Effect of treatment of vitamin D deficiency and insufficiency during pregnancy on fetal growth indices and maternal weight gain: a randomized clinical trial
European Journal of Obstetrics & Gynecology and Reproductive Biology, Available online 19 October 2013
Fatemeh Lalooha, lalooha44 at yahoo.com
Metabolic Diseases Research Centre, Qazvin University of Medical Science, Qazvin, Iran
Objective To determine whether treatment of low serum vitamin D in pregnant women improves fetal growth indices.
Study design: In this open-label randomized clinical trial, 130 Iranian pregnant women (24–26 weeks of gestation) with vitamin D deficiency or insufficiency [25(OH)D <30 ng/ml] were divided at random into an intervention group and a control group. The control group received 200 mg calcium plus a multivitamin (containing vitamin D3 400 U) each day, and the intervention group received 200 mg calcium plus a multivitamin (containing vitamin D3 400 U) each day, plus vitamin D3 (50,000 U) each week for 8 weeks. At delivery, maternal and cord blood 25(OH)D levels, maternal weight gain, neonatal length, neonatal weight and neonatal head circumference were compared between two groups. Serum vitamin D was measured using enzyme-linked immunosorbent assay. A multivariate regression analysis was performed to examine the independent effect of maternal vitamin D level on fetal growth indices.
Results Mean (±standard deviation)
- length (intervention group: 49 ± 1.6 cm; control group: 48.2 ± 1.7 cm; p = 0.001),
- head circumference (intervention group: 35.9 ± 0.7 cm; control group: 35.3 ± 1.0 cm; p = 0.001) and
- weight (intervention group: 3429 ± 351.9 g; control group: 3258.8 ± 328.2 g; p = 0.01)
were higher in the intervention group compared with the control group.
Mean maternal weight gain was higher in the intervention group compared with the control group (13.3 ± 2.4 kg vs 11.7 ± 2.7 kg; p = 0.006).
Multivariate regression analysis for maternal weight gain, neonatal length, neonatal weight and neonatal head circumference showed an independent correlation with maternal vitamin D level.
Conclusion Treatment of low serum vitamin D during pregnancy improves fetal growth indices and maternal weight gain.
- Near the end of pregnancy 50,000 IU vitamin D weekly was great – RCT April 2013
- 35,000 IU vitamin D weekly during 3rd quarter pregnancy – RCT March 2013
- Prenatal Vitamin D (35,000 weekly, 3rd trimester) resulted in 1 cm taller infants at age 1 year – RCT Aug 2013
- Overview Pregnancy and vitamin D which 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 is 1.6 X more likely if mother was vitamin D deficient – meta-analysis Aug 2017