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Pregnant in New Zealand – should supplement with vitamin D in Winter and Spring – Sept 2015

Predictors of vitamin D status in pregnant women in New Zealand.

N Z Med J. 2015 Sep 25;128(1422):24-34.
Ekeroma AJ1, Camargo CA Jr, Scragg R, Wall C, Stewart A, Mitchell E, Crane J, Grant CC.

See also VitaminDWiki

Overview Pregnancy and vitamin D has the following summary

IU Cumulative Benefit Blood level CofactorsCalcium $*/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
cofactors		 < 750 mg $3
6000 Probable: larger benefits for above items
Just enough D for breastfed infant
More maternal and infant weight 		Should have
cofactors		 < 750 mg $4

Pregnancy category starts with

923 items in Pregnancy category

 - see also

Healthy pregnancies need lots of vitamin D has the following summary
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 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
The items in both Pregnancy and Aust/NZ are


INTRODUCTION:
Newborn vitamin D status is largely determined by maternal vitamin D status during pregnancy. New Zealand has a sun avoidance health policy and minimal dietary vitamin D fortification. Vitamin D deficiency (serum 25-hydroxyvitamin D (25(OH)D) concentration <50 nmol/L) is present in 57% of a sample of newborns from Christchurch and Wellington. To inform vitamin D supplementation policy, our aim was to describe the frequency of, and factors associated with, vitamin D deficiency during pregnancy.

METHODS:
We enrolled an ethnically diverse sample of pregnant women from a community maternity clinic in South Auckland, New Zealand, with serum 25(OH)D concentration measured at 27 weeks gestation. We examined the associations of enrolment season, maternal demographics, health, sunlight exposure and vitamin D intake with vitamin D deficiency.

RESULTS:
Vitamin D deficiency was present in 109/259 (42%). Enrolment season (P<0.001) and ethnicity (P=0.003) were independently associated with the odds of vitamin D deficiency, but not sunlight exposure or dietary vitamin D intake. Of those enrolled in winter (June-August)/spring (September-November), vitamin D deficiency was present in

  • 43% of European,
  • 67% of Māori,
  • 80% of Pacific and
  • 59% of women of other ethnic groups.


CONCLUSIONS:
These findings suggest that New Zealand's targeted strategy for vitamin D supplementation may miss up to 42% of women with vitamin D deficiency in our population. Supplementation for all pregnant women during winter/spring could be an appropriate intervention for prevention of vitamin D deficiency during pregnancy in New Zealand.

PMID: 26411844

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References

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Pregnant in New Zealand – should supplement with vitamin D in Winter and Spring – Sept 2015        
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