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Vitamin D supplementation of all pregnant women (in UK) would be cost effective – just considering pre-eclampsia – March 2016

An estimate of the economic burden of vitamin D deficiency in pregnant women in the United Kingdom.

Gynecol Endocrinol. 2016 Mar 29:1-6. [Epub ahead of print]
Kamudoni P1, Poole C2, Davies SJ3.
1a Research Fellow, Centre for Socioeconomic Research, School of Pharmacy and Pharmaceutical Sciences, Cardiff University , Cardiff , UK .
2b Senior Lecturer, Department of Primary Care and Public Health, School of Medicine, Cardiff University , Cardiff , UK , and.
3c Consultant Endocrinologist, University Hospital of Wales , Cardiff , UK.

Pregnancy is associated with an increased risk of vitamin D deficiency beyond that of the general population. The aim of the current analysis was to synthesize the current evidence on the dose-outcome relationship of vitamin D/serum 25 hydroxyvitamin D (25-OHD) and complications during pregnancy. An additional aim was to estimate the economic burden attributable to inadequate levels of serum 25-OHD. Published literature on the effects of vitamin D supplementation/serum 25-OHD on pregnancy complications, including randomized control trials and non-interventional studies, was searched in bibliographic databases including Pubmed, Google Scholar, Scopus and EMBASE.
A positive and significant treatment effect was obtained for

  • pre-eclampsia (OR = 0.75 95% CI 0.662-0.843),
  • but not for preterm birth (OR = 0.783, 95% CI 0.49-1.251)
  • or small for gestational age (OR = 0.76 95% CI 0.38-1.28).

Inadequate vitamin D accounted for 14.04% of risk for pre-eclampsia. It is estimated that addressing vitamin D inadequacy in pregnant women in England and Wales would reduce the number of cases of pre-eclampsia by 4126; and would result in a net saving of £18.6 million for the NHS in England and Wales. The current results suggest that based on current evidence a public health policy preventing vitamin D inadequacy in pregnant women is likely to have a positive impact on the NHS budget in England and Wales. This is contingent upon further evidence regarding the vitamin D dose-pregnancy outcome relationship becoming available.

PMID: 27023277

Publisher wants $54 for PDF

Notes on study by VitaminDWiki - after purchasing the PDF

  • Failed to include costs included for education, distribution, etc.
  • Dose sizes of the studies ranged from 200 IU/day to 4 doses of 120 000 IU
  • 800 IU daily dose size recommended by study was determined by the maximum licensed in the UK, not the studies
    800 IU is rarely enough to make a difference for anyone
  • Cost of the vitamin D for pregnancy £27
  • Study did not consider that a loading dose allows the pregnant woman to get the benefit of the vitamin D many months before the small daily dose

VitaminDWiki recommedations for pregnancy

Supplementation with Vitamin D, etc, is extremely cost effective and also very beneficial to mom and infant

  • Vitamin D 4,000 to 12,000 IU average daily - depending on weight, pre-existing conditions, distance from equator, etc.
    probably given as 50,000 IU every 4-14 days
  • Risk of preeclampsia might be cut in half if take an amount of Vitamin D – meta-analysis Sept 2017
  • Vitamin D loading dose to get the benefits in days instead of months (range of 100,000 to 800,000 IU)
  • Omega-3 - amount and dose frequency is TBD
    Perhaps stop Omega-3 before birth to avoid excessive bleeding
  • Magnesium - at least 100 milligrams in the form of Magnesium Chloride

See also VitaminDWiki


Healthy pregnancies need lots of vitamin D looks at the cost-effectiveness of vitamin D with pregnancy

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

  Download the PDF for Vitamin D in UK June 2015 from VitaminDWiki

Attached files

ID Name Comment Uploaded Size Downloads
6518 2015_June UK VitD.pdf PDF 2015 admin 02 Apr, 2016 16:44 121.33 Kb 614
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