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Pregnancies - Vitamin D intervention benefits not seen for 6 reasons– July 2015

Vitamin D during pregnancy: why observational studies suggest deficiency and interventional studies show no improvement in clinical outcomes? A narrative review

Journal of Endocrinological Investigation, July 2015
S. N. Karras karraspiros at yahoo.gr , P. Anagnostis, D. Naughton, C. Annweiler, A. Petroczi, D. G. Goulis
1. Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
2. School of Life Sciences, Kingston University, Kingston upon Thames, London, UK
3. Robarts Research Institute, The University of Western Ontario, London, ON, Canada
4. Department of Geriatric Medicine, UPRES EA 4638, University Hospital Angers, Angers, France

A considerable number of studies have examined vitamin D status during pregnancy. Although data from observational studies denote vitamin D hypovitaminosis (deficiency or insufficiency) during pregnancy is associated with a plethora of adverse maternal and neonatal outcomes, data from interventional (supplementation) trials fail to reveal a significant impact on maternal and offspring health. The aim of this narrative review was to critically appraise the methodology of the most representative published randomized controlled trials in an attempt to explain the difference between observational and supplementation results.
We found that this difference could be attributed to a variety of factors, namely:

  • (i) study design (lack of a specific outcome in conjunction with timing of supplementation, enrolment of participants with heterogeneous vitamin D status);
  • (ii) pitfalls in the interpretation of vitamin D equilibrium (lack of determination of plasma half-life);
  • (iii) supplementation regimen (administration of a wide range of regimens, in terms of dose, bolus and form);
  • (iv) geographical characteristics (vitamin D needs could vary significantly within a country, particularly in areas with a wide range of latitude gradient);
  • (v) adaptations of vitamin D metabolism during pregnancy (vitamin D and calcium equilibrium are changed during pregnancy compared with the non-pregnant state) and
  • (vi) supplementation of populations with low baseline 25(OH)D values would likely manifest beneficial effects.

All these parameters should be taken into consideration in the design of future vitamin D supplementation trials.

VitaminDWiki

There is been many positive intervention trials and meta-analyses
The articles in Pregnancy AND Intervention are here:

The articles in Pregnancy AND Meta-analysis are here:

Pregnancy category listing has 782 items along with related searches

Overview Pregnancy and vitamin D has the following summary

IU Cumulative Benefit Blood level CofactorsCalcium $*/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

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