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Vitamin D supplementation reduced SGA, fetal mortality, infant mortality – JAMA Meta – May 2018

Association Between Vitamin D Supplementation During Pregnancy and Offspring Growth, Morbidity, and Mortality A Systematic Review and Meta-analysis

JAMA Pediatr. oi:10.1001/jamapediatrics.2018.0302 online May 29,2018.
WeiGuangBi, BSc; Anne Monique Nuyt, MD; HopeWeiler, PhD; LineLeduc, MD;
Christina Santamaria, BSc; Shu Qin Wei, MD, PhD

VitaminDWiki

Healthy pregnancies need lots of vitamin D has the following summary

Problem
Vit. D
Reduces
Evidence
0. Chance of not conceiving3.4 times Observe
1. Miscarriage 2.5 times Observe
2. Pre-eclampsia 3.6 timesRCT
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 timesObserve
     Stillbirth - OMEGA-3 4 timesRCT - 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 timesObserve
13. Preeclampsia in young adult 3.5 timesRCT
14. Good motor skills @ age 31.4 times Observe
15. Childhood Mite allergy 5 times RCT
16. Childhood Respiratory Tract visits 2.5 times RCT

RCT = Randomized Controlled Trial
Pregnancy category starts with

884 items in Pregnancy category

 - see also

 Download the PDF from VitaminDWiki

IMPORTANCE Whether vitamin D supplementation during pregnancy is beneficial and safe for offspring is unclear.

OBJECTIVE To systematically review studies of the effects of vitamin D supplementation during pregnancy on offspring growth, morbidity, and mortality.

DATA SOURCES Searches of Medline, Embase, and the Cochrane Database of Systematic Reviews were conducted up to October 31, 2017 Key search terms were vitamin D, pregnancy, randomized controlled trials, and offspring outcomes.
STUDY SELECTION Randomized clinical trials of vitamin D supplementation during pregnancy and offspring outcomes.
DATA EXTRACTION AND SYNTHESIS Two authors independently extracted data, and the quality of the studies was assessed. Summary risk ratio (RR), risk difference (RD) or mean difference (MD), and 95% CI were calculated using fixed-effects or random-effects meta-analysis.

MAIN OUTCOMES AND MEASURES Main outcomes were fetal or neonatal mortality, small for gestational age (SGA), congenital malformation, admission to a neonatal intensive care unit, birth weight, Apgar scores, neonatal 25-hydroxyvitamin D (25OHD) and calcium concentrations, gestational age, preterm birth, infant anthropometry, and respiratory morbidity during childhood.

RESULTS Twenty-four clinical trials involving 5405 participants met inclusion criteria. Vitamin □ supplementation during pregnancy was associated with a lower risk of SGA (RR, 0.72; 95% CI, 0.52 to 0.99; RD, -5.60%; 95% CI, -0.86% to -10.34%) without risk of fetal or neonatal mortality (RR, 0.72; 95% CI, 0.47 to 1.11) or congenital abnormality (RR, 0.94; 95% CI, 0.61 to 1.43).
Neonates with prenatal vitamin D supplementation had higher 25(OH)D levels (MD, 13.50 ng/mL; 95% CI, 10.12 to 16.87 ng/mL), calcium levels (MD, 0.19 mg/dL; 95% CI, 0.003 to 0.38 mg/dL), and weight at birth (MD, 75.38 g; 95% CI, 22.88 to 127.88 g), 3 months (MD, 0.21 kg; 95% CI, 0.13 to 0.28 kg), 6 months (MD, 0.46 kg; 95% CI, 0.33 to 0.58 kg), 9 months (MD, 0.50 kg; 95% CI, 0.01 to 0.99 kg), and 12 months (MD, 0.32 kg; 95% CI, 0.12 to 0.52 kg).
Subgroup analysis by doses showed that low-dose vitamin D supplementation (<2000 IU/d) was associated with a reduced risk of fetal or neonatal mortality (RR, 0.35; 95% CI, 0.15 to 0.80), but higher doses (>2000 IU/d) did not reduce this risk (RR, 0.95; 95% CI, 0.59 to 1.54).

Comment by VitaminDWiki - Strange - Have not seen >2,000 IU being a problem before this.
Wonder if it is correct?


CONCLUSIONS AND RELEVANCE Vitamin D supplementation during pregnancy is associated witha reduced risk of SGA and improved infant growth without risk of fetal or neonatal mortality or congenital abnormality. Vitamin D supplementation with doses of 2000 IU/d or lower during pregnancy may reduce the risk of fetal or neonatal mortality


Created by admin. Last Modification: Saturday June 30, 2018 00:27:38 GMT-0000 by admin. (Version 2)

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10016 Offspring Growth, Morbidity, and Mortality.pdf admin 24 Jun, 2018 530.95 Kb 697