Supplementation of Vitamin D in Pregnancy and its Correlation with feto-maternal outcome
Clinical Endocrinology, DOI: 10.1111/cen.12751
Aanchal Sablok1,*, Aruna Batra1, Karishma Thariani1, Achla Batra1, Rekha Bharti1, Abha Rani Aggarwal2, BC Kabi3 and Harish Chellani4
1 Department of Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
2 National Institute of Medical Statistics, All India Institute of Medical Sciences, New Delhi, India
3 Department of Biochemistry, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
4 Department of Paediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
- Corresponding author: Dr. Aanchal Sablok, Senior Resident, Department of Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi. 110029, India. aanchalsablok54 at gmail.com
| Control | Intervention | |
| Vitamin D Level | 18 ng | 32 ng |
| Preterm labor or Pre-eclampsia or Gestational Diabetes | 44 % | 20 % |
| Birth weight | 2.4 kg | 2.6 kg |
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Context: Vitamin D deficiency is widely prevalent throughout the world. Pregnant women, neonates, and infants form the most vulnerable groups for vitamin D deficiency.
Objective: 1) To find the prevalence of vitamin D deficiency in pregnant women. 2) To evaluate the effect of supplementation with cholecalciferol in improving vitamin D levels in pregnant women and evaluate its correlation with feto-maternal outcome.
Design: Randomized control trial from the years 2010-2012.
Setting: Tertiary care center, Delhi, India.
Participants: 180 pregnant women. The study population was divided randomly into 2 groups; Group A: non-intervention (60 women) and Group B: intervention (120 women).
Intervention: The intervention group received supplementation of vitamin D in dosages depending upon 25(OH)-D levels.
Main Outcome Measures: Risk of maternal complications like Preterm labor, pre-eclampsia, and gestational diabetes associated with Vitamin D deficiency and risk of Low birth weight and poor APGAR score in infants of mothers with Vitamin D deficiency.
Results: Adjusted serum 25(OH)-D concentration was lower in group A as compared to group B (mean 46.11 ± 74.21 nmol/L vs 80 ± 51.53 nmol/L). 44% of patients in group A and 20.3% of patients in group B developed Pre-term labor/Pre-eclampsia/Gestational Diabetes. New-borns of mothers in group A had lower cord blood levels of 25(OH)-D levels as compared to group B (mean 43.11 ± 81.32 nmol/L vs 56.8 ± 47.52 nmol/L). They also had lower birth weight of mean 2.4 ± 0.38 kg as compared to group B 2.6 ± 0.33 kg.
Conclusions: Vitamin D supplementation reduces the risk of maternal comorbidities and helps improve neonatal outcomes.
See also VitaminDWiki
- Monthly 120,000 IU Vitamin D plus daily Calcium was great during pregnancies – RCT Sept 2017
- 35,000 IU vitamin D weekly during 3rd quarter pregnancy – RCT March 2013
- Near the end of pregnancy 50,000 IU vitamin D weekly was great – RCT April 2013
- Pregnant women need at least 40 ng of Vitamin D (Wagner, genes) – Oct 2017
- Pregnancy needs at least 40 ng of vitamin D, achieved by at least 4,000 IU – Hollis Aug 2017
Healthy pregnancies need lots of vitamin D the following summary
Most were taking 2,000 to 7,000 IU daily for >50% of pregnancy
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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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