1.
1 Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark.
2 Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.
3 Department of Operative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-Universität München, München, Germany.
4 Department of Pediatrics, Naestved Hospital, Naestved, Denmark.

IMPORTANCE:
Enamel defects of developmental origin affect up to 38% of schoolchildren and is recognized as a global public health challenge. The impaired enamel formation results in pain owing to hypersensitivity, posteruptive breakdowns, rapid caries progression, and extractions in some cases. The etiology is unknown; therefore, prevention is currently not possible.

OBJECTIVE:
To assess the association of a high-dose vitamin D supplementation in pregnant women with enamel defects and caries in their offspring.

DESIGN, SETTING, AND PARTICIPANTS:
Post hoc analysis of a double-blind, single-center, randomized clinical trial, the Copenhagen Prospective Studies on Asthma in Childhood 2010 cohort (COPSAC2010). Enrollment began March 2009 and included 623 women recruited at 24 weeks of pregnancy and 588 of their children. A dental examination was completed at age 6 years in 496 of 588 children (84%). Data were analyzed in 2018.

INTERVENTION:
High-dose vitamin D3 (2400 IU/d; N = 315) or matching placebo tablets (N = 308) from pregnancy week 24 to 1 week post partum. In addition, all women received 400 IU/d of vitamin D3 as part of standard care.

MAIN OUTCOMES AND MEASURES:
Enamel defect was defined as having at least 1 molar affected by demarcated opacity, enamel breakdown, and/or atypical restoration. Caries was defined as decayed, missing, or filled surfaces in both the deciduous and permanent dentitions (World Health Organization standard).

RESULTS:
The risk of enamel defects in the permanent dentition was lower in the offspring of mothers who received high-dose vitamin D supplementation during pregnancy compared with standard dose (15.1% [n = 26 of 172] vs 27.5% [n = 44 of 160]; odds ratio, 0.47; 95% CI, 0.27-0.81). A similar association was observed for the deciduous dentition (8.6% [n = 21 of 244] vs 15.9% [n = 40 of 252]; odds ratio, 0.50; 95% CI, 0.28-0.87). There was no association between supplementation and caries.

CONCLUSIONS AND RELEVANCE:
High-dose vitamin D supplementation during pregnancy was associated with approximately 50% reduced odds of enamel defects in the offspring. This suggests prenatal vitamin D supplementation as a preventive intervention for enamel defects, with a clinically important association with dental health.


Primary outcome of the study: 24% reduction in wheeze if mother started getting 2,400 IU doses at week 24

Reduced wheezing at age 3 was not statistically significant (p = 0.16)


Tooth development starts at week 6. This study did not add Vitamin D until week 24

Fetal Development
Image

Created by admin. Last Modification: Monday August 12, 2019 14:34:52 GMT-0000 by admin. (Version 7)

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ID Name Comment Uploaded Size Downloads
12433 Teeth vs weeks.jpg admin 07 Aug, 2019 11:34 174.25 Kb 47
12432 Fetal development.jpg admin 07 Aug, 2019 11:32 57.41 Kb 24
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