95 percent of pregnant women in Finland took vitamin D – PHD Dissertation Dec 2019

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Vitamin D in pregnancy and infancy : dietary sources and associations with pregnancy outcomes and infant growth

Helena Hauta-alus
HUS Lasten ja nuorten sairaudetLastenklinikkaDoctoral Programme in Clinical ResearchHelsingin yliopisto
Tutkimustuotos: Opinnäyte › Väitöskirja

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Kuvaus
Vitamin D is vital for normal growth and development. Vitamin D is produced endogenously in the skin after sunlight exposure or obtained from dietary sources. In Finland, solar radiation is inadequate for cutaneous vitamin D synthesis in winter, leading to a high risk for vitamin D insufficiency, defined by circulating 25-hydroxyvitamin D concentration [25(OH)D] below 50 nmol/l. Poor maternal 25(OH)D has been associated with adverse pregnancy and neonatal outcomes, such as pre-eclampsia, gestational diabetes mellitus (GDM), and low birth weight. Only a few studies have explored the relationship between vitamin D and infant postnatal growth, and these studies show inconsistent results. Further, data on current maternal vitamin D status and infant vitamin D intake in Finland are lacking. The objectives of this thesis were to

• 1) define maternal and newborn 25(OH)D concentrations and characterize maternal determinants of vitamin D status during pregnancy;
• 2) examine whether vitamin D status differs between mothers with and without GDM;
• 3) describe vitamin D intake from food and identify food sources of vitamin D in 1-year-old infants, and finally,
• 4) investigate whether maternal or infant vitamin D status associate with pre- and postnatal infant growth.

This thesis is part of the Vitamin D Intervention in Infants (VIDI) study. At Helsinki Maternity Hospital, 987 families were recruited to the study from January 2013 to June 2014.
Infants were randomized to daily supplemental vitamin D dosages of 10 µg or 30 µg from 2 weeks until 2 years of age.
Mothers were of Northern European ethnicity without regular medication. Infants were born at term with birth weights appropriate for gestational age. Maternal serum samples were collected at prenatal clinics between 2012 and 2013 in early pregnancy. At birth, umbilical cord blood (UCB) was obtained. Circulating 25(OH)D was analyzed with IDS-iSYS from pregnancy, UCB and infant serum samples at 1 year of age. Maternal dietary patterns were derived from a 22-item food frequency questionnaire and infant vitamin D intake was assessed with a 3-day food record. GDM diagnosis and data on infant birth size were obtained from medical records. Infant growth was measured at study visits at the ages of 6 months and 1 year.
Overall, the pregnant women and their newborns were vitamin D sufficient as the concentration of 25(OH)D in 96% of all subjects was ≥50 nmol/l.
Of pregnant women, 95% used vitamin D supplements with a mean daily intake of 16 µg. Maternal positive predictors of 25(OH)D during pregnancy, based on 25(OH)D from early pregnancy to UCB, were supplemental vitamin D intake, a dietary pattern characterized by regular use of vitamin D–fortified foods and prepregnancy physical activity. In contrast, factors associating with declining 25(OH)D during pregnancy were smoking and multiparity. GDM was observed in 11% of the pregnant women. Maternal 25(OH)D concentrations did not differ between GDM and non-GDM women. Furthermore, 25(OH)D had no relation to oral glucose tolerance test results. Mean daily intake of vitamin D from food was 7.5 µg in non-breastfed and 3.8 µg in breastfed 1-year-old infants. The main food sources of vitamin D were infant formula, dairy milk, porridge, and fish foods. Higher maternal and infant 25(OH)D were associated with slower infant growth. At 6 months of age, infants to mothers with high pregnancy 25(OH)D (>125 nmol/l) were the shortest (in length), lightest (in weight), and thinnest (in length-adjusted weight). Higher UCB 25(OH)D had an inverse association with head circumference at birth and infant length at 6 months. In infants, higher UCB 25(OH)D associated with slower linear growth from birth to 6 months, but an accelerated growth from 6 months to 1 year of age. Infants with 25(OH)D >125 nmol/l were the lightest and thinnest at 1 year of age, whereas mothers with UCB 25(OH)D <50 nmol/l had the thinnest infants at 6 months.
In conclusion, vitamin D status was sufficient among pregnant women in Finland. Likewise, infants who participated in a vitamin D supplementation trial had sufficient vitamin D status at 1 year of age. High maternal and infant 25(OH)D associated with slower infant growth. These results may indicate a
possible inverse U-shaped relationship between vitamin D status and growth. The clinical relevance of this finding remains unknown. Until more data emerge, there is no need to aim for higher maternal or infant 25(OH)D concentrations beyond vitamin D sufficiency with excessive supplementation as this may have disadvantageous effects on infant growth.

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Pregnancy category contains:

926 items in Pregnancy category

 - see also

• Overview Pregnancy and vitamin D
• Number of articles in both categories of Pregnancy and:Dark Skin 30;   Depression 21;   Diabetes 44;   Obesity 18;  Hypertension 44;   Breathing 36;  Omega-3 44;  Vitamin D Receptor 24 Click here for details
• All items in category Infant/Child 855 items
• Pregnancy needs at least 40 ng of vitamin D, achieved by at least 4,000 IU – Hollis Aug 2017
• 38+ papers with Breastfed etc, in the title
• Call to action – more Vitamin D for pregnancies, loading doses are OK – Holick Aug 2019
• 53+ preeclampsia studies
• 94+ studies with PRETERM in the title
• Fertility problem (PCOS) reduced by vitamin D, etc: many studies 15+
• 94+ Gestational Diabetes
• Caesarean birth much more likely if low Vitamin D - many studies 15+ studies
• Post-partum depression and low Vitamin D - many studies 15+ studies
• Stillbirth reduced by Vitamin D, Zinc, Omega-3 - several studies 5+ studies
• Search VitaminDWiki for "Assisted reproduction" 33 items as of Aug 2022
• Fertility and Sperm category listing has 142 items along with related searches
• (Stunting OR “low birth weight” OR LBW) 1180 items as of June 2020
• Less labor pain if higher level of vitamin D – August 2021
• Healthy pregnancies need lots of vitamin D
• Ensure a healthy pregnancy and baby - take Vitamin D before conception
  

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Healthy pregnancies need lots of vitamin D contains:

Most were taking 2,000 to 7,000 IU daily for >50% of pregnancy
   Click on hyperlinks for details

Problem	Vit. D 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 Trial

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VitaminDWiki pages with FINLAND in title (17 as of March 2022)

This list is automatically updated

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