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Little Vitamin D while pregnant in Asia – survey Nov 2023


Clinical practice of vitamin D screening and supplementation in pregnancy in Asia-pacific countries: A cross-sectional study

Heliyon https://doi.org/10.10167j.heliyon.2023.e21186
Ryan Wai Kheong Lee, Alicia Li Bin Chng, Kok Hian Tan , IPRAMHO International Study Group

Background: Vitamin D deficiency is common in pregnant women. There is scarce information in the Asia-Pacific region on the understanding of vitamin D screening and supplementation in pregnancy among health care professionals.

Methods: We performed a cross-sectional study among health care professionals who are part of the Integrated Platform for Research in Advancing Metabolic Health outcomes of Women and Children (IPRMAHO) international study group on their understanding and perception of Vitamin D screening and supplementation in pregnancy. The cross-sectional survey comprised 4 main sections: demographics, existing policies, nutrient supplementation in pregnancy and various practices on screening, treatment and perceptions, with a total of 22 questions. A total of 15 responses were obtained from attendees from distinct health facilities across eleven participating Asia-Pacific countries.

Results: Majority of the surveyed hospitals (11/15, 78.6 %) did not have a national policy or regional guideline regarding Vitamin D screening and supplementation in pregnancy. More than half of respondents were (9/14, 64.3 %) were unsure of the percentage of women seen with Vitamin D deficiencies each year and were unsure of Vitamin D dosage prescribed to pregnant women with (8/15, 53.3 %) or without (6/14, 42.9 %) Vitamin D deficiency. Vitamin D was rarely prescribed in pregnancy when compared to other nutrient supplements such as folic acid and iron. Majority of respondents (9/11, 72.7 %) indicated that their hospital did not screen for Vitamin D deficiencies in pregnancy, even amongst high risk pregnant women. Nevertheless, majority of respondents indicated a need (12/15, 80.0 %) for a guideline or consensus regarding Vitamin D screening and supplementation in pregnancy.

Conclusion: While majority of the surveyed hospitals did not have a national policy or regional guideline regarding Vitamin D screening and supplementation in pregnancy, majority of re­spondents indicated a need for the policy or guideline. There were varying clinical knowledge gaps and different perceptions on Vitamin D screening and supplementation in pregnancy among healthcare professionals.
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VitaminDWiki recommends: 50,000 IU D3 weekly before, during, and after pregnancy

Preferably starting 50,000 IU daily for the first week.
Otherwise it takes 5 month for the vitamin D levels to plateau

Any amount of Vitamin D is far better than no Vitamin D
No Vitamin D screening nor test is needed

Note: Vitamin D2 should NOT be taken, and if taken, D2 must be daily

10+ VitaminDWiki Pregnancy pages with WEEKLY or BIWEEKLY in the title

This list is automatically updated

Items found: 11

VitaminDWiki - Can get 50,000 IU Vitamin D anywhere on the globe

Many companies recommend 50,000 IU weekly on the bottle

Survey Questions:

Practices on screening, treatment and perceptions
Question (Response) Number of responses (%)

Does your hospital screen for vitamin D deficiency in pregnancy?

Yes 0/15 (0.0 %)
No 12/15 (80.0 %)
Sometimes 3/15 (20.0 %)

Does your hospital screen for vitamin D deficiency in specific group of patients based on risk profile?

Yes 3/15 (20.0 %)
No 10/15 (66.7 %)
Sometimes 2/15 (13.3 %)

What is your hospital policy on screening for vitamin D deficiency in pregnancy?

Assessment of patient risk profile 3/15 (20.0 %)
Measurement of serum vitamin D levels based on risk profile 1/15 (6.7 %)
Research purpose, affordability 2/15 (14.3 %)
Leave it for physicians to decide 4/15 (26.7 %)
No screening for vitamin D 10/15 (66.7 %)

How does your hospital follow up on vitamin D levels in pregnancy women with vitamin D deficiency?

No need to repeat routinely 4/15 (26.7 %)
Repeat only if symptomatic 3/15 (20.0 %)
Repeat every trimester 2/15 (13.3 %)
Not sure 6/15 (40.0 %)

What do you think is the cut-off value to determine vitamin D deficiency (nmol/L) in pregnant women?

10 nmol/L 1/15 (6.7 %)
20 nmol/L 2/15 (13.3 %)
30 nmol/L 3/15 (20.0 %)
40 nmol/L 1/15 (6.7 %)
50 nmol/L 4/15 (26.7 %)
Not sure 4/15 (26.7 %)

Do you think that there is a need for a guideline and/or consensus on vitamin D screening and supplementation in pregnancy?

Yes 14/15 (93.3 %)
Not sure 1/15 (6.7 %)

Is there a national policy and/or regional guideline which your hospital refers to for vitamin D screening and supplementation in pregnancy?

Yes 3/15 (20.0 %)
No 10/15 (66.7 %)
Not sure 2/15 (13.3 %)

Does your hospital have a written protocol on vitamin D screening and supplementation deficiency in pregnancy?

Yes 1/14 (14.3 %)
No 11/14 (78.6 %)
Not sure 1/14 (7.1 %)

What percentage of pregnant women does your hospital see have vitamin D deficiency?

>80 % 2/14 (14.3 %)
40-60 % 2/14 (14.3 %)
<40 % 1/14 (7.1 %)
Not sure 9/14 (64.3 %)

What dose of vitamin D does your hospital prescribe in pregnant women WITHOUT vitamin D deficiency?

400IU 5/14 (40.0 %)
800IU 0/15 (0.0 %)
1,000 IU 1/14 (7.1 %)
1,500 IU 1/14 (7.1 %)
2,000 IU 1/14 (7.1 %)
Not sure 6/14 (42.9 %)

What dose of vitamin D does your hospital prescribe in pregnant women WITH vitamin D deficiency ?

400IU 0/15 (0.0 %)
800IU 0/15 (0.0 %)
1,000 IU 4/15 (25.0 %)
1,500 IU 0/15 (0.0 %)
2,000 IU 3/15 (20.0 %)
Not Sure 8/15 (53.3 %)


VitaminDWiki - Pregnancy category contains

922 items in Pregnancy category

 - see also


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 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


VitaminDWiki – Breastfeeding and Vitamin D - many studies: 39+ as of Dec 2023

Attached files

ID Name Comment Uploaded Size Downloads
20427 Asian pregnancies.pdf admin 02 Dec, 2023 382.24 Kb 85