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Improved births with 2,000 IU vitamin D during pregnancy in India - RCT Feb 2015

Role of vitamin D in reducing the risk of preterm labour

Int J Reprod Contracept Obstet Gynecol. 2015; 4(1): 86-93doi: 10.5455/2320-1770.ijrcog20150217
Jyoti Singh, Chella Hariharan, Dilip Bhaumik.

Background: Although vitamin D insufficiency is increasingly recognized as a health problem across the world, inadequate vitamin D status appears to be particularly prevalent in certain populations such as the elderly and pregnant women. With respect to the latter, impaired vitamin D status during gestation is associated with adverse outcomes in pregnancy such as preterm birth and poor neonatal outcome.

Methods: A total of 100 healthy, pregnant women in Sawangi, Meghe, Wardha, were recruited in 2012. Of these, 50 were randomised to receive either 2000 IU (study group) of vitamin D3 per day from 12-16 weeks of gestation of pregnancy. The remaining 50 pregnant women, who formed the control group were not supplemented with any drug. 25-hydroxyvitamin D [25(OH)D] in maternal blood was measured by chemiluminescence immunoassay, at recruitment and at the time of delivery and a serum 25(OH)D level <30 nmol/l was defined as deficiency.

Results: Patients had deficiency of vitamin D at baseline (80.00%) was converted into sufficient level (76.00%) in cases after vitamin D supplementation. It was statistically significant at 5% level as P value <0.05 and there was also evidence in reduction of preterm birth.

Conclusions: Maternal vitamin D deficiency is associated with significant increase risk for premature birth with P = 0.001. Maternal serum vitamin D sufficiency can be achieved by supplementing pregnant women with 2000 IU vitamin D supplements.

Effect of vitamin D supplementation

Cases (Vit D) Control
Age 23.94 ± 1.45 25.02 ± 1.23
Gestational age at recruitment (Mean)14.54 ± 1.24 15.68 ± 1.23
Gestational age at delivery (Mean)38.10 ± 2.35 35.10 ± 1.23
Vitamin D levels at recruitment (nmol/L)3.69 ± 10.57 9.45 ± 11.65
Vitamin D levels at delivery (nmol/L)29.85 ± 9.85 25.46 ± 3.69
Preterm birth 12% 30%
Caesarean section 8% 38%
Apgar score 1 Min 8.38 ± 1.23 7.10 ± 0.73
Apgar score 5 Min 9.44 ± 1.10 8.58 ± 1.75
Birth weight 3.16 ± 0.58 2.33 ± 0.52


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IU Cumulative Benefit Blood level CofactorsCalcium $*/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
cofactors
< 750 mg $3
6000 Probable: larger benefits for above items
Just enough D for breastfed infant
More maternal and infant weight
Should have
cofactors
< 750 mg $4

Attached files

ID Name Comment Uploaded Size Downloads
5096 Preterm 2000.pdf PDF 2015 admin 25 Feb, 2015 20:45 516.67 Kb 1018
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