Compare IOM and WHO
| Organization | most adults | Elderly | Pregnant |
| IOM RDA | 600 IU | 800 IU | 600 IU |
| WHO RNI | 200 IU | 600 IU | 0 IU |
Chart adapted from Vitamin D Recommendations around the world - IU and ng
WHO: Vitamin D supplementation during pregnancy
WHO: Vitamin D supplementation is not recommended for pregnant women to improve maternal and perinatal outcomes
WHO allows 200 IU to be given only if the pregnant women has a proven Vitamin D deifciency
VitaminDWiki
Example of problems with their references - ignored
1) Dose size
2) When it was given during pregnancy
3) How often the dose was given (daily, weekly, monthly, or a single time)
4) If Calcium was also given
- Overview Pregnancy and vitamin D
- Preterm birth interventions – 4 studies found possible vitamin D benefit – Cochrane – Nov 2018 W.H.O.. seems to have missed this
- A paltry 400 IU Vitamin D recommended during pregnancy - NICE UK Dec 2018
- Before W.H.O. of zero IU I thought UK of 400 IU was tiny
- Vitamin D is at least 100 X better than Folic Acid which WHO recommends
- 4,000 IU of Vitamin D is OK - 19 organizations agree - 2018 - Rest of world = 4,000 IU,WHO = 0 IU
- Healthy pregnancies need lots of vitamin D had the following summary as of Dec 2018
Problem | Reduces | Evidence | |
| 0. Chance of not conceiving | 3.4 times | Observe | |
| 1. Miscarriage | 2.5 times | Observe | |
| 2. Pre-eclampsia | 3.6 times | Randomized Controlled Trial | |
| 3. Gestational Diabetes | 3 times | Randomized Controlled Trial | |
| 4. Good 2nd trimester sleep quality | 3.5 times | Observe | |
| 5. Premature birth | 2 times | Randomized Controlled Trial | |
| 6. C-section - unplanned | 1.6 times | Observe | |
| Stillbirth - OMEGA-3 | 4 times | RCT - Omega-3 | |
| 7. Depression AFTER pregnancy | 1.4 times | Randomized Controlled Trial | |
| 8. Small for Gestational Age | 1.6 times | meta-analysis | |
| 9. Infant height, weight, head size within normal limits | Randomized Controlled Trial | ||
| 10. Childhood Wheezing | 1.3 times | Randomized Controlled Trial | |
| 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 | Randomized Controlled Trial | |
| 14. Good motor skills @ age 3 | 1.4 times | Observe | |
| 15. Childhood Mite allergy | 5 times | Randomized Controlled Trial | |
| 16. Childhood Respiratory Tract visits | 2.5 times | Randomized Controlled Trial | |
The articles in Pregnancy AND Intervention are here:
- 3X reduction in preemie Bronchopulmonary Dysplasia if add tiny amount of Vitamin D – meta-analysis June 2024
- 4,000 IU of daily Vitamin D during pregnancy is good (Mongolia this time) – RCT Oct 2023
- Resulting childhood Asthma cut in half if 4,400 IU Vitamin D daily while pregnant - RCT April 2023
- 6,400 IU of Vitamin D is safe and effective during breastfeeding – RCT Dec, 2020
- Vitamin D during pregnancy – single 200,000 IU similar to daily 5,000 IU – April 2020
- Massive improvement in vaginal microbiome during pregnancy with Vitamin D – March 2019
- Autism risk reduced 2X by prenatal vitamins (Vitamin D or Folic) – Feb 2019
- Fetal bones helped a bit by 1,000 IU of vitamin D – RCT Feb 2019
- Adding 1,000 IU vitamin D while pregnant did not help much (no surprise) – RCT Jan 2019
- Pregnancies helped a lot by Vitamin D (injection then 50,000 IU monthly) – RCT May 2018
- 430 genes changed when 3,800 IU Vitamin D added in late second trimester – RCT May 2018
- 300,000 IU of Vitamin D is not enough during pregnancy – RCT May 2018
- Preeclampsia risk reduced 7X by 4,000 IU of Vitamin D daily – RCT March 2018
- Risk of infant Asthma cut in half if mother supplemented Vitamin D to get more than 30 ng – RCT Oct 2017
- Gestational diabetes 30 percent less likely if consumed more than 400 IU of vitamin D daily – Oct 2017
- Monthly 120,000 IU Vitamin D plus daily Calcium was great during pregnancies – RCT Sept 2017
- Preterm birth rate reduced by vitamin D – 78 percent if non-white, 39 percent if white – July 2017
- 1,000 IU of Vitamin D while pregnant helped a little bit (4,000 IU helps a lot) – RCT Dec 2016
- Preeclampsia recurrence reduced 2 X by 50,000 IU of vitamin D every two weeks – RCT July 2017
- Only a select group of women will get a modest benefit from 800 IU of vitamin D – Jan 2017
- Reduction of infant asthma may require good vitamin D when lung development starts (4 weeks) – March 2017
- Gestational diabetes treated by Vitamin D plus Omega-3 – RCT Feb 2017
- 3,800 IU Vitamin D during pregnancy did not help much – RCT Jan 2017
- 50,000 IU of vitamin D for 8 weeks of pregnancy raised most above 30 nanograms - RCT Jan 2017
- Gestational Diabetes reduce 3 times by 5,000 IU of Vitamin D – RCT Jan 2016
- Preeclampsia risk reduced by higher levels of vitamin D (VDAART 4,400 IU) - RCT Nov 2016
- Gestational Diabetes treated with 50,000 IU every two weeks – RCT Sept 2016
- Perinatal depression decreased 40 percent with just a few weeks of 2,000 IU of vitamin D – RCT Aug 2016
- Pregnancy – adding 35,000 IU Vitamin D weekly was nice, but not enough – RCT April 2016
- Vitamin D once during pregnancy reduced infant health care costs (300 times ROI) – RCT Dec 2015
- Autism rate in siblings reduced 4X by vitamin D: 5,000 IU during pregnancy, 1,000 IU to infants – Feb 2016
- Preterm birth rate reduced 57 percent by Vitamin D – Nov 2015
- Pregnancy supplemented with 2,000 IU vitamin D got most infants to more than 12 nanograms – Aug 2015
- Preeclampsia reduced by Vitamin D (50,000 IU bi-weekly) and Calcium – Oct 2015
- Clinical trials for pregnancy with Vitamin D intervention – 51 as of Sept 2015
- No multiple sclerosis relapses during pregnancy if 50,000 IU of Vitamin D weekly – RCT April 2015
- Wheezing reduced 35 percent if vitamin D added during pregnancy – April 2015
- 4,000 IU raised vitamin D levels during pregnancy – July 2014
- Pregnant mothers in Quatar needed more than weekly 50,000 IU Vitamin D – Nov 2013
- Gestational diabetes – Vitamin D and Calcium provided huge benefits – RCT March 2015
- Pregnancy helped by single dose of 60,000 IU of Vitamin D – RCT March 2015
- Gestational diabetes reduced by just two 50,000 IU doses of vitamin D – RCT Nov 2014
- Improved births with 2,000 IU vitamin D during pregnancy in India - RCT Feb 2015
- 50,000 IU of Vitamin D every 2 weeks reduced gestational diabetes – RCT Feb 2015
- Infant much healthier if Gestational Diabetic mother got 2 doses of vitamin D – RCT Nov 2014
- 2000 IU vitamin D during pregnancy and 800 IU to infant resulted in less use of antibiotics – RCT April 2014
- Gestational Diabetes reduced with 50,000 IU of vitamin D every 3 weeks and daily Calcium – RCT June 2014
- Gestational Diabetes reduced 40 percent by 5,000 IU of vitamin D – RCT April 2014
- 5,000 IU Vitamin D was not enough to reduce preeclampsia but did help future infant – RCT April 2014
- Breast milk resulted in 20 ng of vitamin D for infant if mother had taken 5,000 IU daily – RCT Dec 2013
The articles in Pregnancy AND Meta-analysis are here:
- Pregnancy and offspring health - umbrella of 250,000 pregnancies - meta-analysis May 2024
- Vitamin D reduces: pre-eclampia 1.6 X, postpartum dep. 3.6 X, autism 1.5X etc. - meta-analysis March 2024
- Vitamin D supplementation decreased the risk of preeclampsia by 39% – meta-analysis Feb 2024
- Yet another reason to take Vitamin D while pregnant – fight COVID - meta-analysis May 2023
- Vitamin D during pregnancy increased child’s bone mineral density – meta-analysis April 2023
- Preeclampsia reduced by 33 percent if high vitamin D – meta-analysis Feb 2023
- Maternal pregnancy problems if Vitamin D is less than 40 ng – meta-analysis Oct 2022
- Worse COVID during 3Q pregnancy if 2.5 ng lower Vitamin D – meta-analysis Sept 2022
- Miscarriage 1.6 X more likely if low vitamin D – meta-analysis May 2022
- Recurrent Miscarriage 4X more likely if low vitamin D – meta-analysis June 2022
- Pregnancy problems (LBW, PTB, SGA) associated with low vitamin D, 42nd meta-analysis – March 2022
- Low Vitamin D associated with preeclampsia - meta-analysis Feb 2022
- Low Vitamin D associated with pre-eclampsia -40th meta-analysis – Feb 2022
- Small vitamin D doses while pregnant do not decrease infant allergies – meta-analysis Feb 2022
- Anemia 1.6 X more likely during pregnancy if low Vitamin D – meta-analysis Dec 2021
- Vitamin D reduces preeclampsia, gestational diabetes and hypertension - 38th meta-analysis Dec 2021
- Need at least 6,000 IU daily while breastfeeding to eliminate Vitamin D deficiency – meta-analysis Oct 2021
- Gestational diabetes risk reduced 1.5X by Vitamin D – meta-analysis March 2021
- Gestational Diabetes – increased risk if poor Vitamin D Receptor – 2 Meta-Analyses 2021
- Small vitamin D doses given during pregnancy do not reduce childhood asthma – meta-analysis Dec 2020
- Multiple Sclerosis 40 percent more likely if mother had low vitamin D – meta-analysis Jan 2020
- Pregnancies helped by Vitamin D (insulin and birth weight in this case) – meta-analysis Oct 2019
- Preeclampsia 2.7 X less likely if 50,000 IU of Vitamin D every 2 weeks – meta-analysis Sept 2019
- Autism risk increased 30 percent by Cesareans (both low vitamin D) – meta-analysis Sept 2019
- Vitamin D treats Gestational Diabetes, decreases hospitalization and newborn complications – meta-analysis March 2019
- Birth size and weight increased by Vitamin D – meta-analysis Feb 2019
- Pregnancies helped by Vitamin D in many ways – 27th meta-analysis Jan 2019
- Vitamin D supplementation reduced SGA, fetal mortality, infant mortality – JAMA Meta – May 2018
- Gestational Diabetes 39 percent more likely if insufficient Vitamin D – Meta-analysis March 2018
- Preeclampsia reduced 2X by Vitamin D, by 5X if also add Calcium – meta-analysis Oct 2017
- Preeclampsia risk reduced 60 percent if supplement with Vitamin D (they ignored dose size) – meta-analysis Sept 2017
- Small for gestational age is 1.6 X more likely if mother was vitamin D deficient – meta-analysis Aug 2017
- Miscarriage 2 times more likely if low vitamin D – meta-analysis May 2017
- Fewer than half of pregnancies will get even 20 ng of vitamin D with 800 IU daily dose – meta-analysis May 2017
- Low Vitamin D results in adverse pregnancy and birth outcomes – Wagner meta-analysis March 2017
- Bacterial vaginosis in pregnancy increased prematurity risk by 60 percent - meta-analysis 1999
- Preterm birth rate reduced by 43 percent with adequate Vitamin D supplementation – meta-analysis Feb 2017
- Vitamin D during pregnancy reduces risk of childhood asthma by 13 percent – meta-analysis Dec 2016
- Vitamin D helps during pregnancy – meta-analysis Feb 2016
- Preterm birth 30 percent more likely if low vitamin D – meta-analysis May 2016
- Preterm birth extended by 2 weeks with Omega-3 – Meta-analysis Nov 2015
- Gestational Diabetes Mellitus 1.5X more likely if low vitamin D – meta-analysis Oct 2015
- Infant wheezing 40 percent less likely if mother supplemented with vitamin D, vitamin E, or Zinc – meta-analysis Aug 2015
- Birth weight and length increased with high levels of vitamin D – meta-analysis March 2015
- Pregnancy and Vitamin D – meta-analysis April 2015
- More vitamin D needed during pregnancy – meta-analysis Oct 2014
- Preeclampsia rate cut in half by high level of vitamin D – meta-analysis March 2014
- Preeclampsia 2.7X more frequent if low vitamin D – meta-analysis Sept 2013
- 2X more preeclampsia when vitamin D less than 30 ng, etc. - meta-analysis March 2013
- 2X more likely to have preeclampsia if less than 20 ng of vitamin D – Meta-analysis Jan 2013
WHO recommendation of 200 IU during pregnancy was reduced to 0 IU (by 2018)
Download the PDF from VitaminDWiki
Remarks
- This recommendation supersedes the previous WHO recommendation found in the 2012 Guideline: vitamin D supplementation in pregnant women (1).
- Pregnant women should be advised that sunlight is the most important source of vitamin D. The amount of time needed in the sun is not known and depends on many variables, such as the amount of skin exposed, the time of day, latitude and season, skin pigmentation (darker skin pigments synthesize less vitamin D than lighter pigments) and sunscreen use (1).
- Pregnant women should be encouraged to receive adequate nutrition, which is best achieved through consumption of a healthy, balanced diet, and to refer to WHO guidance on healthy eating (2).
- For pregnant women with documented vitamin D deficiency, vitamin D supplements may be given at the current recommended nutrient intake (RNI) of 200 IU (5 µg) per day.
- According to the Cochrane review, there are 23 ongoing or unpublished studies on vitamin D supplementation in pregnancy (3). Evidence from these trials should help to clarify the current uncertainties regarding vitamin D effects, particularly the effect on preterm birth, and any other associated benefits or harms of vitamin D when combined with other vitamins and minerals, particularly calcium.
* This is an extract from the relevant guideline (4). Additional guidance information can be found in these documents.
References
- 1. Guideline: Vitamin D supplementation in pregnant women. Geneva: World Health Organization; 2012 [archived]http://www.who.int/nutrition/publications/micronutrients/guidelines/vit_d_supp_pregnant_women/en/
- 2. Healthy diet. Fact sheet No. 394. Geneva: World Health Organization; 2015 http://www.who.int/ mediacentre/factsheets/fs394/en/
- 3. WDe-Regil LM, Palacios C, Lombardo LK, PeñaRosas JP. Vitamin D supplementation for women during pregnancy. Cochrane Database Syst Rev. 2016;(1):CD008873.
- 4. WHO recommendations on antenatal care for a positive pregnancy experience. Geneva: World Health Organization; 2016 http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/anc-positive-pregnancy-experience/en/
Vitamin D supplementation during pregnancy Dec 17, 2018
Evidence – go to above website to get more hyperlinks
Systematic reviews used to develop the guidelines
Vitamin D supplementation for women during pregnancy
De-Regil LM, Palacios C, Lombardo LK, Peña-Rosas JP.
Cochrane Database of Systematic Reviews 2016, Issue 1. Art. No.: CD008873.
Summary of this review
Podcast (Cochrane)
Related systematic reviews
Effect of vitamin D supplementation during pregnancy on maternal and neonatal outcomes: a systematic review and meta-analysis of randomized controlled trials
Pérez-López FR, Pasupuleti V, Mezones-Holguin E, Benites-Zapata VA, Thota P, Deshpande A, Hernandez AV.
Fertility and Sterility. 2015; 103(5):1278-88.e4. Download the PDF from VitaminDWiki
Comment by VitaminDWiki: This old study ignored
Dose size
When it was given during pregnancy
How often the dose was given (daily, weekly, monthly, or a single time)
If Calcium was also given
Vitamin D during pregnancy and maternal, neonatal and infant health outcomes: a systematic review and meta-analysis
Thorne-Lyman A, Fawzi WW.Paediatric and Perinatal Epidemiology. 2012; 26(s1):75–90.
Clinical trials
Current and ongoing clinical trials relating to vitamin D supplementation during pregnancy
WHO 2020 update - similar
Download the PDF from VitaminDWiki
My impression is that WHO considered only trials which used low doses of vitamin D and too late in pregnancy
THEN
proceeded to ignore the dose size and took the weighted average of result of the trials
where the weighting is were based on number of participants (not the dose size).
Download the Cochrane PDF that they refer to from VitaminDWiki
There have actually been
WHO recommends zero vitamin D during pregnancy, rest of the world disagrees – 2018, 2020
(Cached)
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