Preterm birth and low Vitamin D - many studies

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Summary

Preterm birth rates are higher if

• Low vitamin D
• Low Omega-3
• Poor vitamin D receptor
• Dark Skin
• High BMI

Preterm birth rates decrease when add

• Vitamin D (if low, and most people are)
• Zinc (small decrease)

• Obese - who have lower vitamin D levels
• Dark-skin - who have lower D levels due to less D from the sun
• Mother has a poor Vitamin D Receptor

Preterm births are LESS likely if more Vitamin D

• Give Vitamin D to pregnant women

Preterm births are LESS likely if more Omega-3, etc.

• Omega-3 (if low Omega-3 index, like most people)
• Preterm Births decreased by Omega-3 (analysis of 184 countries) – April 2019
• Preterm births strongly related to Vitamin D, Vitamin D Receptor, Iodine, Omega-3, etc
• Pre-term birth - many of risk factors are associated with low vitamin D

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156+ VitaminDWiki pages have PREEMIE or PRE-TERM in the title

This list is automatically updated

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6 Preterm Charts

US - 2022

global rate increasing

Suspect lifetime cost of health problems of preemies exceeds that of term birth

Only includes the first 6 month costs. Ignores additional costs for the rest of the life

Preterm Birth rates around the world (Lancet)

the study is on this page

Preterm birth rate increased 60 percent in 50 years (US)

From data gathered from web by Henry Lahore Nov 2017

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Preterm births, degree of complications, warnings to not vaccinate too soon (nothing about vitamin D) - Dec 2024

Follow-up of the preterm NICU graduates   FREE PDF
Note: US policy is to vaccinate on the first day of birth, which could be 2 months before the immunse system is developed enough
"The US has the highest infant mortality rate among high-income countries, at 5.4 deaths per 1,000 live births, compared to Norway's 1.6 deaths per 1,000 live births"

• "US mortality rate becomes worse for infants at 32-36 weeks and is highest among studied countries for infants at 37 weeks or more"
  • Perplexity AI Dec 2024

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Preterm infants given 800 IU of vitamin D daily a month after birth (too little, too late to help much) – Oct 2024

Effects of vitamin D supplementation on serum 25(OH)D3 levels and neurobehavioral development in premature infants after birth
Scientific Reports volume 14, Article number: 23972 (2024)
Hong Guo, Jianing Xie, Xiaoya Yu, Yuan Tian, Meiqi Guan & Jingjing Wei

This study explored the factors influencing serum 25(OH)D3 levels and the effects of Vitamin D deficiency (VDD) and VD supplementation on 25(OH)D3 levels and neuropsychobehavioral development in premature infants, to provide a theoretical basis for improving their prognosis. Physical examination, neuropsychobehavioral development and serum 25(OH)D3 levels were assessed regularly in 158 preterm infants supplemented with VD formulation. 25(OH)D3 levels were analyzed at 3, 6, 9, 12, and 18 months after birth. The Gesell neuropsychological development test was conducted at 6, 9, 12, and 18 months after birth to obtain the developmental quotient (DQ). Based on the serum 25(OH)D3 levels at 42 days of age, the infants were divided into VDD and non-VDD groups. Preterm infants in the VDD group were supplemented with more VD until their 25(OH)D3 levels were normal, and were divided into sustained VDD (SVDD) and corrected VDD (CVDD) groups according to serum 25(OH)D3 levels at 3 months of age. Appropriate statistical methods were chosen to compare differences in 25(OH)D3 and DQ between or among different groups, screen for the factors influencing 25(OH)D3 levels in preterm infants at 42 days of age, and analyze the relationship between 25(OH)D3 and DQ. The 25(OH)D3 levels of preterm infants at 42 days of age were positively correlated with VD supplementation during pregnancy, and before 42 days after birth (P < 0.05). The 25(OH)D3 levels in preterm infants at 42 days and 3 months of age were positively correlated with the DQ levels at 6, 9, 12, and 18 months of age (P < 0.05). The DQ level in the VDD group, especially SVDD group, was lower than that in CVDD and non-VDD groups at the same time point (P < 0.05). This research thus demonstrates that VD supplementations during pregnancy and after birth is a major factor affecting 25(OH)D3 levels in premature infants. Early VDD and SVDD can affect their neuropsychobehavioral development, and effective VD supplementation can gradually correct VDD and mitigate this influence.
 Download the PDF from VitaminDWiki

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Preterm birth 7 times more likely if low vitamin D 1 month before – May 2023

Post-hoc Analysis of NICHD Vitamin D Pregnancy Cohort and The Role of Functional Vitamin D Deficiency in Pregnancy
Am J Perinatol. 2023 May 22. doi: 10.1055/a-2097-2098 PDF is behind paywall
Shellie Davis 1, Elliott Lyles 2, Judy Shary 3, Myla Ebeling 4, Susan G Reed 1, John E Baatz 1, Bruce W Hollis 3, Carol L Wagner 1

Objective: Conduct a secondary, post-hoc analysis of NICHD vitamin D (vitD) pregnancy study by Hollis et al. (Hollis, 2011), which reported on the effect of vitD supplementation in pregnant women, and determine the potential interaction between intact parathyroid hormone (iPTH) concentrations, vitD status, and various comorbidities associated with pregnancy.

Hypothesis: Women with low 25(OH)D concentrations and high iPTH concentrations during pregnancy, known as functional vitD deficiency (FVDD), were more likely to acquire complications also affecting their neonates.

Study design: This post-hoc analysis of data collected from a diverse group of pregnant women participating in the NICHD vitD pregnancy study, was applied to investigate the applicability of the concept of FVDD in pregnancy (Hemmingway, 2018) in identifying potential risks for certain comorbidities of pregnancy. This analysis defines FVDD as maternal serum 25(OH)D concentrations below 20 ng/mL and iPTH concentrations above 65 pg/mL creating a definitive ratio number, 0.308, to classify mothers as having FVDD prior to delivery (PTD). Statistical analyses were performed using SAS 9.4 (Cary, NC).

Results: 281 women (85 African American, 115 Hispanic, 81 Caucasian) with 25(OH)D and iPTH concentrations measured at monthly visits were included in this analysis. No statistically significant association was found between mothers classified as having FVDD at baseline or one-month PTD and hypertensive disorders of pregnancy, infection, or admittance to the NICU. When combining all comorbidities of pregnancy in this cohort, results showed those with FVDD at baseline, 24 weeks' gestation, and one-month PTD were more likely to experience a comorbidity (p=0.001; p=0.001; p=0.004, respectively).
Those with FVDD one-month PTD were 7.1 times (CI 1.71-29.81) more likely to have preterm birth (<37 weeks) than women without FVDD.

Conclusions: Participants were more likely to have experienced preterm birth if they met the criteria for FVDD. This study supports the importance of FVDD during pregnancy.

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Preterm birth 1.53 X more likely if low vitamin D - May 2023

Vitamin D deficiency in pregnancy and the risk of preterm birth: a nested case–control study
BMC Pregnancy and Childbirth Vol 23, article number 322, (2023)
Tashnia Tahsin, Rasheda Khanam, Nabidul Haque Chowdhury, A. S. M. Tarik Hasan, Md. Biplob Hosen, Sayedur Rahman, Anjan Kumar Roy, Salahuddin Ahmed, Rubhana Raqib & Abdullah H. Baqui

Background
Each year, an estimated 15 million babies are born preterm. Micronutrient deficiencies, including vitamin D deficiency (VDD), are common in many low- and middle-income countries (LMICs), and these conditions are often associated with adverse pregnancy outcomes. Bangladesh experiences a high prevalence of VDD. The country also has a high preterm birth (PTB) rate. Using data from a population-based pregnancy cohort, we estimated the burden of VDD during pregnancy and its association with PTB.

Methods
Pregnant women (N = 3,000) were enrolled after ultrasound confirmation of gestational age at 8–19 weeks of gestation. Trained health workers prospectively collected phenotypic and epidemiological data at scheduled home visits. Trained phlebotomists collected maternal blood samples at enrollment and 24 -28 weeks of gestation. Aliquots of serum were stored at -80.0 C. We conducted a nested case–control study with all PTB (n = 262) and a random sample of term births (n = 668). The outcome, PTB, was defined as live births < 37 weeks of gestation, based on ultrasound. The main exposure was vitamin D concentrations of 24–28 weeks maternal blood samples. The analysis was adjusted for other PTB risk factors. Women were categorized as VDD (lowest quartile of 25(OH)D; <  = 30.25 nmol/L) or not deficient (upper-three quartiles of 25(OH)D; > 30.25 nmol/L). We used logistic regression to determine the association of VDD with PTB, adjusting for potential confounders.

Results
The median and interquartile range of serum 25(OH)D was 38.0 nmol/L; 30.18 to 48.52 (nmol/L). After adjusting for co-variates, VDD was significantly associated with PTB [adjusted odds ratio (aOR) = 1.53, 95% confidence interval (CI) = 1.10 – 2.12].
The risk of PTB was also higher among women who were

• shorter (aOR = 1.81, 95% CI: 1.27–2.57),
• primiparous (aOR = 1.55, 95% CI = 1.12 – 2.12),
• passive smokers (aOR = 1.60, 95% CI = 1.09 – 2.34), and those who
• received iron supplementation during pregnancy (aOR = 1.66, 95% CI: 1.17, 2.37).

Conclusion
VDD is common in Bangladeshi pregnant women and is associated with an increased risk of PTB.
 Download the PDF from VitaminDWiki

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Preterm birth 1.3X more-likely if low vitamin D in 2nd trimester - meta-analysis June 2021

Systematic review and meta-analysis of vitamin D deficiency in different pregnancy on preterm birth Deficiency in middle pregnancy might be at risk
DOI: 10.1097/MD.000000000002630 FREE PDF

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VitaminDWiki - Pregnancy category contains

924 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 17;  Hypertension 44;   Breathing 36;  Omega-3 44;  Vitamin D Receptor 24 Click here for details
• All items in category Infant/Child 854 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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VitaminDWiki - 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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Global preterm birth rates 2010 - Lancet

National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications
Published:June 09, 2012 DOI:https://doi.org/10.1016/S0140-6736(12)60820-4

Background
Preterm birth is the second largest direct cause of child deaths in children younger than 5 years. Yet, data regarding preterm birth (<37 completed weeks of gestation) are not routinely collected by UN agencies, and no systematic country estimates nor time trend analyses have been done. We report worldwide, regional, and national estimates of preterm birth rates for 184 countries in 2010 with time trends for selected countries, and provide a quantitative assessment of the uncertainty surrounding these estimates.
Methods
We assessed various data sources according to prespecified inclusion criteria. National Registries (563 datapoints, 51 countries), Reproductive Health Surveys (13 datapoints, eight countries), and studies identified through systematic searches and unpublished data (162 datapoints, 40 countries) were included. 55 countries submitted additional data during WHO's country consultation process. For 13 countries with adequate quality and quantity of data, we estimated preterm birth rates using country-level loess regression for 2010. For 171 countries, two regional multilevel statistical models were developed to estimate preterm birth rates for 2010. We estimated time trends from 1990 to 2010 for 65 countries with reliable time trend data and more than 10 000 livebirths per year. We calculated uncertainty ranges for all countries.

Findings
In 2010, an estimated 14·9 million babies (uncertainty range 12·3–18·1 million) were born preterm, 11·1% of all livebirths worldwide, ranging from about 5% in several European countries to 18% in some African countries. More than 60% of preterm babies were born in south Asia and sub-Saharan Africa, where 52% of the global livebirths occur. Preterm birth also affects rich countries, for example, USA has high rates and is one of the ten countries with the highest numbers of preterm births. Of the 65 countries with estimated time trends, only three (Croatia, Ecuador, and Estonia), had reduced preterm birth rates 1990–2010.

Interpretation
The burden of preterm birth is substantial and is increasing in those regions with reliable data. Improved recording of all pregnancy outcomes and standard application of preterm definitions is important. We recommend the addition of a data-quality indicator of the per cent of all live preterm births that are under 28 weeks' gestation. Distinguishing preterm births that are spontaneous from those that are provider-initiated is important to monitor trends associated with increased caesarean sections. Rapid scale up of basic interventions could accelerate progress towards Millennium Development Goal 4 for child survival and beyond.
 Download the PDF from VitaminDWiki

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See also Preterm birth decreased by Omega-3, etc. - many studies

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17,300 Google Scholar hits for preterm etc. and "Vitamin D" as of Aug 2024

Google Scholar

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Asked Chat-GPT: "What health problems do preemies have as adults?" (Dec 2023)

Premature babies, often referred to as "preemies," can face a range of health issues in adulthood, which are partly determined by the degree of prematurity and the medical complications they experienced as infants. Some of the common long-term health problems that preemies may encounter as adults include:

1. Respiratory Problems: Premature babies are at a higher risk for developing respiratory issues, such as asthma and chronic obstructive pulmonary disease (COPD), because their lungs may not have fully developed before birth.
2. Cardiovascular Issues: Adults who were born prematurely may have a higher risk of high blood pressure, heart disease, and stroke. This increased risk is thought to be related to the underdevelopment of the heart and vascular system in preemies.
3. Neurological Problems: Premature birth can affect brain development, leading to a higher risk of neurological disorders in adulthood, such as cerebral palsy, learning disabilities, and attention deficit hyperactivity disorder (ADHD).
4. Metabolic Disorders: Being born prematurely is associated with an increased risk of metabolic syndromes, such as type 2 diabetes and obesity, in adulthood.
5. Visual and Hearing Impairments: Premature infants are at a higher risk for vision and hearing problems, which can persist into adulthood. Conditions like retinopathy of prematurity (ROP) can lead to visual impairment.
6. Mental Health Issues: There is evidence suggesting that adults who were born prematurely may have an increased risk of mental health disorders, including depression and anxiety.
7. Dental Problems: Preemies might face a higher risk of dental issues, including enamel hypoplasia (defective enamel), which can lead to an increased risk of cavities and other dental problems.
8. Reproductive Challenges: Women who were born prematurely may experience reproductive issues, such as a higher risk of giving birth prematurely themselves.

It's important to note that while preemies are at a higher risk for these health problems, not all premature babies will experience them. Advances in neonatal care have significantly improved the outcomes for premature babies, and many go on to lead healthy lives. Regular medical follow-up and a healthy lifestyle can help mitigate some of these risks.

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Preemies have health problems as seniors - Dec 2024

MDEdge
Cardiovascular, Diabetes, Hypertension, All-cause mortality

Note: Many of these health problems have been treated by Vitamin D

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