Post-hoc Analysis of NICHD Vitamin D Pregnancy Cohort and The Role of Functional Vitamin D Deficiency in Pregnancy
Am J Perinatol. 2023 May 22. doi: 10.1055/a-2097-2098 PDF is behind paywall
Shellie Davis 1, Elliott Lyles 2, Judy Shary 3, Myla Ebeling 4, Susan G Reed 1, John E Baatz 1, Bruce W Hollis 3, Carol L Wagner 1
Objective: Conduct a secondary, post-hoc analysis of NICHD vitamin D (vitD) pregnancy study by Hollis et al. (Hollis, 2011), which reported on the effect of vitD supplementation in pregnant women; and determine the potential interaction between intact parathyroid hormone (iPTH) concentrations, vitD status, and various comorbidities associated with pregnancy.
Hypothesis: Women with low 25(OH)D concentrations and high iPTH concentrations during pregnancy, known as functional vitD deficiency (FVDD), were more likely to acquire complications also affecting their neonates.
Study design: This post-hoc analysis of data collected from a diverse group of pregnant women participating in the NICHD vitD pregnancy study, was applied to investigate the applicability of the concept of FVDD in pregnancy (Hemmingway, 2018) in identifying potential risks for certain comorbidities of pregnancy. This analysis defines FVDD as maternal serum 25(OH)D concentrations below 20 ng/mL and iPTH concentrations above 65 pg/mL creating a definitive ratio number, 0.308, to classify mothers as having FVDD prior to delivery (PTD). Statistical analyses were performed using SAS 9.4 (Cary, NC).
Results: 281 women (85 African American, 115 Hispanic, 81 Caucasian) with 25(OH)D and iPTH concentrations measured at monthly visits were included in this analysis. No statistically significant association was found between mothers classified as having FVDD at baseline or one-month PTD and hypertensive disorders of pregnancy, infection, or admittance to the NICU. When combining all comorbidities of pregnancy in this cohort, results showed those with FVDD at baseline, 24 weeks' gestation, and one-month PTD were more likely to experience a comorbidity (p=0.001; p=0.001; p=0.004, respectively).
Those with FVDD one-month PTD were 7.1 times (CI 1.71-29.81) more likely to have preterm birth (<37 weeks) than women without FVDD.
Conclusions: Participants were more likely to have experienced preterm birth if they met the criteria for FVDD. This study supports the importance of FVDD during pregnancy.
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27 ; Depression 21 ; Diabetes 42 ; Obesity 15 ; Hypertension 43 ; Breathing 33 ; Omega-3 39 ; Vitamin D Receptor 23 Click here for details
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- Pregnancy needs at least 40 ng of vitamin D, achieved by at least 4,000 IU – Hollis Aug 2017
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- Call to action – more Vitamin D for pregnancies, loading doses are OK – Holick Aug 2019
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VitaminDWiki - Healthy pregnancies need lots of vitamin D containsProblem
Reduces Evidence 0. Chance of not conceiving 3.4 times Observe 1. Miscarriage 2.5 times Observe 2. Pre-eclampsia 3.6 times RCT 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 times Observe Stillbirth - OMEGA-3 4 times RCT - 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 times Observe 13. Preeclampsia in young adult 3.5 times RCT 14. Good motor skills @ age 3 1.4 times Observe 15. Childhood Mite allergy 5 times RCT 16. Childhood Respiratory Tract visits 2.5 times RCT
RCT = Randomized Controlled TrialPreterm birth 7 X more likely if both low vitamin D and high PTH 1 month before birth – May 2023
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