Clinical Endocrinology, DOI: 10.1111/cen.12751
Aanchal Sablok1,*, Aruna Batra1, Karishma Thariani1, Achla Batra1, Rekha Bharti1, Abha Rani Aggarwal2, B C 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. Email: aanchalsablok54 at gmail.com
|Vitamin D Level||18 ng||32 ng|
|Preterm labor |
or Gestational Diabetes
|44 %||20 %|
|Birth weight||2.4 kg||2.6 kg|
Context: Vitamin D deficiency widely prevalent throughout the world. Pregnant women, neonates and infants form most vulnerable groups for vitamin D deficiency.
Objective: 1) To find prevalence of vitamin D deficiency in pregnant women. 2) To evaluate 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 years 2010-2012.
Setting: Tertiary care centre, Delhi, India.
Participants: 180 pregnant women. Study population 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 Pre-term labour; 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% patients in group A and 20.3% patients in group B developed Pre-term labour/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 risk of maternal comorbidities and helps improve neonatal outcomes.
- 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 has the following summary
|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
|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