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Pregnant in New Zealand – should supplement with vitamin D in Winter and Spring – Sept 2015

Predictors of vitamin D status in pregnant women in New Zealand.

N Z Med J. 2015 Sep 25;128(1422):24-34.
Ekeroma AJ1, Camargo CA Jr, Scragg R, Wall C, Stewart A, Mitchell E, Crane J, Grant CC.

See also VitaminDWiki

Overview Pregnancy and vitamin D has the following summary

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

Pregnancy category starts with

716 items in Pregnancy category

 - see also

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

The items in both Pregnancy and Aust/NZ are


INTRODUCTION:
Newborn vitamin D status is largely determined by maternal vitamin D status during pregnancy. New Zealand has a sun avoidance health policy and minimal dietary vitamin D fortification. Vitamin D deficiency (serum 25-hydroxyvitamin D (25(OH)D) concentration <50 nmol/L) is present in 57% of a sample of newborns from Christchurch and Wellington. To inform vitamin D supplementation policy, our aim was to describe the frequency of, and factors associated with, vitamin D deficiency during pregnancy.

METHODS:
We enrolled an ethnically diverse sample of pregnant women from a community maternity clinic in South Auckland, New Zealand, with serum 25(OH)D concentration measured at 27 weeks gestation. We examined the associations of enrolment season, maternal demographics, health, sunlight exposure and vitamin D intake with vitamin D deficiency.

RESULTS:
Vitamin D deficiency was present in 109/259 (42%). Enrolment season (P<0.001) and ethnicity (P=0.003) were independently associated with the odds of vitamin D deficiency, but not sunlight exposure or dietary vitamin D intake. Of those enrolled in winter (June-August)/spring (September-November), vitamin D deficiency was present in

  • 43% of European,
  • 67% of Māori,
  • 80% of Pacific and
  • 59% of women of other ethnic groups.


CONCLUSIONS:
These findings suggest that New Zealand's targeted strategy for vitamin D supplementation may miss up to 42% of women with vitamin D deficiency in our population. Supplementation for all pregnant women during winter/spring could be an appropriate intervention for prevention of vitamin D deficiency during pregnancy in New Zealand.

PMID: 26411844

Publisher does not sell or rent the PDF

References

  1. Nassar N, Halligan G, Roberts C, Morris J, Ashton A. Systematic review of first-trimester vitamin D normative levels and outcomes of pregnancy. Am J Obstet Gynecol 2011; 205: 208.e1-7.
  2. De-Regil LM, Palacios C, Ansary A, Kulier R, PenaRosas PJ. Vitamin D supplementation for women during pregnancy. Cochrane Database of Systematic Reviews Issue 2. . Cochrane Database of Systematic Reviews 2012.
  3. Aghajafari F, Nagulesapillai T, Ronksley PE, Tough SC, O’Beirne M, Rabi DM. Association between maternal serum 25-hydroxyvitamin D level and pregnancy and neonatal outcomes: systematic review and meta-analysis of observational studies. BMJ 2013; 346: f1169.
  4. Wei S-Q, Qi H-P, Luo Z-C, Fraser WD. Maternal vitamin D status and adverse pregnancy outcomes: a systematic review and meta-analysis. The Journal of Maternal-Fetal & Neonatal Medicine 2013; 26(9): 889-99.
  5. Judkins A, Eagleton C. Vitamin D deficiency in pregnant New Zealand women. NZMJ 2006; 119(1241): http://journal.nzma.org.nz/journal/119-1241/2144/.
  6. von Hurst PR, Stonehouse W, Coad J. Vitamin D status and attitudes towards sun exposure in South Asian women living in Auckland, New Zealand. Public Health Nutr 2010; 13(4): 531-6.
  7. Ministry of Health. Vitamin D Status of New Zealand Adults. Findings from the 2008/09 New Zealand Adult Nutrition Survey. Wellington: Ministry of Health, 2012.
  8. Ministry of Health. Companion Statement on Vitamin D and Sun Exposure in Pregnancy and Infancy in New Zealand. . Wellington; 2013.
  9. Camargo CA, Ingham T, Wickens K, et al. Vitamin D status of newborns in New Zealand. Brit J Nutr 2010; 104(07): 1051-7.
  10. Houghton LA, Szymlek-Gay EA, Gray AR, Ferguson EL, Deng X, Heath A-LM. Predictors of vitamin D status and its association with parathyroid hormone in young New Zealand children. Amer J Clinic Nutri 2010; 92(1): 69-76.
  11. Nessvi S, Johansson L, Jopson J, et al. Association of 25-hydroxyvitamin D3)levels in adult New Zealanders with ethnicity, skin color and self-reported skin sensitivity to sun exposure. Photochemistry and photobiology 2011; 87(5): 1173-8.
  12. Levy MA, McKinnon T, Barker T, et al. Predictors of vitamin D status in subjects that consume a vitamin D supplement. European journal of clinical nutrition 2015; 69(84-89).
  13. Andersen LB, Abrahamsen B, Dalgard C, et al. Parity and tanned white skin as novel predictors of vitamin D status in early pregnancy: a population-based cohort study. Clinical endocrinology 2013; 79: 333–41.
  14. Naugler C, Zhang J, Henne D, Woods P, Hemmelgarn BR. Association of vitamin D status with socio-demographic factors in Calgary, Alberta: an ecological study using Census Canada data. BMC Public Health 2013; 13(316).
  15. National Advisory Committee on Health and Disability. Screening to Improve Health in New Zealand: Criteria to assess screening programmes. Wellington; 2003.
  16. Grant C, Stewart A, Scragg R, et al. Vitamin D During Pregnancy and Infancy and Infant Serum 25-Hydroxyvitamin D Concentration. Pediatrics 2014; 133: e143-353.
  17. Crop and Food Research. New Zealand Food Composition Database products. Christchurch; 2008.
  18. Food Standards Australia New Zealand. AUSNUT 2007 Database Files. In: Zealand FSAN, (ed.); 2007.
  19. Scragg R JR, Holdaway IM, Lim T, Beaglehole R. . Myocardial infarction is inversely associated with plasma 25-hydroxyvitamin D3 levels: a community-based study. Int J Epidemiol 1990; 19(3): 559-63.
  20. Maunsell Z, Wright DJ, Rainbow SJ. Routine isotope-dilution liquid chromatography-tandem mass spectrometry assay for simultaneous measurement of the 25-hydroxy metabolites of vitamins D2 and D3. . Clin Chem 2005; 51: 1683-90.
  21. Lewis J, Elder P. Serum 25-OH vitamin D2 and D3 are stable under exaggerated conditions. Clin Chem 2008; 54(11): 1931-2.
  22. Ministry of Health. Presenting Ethnicity: Comparing prioritised and total response ethnicity in descriptive analyses of New Zealand Health Monitor surveys. Wellington; 2008.
  23. Perampalam S, Ganda K, Chow KA, et al. Vitamin D status and its predictive factors in pregnancy in 2 Australian populations. The Australian & New Zealand journal of obstetrics & gynaecology 2011; 51(4): 353-9.
  24. Schneuer FJ, Roberts CL, Guilbert C, et al. Effects of maternal serum 25-hydroxyvitamin D concentrations in the first trimester on subsequent pregnancy outcomes in an Australian population. The American journal of clinical nutrition 2014; 99(2): 287-95.
  25. Li W, Green TJ, Innis SM, et al. Suboptimal vitamin D levels in pregnant women despite supplement use.(QUANTITATIVE RESEARCH)(Report). Canadian Journal of Public Health 2011; 102(4): 308.
  26. Shrapnel W, Truswell S. Vitamin D deficiency in Australia and New Zealand: What are the dietary options? Nutrition & Dietetics 2006; 63(4): 206-12.
  27. Bodnar L, Catov J, Simhan H, Holick M, Powers R, Roberts J. Maternal Vitamin D Deficiency Increases the Risk of Preeclampsia. J Clin Endocrinol Metab 2007; 92: 3517-22.
  28. Williams D, Fraser A, Fraser W, et al. Associations of maternal 25-hydroxyvitamin D in pregnancy with offspring cardiovascular risk factors in childhood and adolescence. Heart 2013; 99: 1849-56.
  29. Bendall A, Costa C, Woods C, Howat P. Vitamin D levels in pregnant women booking for antenatal care in Far North Queensland. Australian and New Zealand Journal of Obstetrics and Gynaecology 2012; 52(4): 391-4.
  30. Morton SMB, Atatoa Carr PE, Bandara DK, al. e. Growing Up in New Zealand: A longitudinal study of New Zealand children and their families. Report 1. Before we are born Auckland:. University of Auckland; 2010.
  31. Holick MF. Vitamin D deficiency. New Engl J Med 2007; 357(3): 266-81.
  32. Paxton GA, Teale GR, Nowson CA, et al. Vitamin D and health in pregnancy, infants, children and adolescents in Australia and New Zealand: a position statement. Med J Aust 2013; 198(3): 142-3.
  33. Binkley N, Novotny R, Krueger D, et al. Low Vitamin D Status despite Abundant Sun Exposure. J Clin Endocrinol Metab 2007; 92(6): 2130-35.
  34. Rockell JE, Green TJ, Skeaff CM, et al. Season and ethnicity are determinants of serum 25-hydroxyvitamin D concentrations in New Zealand children aged 5-14 y. J Nutr 2005; 135(11): 2602-8.
  35. Ministry of Health. Companion Statement on Vitamin D and Sun Exposure in Pregnancy and Infancy in New Zealand. Wellington: Ministry of Health, 2013.
  36. Munns C, Zacharin MR, Rodda CP, et al. Prevention and treatment of infant and childhood vitamin D deficiency in Australia and New Zealand: a consensus statement. Med J Aust 2006; 185(5): 268-72.
  37. Nowson CA, McGrath JJ, Ebeling PR, Haikerwal A, al e. Vitamin D and health in adults in Australia and New Zealand: a position statement. Med J Aust 2012; 196(11): 686-7.
  38. Bjørn Jensen C T-LA, Vadgard Hansen L, Strøm M, Odgaard Nielsen N, et al. Development and Validation of a Vitamin D Status Prediction Model in Danish Pregnant Women: A Study of the Danish National Birth Cohort. PLoS ONE 2013; 8(1): e53059.
  39. Calvo MS WS, Barton CN. . Vitamin D intake: a global perspective of current status. . J Nutr 2005; 135: 310-6.
  40. March KM, Chen NN, Karakochuk CD, Shand AW, Innis SM, et a. Maternal vitamin D3 supplementation at 50 μg/d protects against low serum 25-hydroxyvitamin D in infants at 8 wk of age: a randomized controlled trial of 3 doses of vitamin D beginning in gestation and continued in lactation. J Amer Soc Nutri 2015: 1-9.
  41. Morton S, Grant CC, Wall C, Atatoan Carr PE, Bandara DK, al. e. Adherence to nutritional guidelines in pregnancy: evidence from the Growing Up in New Zealand birth cohort study. Public health nutrition 2014.

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