Near the end of pregnancy 50,000 IU vitamin D weekly was great – RCT April 2013

Effect of vitamin D administration in vitamin D-deficient pregnant women on maternal and neonatal serum calcium and vitamin D concentrations: a randomised clinical trial.

Br J Nutr. 2013 Apr 29:1-6.
Hashemipour S, Lalooha F, Zahir Mirdamadi S, Ziaee A, Dabaghi Ghaleh T.
Metabolic Diseases Research Center, Qazvin University of Medical Science, Qazvin, Iran.

There are several studies in which a correlation between maternal vitamin D deficiency and serum mineral disorders in the mother and the newborn has been reported. The present randomised clinical trial was designed to investigate the effect of vitamin D administration on maternal and fetal Ca and vitamin D status. The trial was carried out on 160 pregnant women. Vitamin D-deficient (25-hydroxyvitamin D (25(OH)D) < 30 ng/ml) pregnant women were recruited at 26-28 weeks of pregnancy. In the control group, a multivitamin supplement containing 400 IU vitamin D3/d was given. Patients in the treatment group were treated with 50 000 IU vitamin D3 weekly for a total duration of 8 weeks. At delivery, maternal and fetal Ca and 25(OH)D levels in both groups were compared.
In total, 81 % of pregnant women were vitamin D deficient. At the time of delivery, Ca and vitamin D levels were higher in the treatment group compared with the control group (92 (sd 3) v. 85 (sd 4) mg/l, respectively, P= 0·001 for serum Ca; 47·8 (sd 11·1) v. 15·9 (sd 6·6) ng/ml, respectively, P< 0·001 for vitamin D).
At the time of delivery, 32·7 % of women in the control group had hypocalcaemia, while no hypocalcaemic case was detected in the vitamin D-treated group.
Mean neonatal serum 25(OH)D was higher in the treatment group compared with the control group (27·7 (sd 5·2) v.10·9 (sd 4·4) ng/ml, respectively, P< 0·01).
The neonatal Ca level in the treatment group was significantly higher than that of the control group (99 (sd 3) v. 91 (sd 3) mg/l, respectively, P< 0·001). The administration of vitamin D to pregnant women with vitamin D deficiency improves both maternal and neonatal Ca levels.

PMID: 23628132

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2nd publication in a different journal of the same study

Effect of treatment of vitamin D deficiency and insufficiency during pregnancy on fetal growth indices and maternal weight gain: a randomized clinical trial.
Eur J Obstet Gynecol Reprod Biol. 2013 Oct 19. pii: S0301-2115(13)00509-5. doi: 10.1016/j.ejogrb.2013.10.010.
Hashemipour S, Ziaee A, Javadi A, Movahed F, Elmizadeh K, Javadi EH, Lalooha F.
Metabolic Diseases Research Center, Qazvin University of Medical Science, Qazvin, Iran.

OBJECTIVE: To determine whether treatment of low serum vitamin D in pregnant women improves fetal growth indices.

STUDY DESIGN: In this open-label randomized clinical trial, 130 Iranian pregnant women (24-26 weeks of gestation) with vitamin D deficiency or insufficiency [25(OH)D <30ng/ml] were divided at random into an intervention group and a control group. The control group received 200mg calcium plus a multivitamin (containing vitamin D3 400U) each day, and the intervention group received 200mg calcium plus a multivitamin (containing vitamin D3 400U) each day, plus vitamin D3 (50,000U) each week for 8 weeks. At delivery, maternal and cord blood 25(OH)D levels, maternal weight gain, neonatal length, neonatal weight and neonatal head circumference were compared between two groups. Serum vitamin D was measured using enzyme-linked immunosorbent assay. A multivariate regression analysis was performed to examine the independent effect of maternal vitamin D level on fetal growth indices.

RESULTS: Mean (±standard deviation)

• length (intervention group: 49±1.6cm; control group: 48.2±1.7cm; p=0.001),
• head circumference (intervention group: 35.9±0.7cm; control group: 35.3±1.0cm; p=0.001) and
• weight (intervention group: 3429±351.9g; control group: 3258.8±328.2g; p=0.01)

were higher in the intervention group compared with the control group.
Mean maternal weight gain was higher in the intervention group compared with the control group (13.3±2.4kg vs 11.7±2.7kg; p=0.006).
Multivariate regression analysis for

• maternal weight gain,
• neonatal length,
• neonatal weight and
• neonatal head circumference

showed an independent correlation with maternal vitamin D level.

CONCLUSION: Treatment of low serum vitamin D during pregnancy improves fetal growth indices and maternal weight gain.

Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
PMID: 24210789

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See also VitaminDWiki

• 35,000 IU vitamin D weekly during 3rd quarter pregnancy – RCT March 2013 which had the following

NH = not pregnant (much higher response to 35,000) solid line
PH = pregnant, higher dose (35,000 IU weekly)
PL = Pregnant and low (14,000 IU weekly)_ _ _ _ _ _ _ _

• Vitamin D of 32 to 60 ng is needed before, during, and after pregnancy – Dec 2012
• All items in Pregnancy and Vitamin D 918 items
• Overview Pregnancy and vitamin D which has the following summary
  

  IU	Cumulative Benefit	Blood level	Cofactors	Calcium	$*/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