Ensure a healthy pregnancy and baby - take Vitamin D before conception

Note:
Clinical trials adding vitamin D at 20 weeks have found little benefit 2018
Most trials now add vitamin D around 10 weeks
Very little reduction in miscarriage, Autism if add Vitmin D at 10 weeks
Loading dose at 4 weeks could greatly reduce miscarriage
Starting Vitamin D 11 weeks before will increase conception by 3 X

Response time is typically 11 weeks

  see charts further down the page for data

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Number needed to treat

NNT = 2    Preconception Vitamin D ==> Increase chance of healthy full-term children by ~ 50%

Increased conception
  + fewer miscarries
     +fewer preterm
      + fewer birth defects
        + fewer C-section
          + fewer SGA
            + less Autism
              + less RTI, flu, pneumonia, Sepsis, etc

NNT = 20    Vitamin D during pregnancy ==> Preterm births drop from 10 % to 5 %

fewer preterm

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See also VitaminDWiki

• The earlier the better- preconception vitamin D - June 2018
• Pregnancies need a lot of vitamin D, even before conception - Hollis Dec 2018
• Preconception vitamin D is great - every extra 10 ng associated with 10 percent more likely to have live birth – Aug 2018
• Vitamin D of 32 to 60 ng is needed before, during, and after pregnancy – Dec 2012
• Reasons for low response to vitamin D

Miscarriage (1 in 5 pregnancies if ignore Vitamin D levels)

• Miscarriage 2 times more likely if low vitamin D – meta-analysis May 2017
• Miscarriage in first trimester 2.5X more likely if less than 20 ng of vitamin D – July 2015
• Miscarriages strongly associated with poor placental, decidua gene which locally activates Vitamin D – Dec 2016
• Miscarriage 10 percent more likely for each 10 ng less vitamin D at preconception – May 2018
• First trimester Vitamin D deficiency in associated with placental inflammation, etc. – July 2018

Vitamin D increases conception success

• Women with more than minimum vitamin D were 3.4 X more likely to achieve pregnancy
• Birth rates doubled with Vitamin D - 300,000 for infertile men – RCT Nov 2017

Preterm birth reduced by Vitamin D

• Preterm birth rate reduced 57 percent by Vitamin D – Nov 2015
• Preterm birth 4X more likely if Vitamin D deficient – Feb 2018
• Probably even more reduction in preterm births if > 4,000 IU and/or start earlier

Less likely to have C-Section if good level of vitamin D

• Search VitaminDWiki for c-section OR "caesarean section" (various spellings) 802 items as of Aug 2018
• Cesarean (associated with low Vitamin D) increased asthma, obesity, miscarriage and stillbirth – meta-analysis Jan 2018

Loading Dose during pregnancy proposed as 2 weeks

• Loading doses span 1 to 50 days
  Loading dose (typically 400,000 IU) is followed by maintenance dose (typically 4,000 IU)
  No data available on time for safe fast loading dose during pregnancy

Many reasons to continue to have a high vitamin D level after the birth

• Recover faster
• Reduced postpartum depression
• Increased ability to withstand the stress of new baby (poor sleep, etc)
• Breastfeeding mother getting 6400 IU of Vitamin D is similar to infant getting 400 IU – RCT Sept 2015

4,000 IU or 40 ng is becoming a consensus for all adults

• 50,000 IU of vitamin D every two weeks – Jordan conclusion - RCT July 2017
  • = 3,600 IU daily average
• Seniors need at least 4,000 IU vitamin D, no test needed – Consensus Jan 2014
• Best Vitamin D- 40 to 52 ng, achieved with 4000 – 6000 IU daily – Heaney Oct 2014
• One pill every two weeks gives you all the vitamin D most adults need
  • 50,000 IU twice a month - minimum recommended by VitaminDWiki
• Is 50 ng of vitamin D too high, just right, or not enough

Other

• Low response to vitamin D for some people – genes are one of the causes – Nov 2014
• 10,000 IU of vitamin D during pregnancy resulted in spectacular infant development – Coimbra April 2018
• Pregnancies with more than 40 ng of vitamin D are great (Sweden, 2,000 pregnancies) – Feb 2018
• 10 reasons for poor response to Vitamin D (race, binding protein, etc.) – Nov 2017
• Pregnancy category listing has 920 items along with related searches
• Studies in both Pregnancy and VDR catgories
• Studies in both Pregnancy and Omega-3 catgories
• 3 X increased risk of being Vitamin D deficient if gut problems while pregnant– March 2018
  • A gut-friendly form of vitamin D is best

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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 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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A lot of development happens BEFORE week 8

Note: Folic acid aupplementation is recommended 4 weeks BEFORE pregnancy to prevent with brain problems at week 2

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Vitamin D Levels Plateau typically in 11 weeks (Vitamin D starts to help in about half that time)

• Defining normal level of vitamin D (need 4000-5000 IU) - Heaney Spring 2013 11 weeks
  
• Vitamin D every 25 days may be BETTER than daily – RCT May 2018 > 11 weeks
  
• 3 to 6 months to plateau with 4,000 IU vitamin D daily (Cardiac Patients) – June 2017 14? weeks
  
• Pregnancy 20 weeks
  
• 35,000 IU vitamin D weekly during 3rd quarter pregnancy – RCT March 2013 4 weeks if pre-load
     70,000 IU pre-load +35,000 IU weekly dose
  

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Web - high costs of pregnancies

• Pregnancy cost calculator Better Birth
• Pregnant under Obamacare - the TRUE costs
  • Labor, Delivery, & Hospital Stay – $6,140.35
• 9 Women Share Exactly How Much It Cost Them to Give Birth March 2015
  • Example $800 charge for blood - in case it was needed
• Big deductibles can mean big stakes in the timing of a baby delivery Jan 2016
  • Jan-April births can cost several thousands of dollars more because deductables reset on Jan 1
  • "For years, doctors have described a phenomenon that could be described as a “deductible rush,” as patients who have already satisfied their deductible for the year rush during the fourth quarter to have procedures done that can be scheduled in advance. That way, the health plan picks up the tab."
  • Suggestion by VitaminDWiki - in case of costly complications, plan for the birth to be before December

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The Role of Vitamin D in Fertility and during Pregnancy and Lactation : A Review of Clinical Data - Oct 2018

• "In pregnancy, however, it should be considered that cord blood 25(OH)D concentrations are only about 50 to 80% of serum 25(OH)D concentrations. Therefore, it could be hypothesized, that the mother may need more 25(OH)D during pregnancy in order to transfer enough 25(OH)D to the fetus"
• "Therefore, to provide sufficient vitamin D content in breast milk for the infant, the vitamin D intake of the mother during lactation has to be much higher compared to the intake during pregnancy as at birth, serum 25(OH)D concentrations in cord blood are about 50 to 80% of serum 25(OH)D concentrations of the mother "
• Very conservative conclusion based on a lack of data and poor target goal. Pregnant women should take 800-1000 IU of vitamin D to maintain > 20 ng level of vitamin D.

 Download the PDF from VitaminDWiki

Short URL for this page=   is.gd/PregVitD