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WHO recommends zero vitamin D during pregnancy, rest of the world disagrees – Dec 2018

Compare IOM and WHO

Organization most adultsElderlyPregnant
IOM RDA 600 IU 800 IU600 IU
WHO RNI 200 IU600 IU 0 IU

Chart adapted from Vitamin D Recommendations around the world - IU and ng

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WHO: Vitamin D supplementation during pregnancy

WHO: Vitamin D supplementation is not recommended for pregnant women to improve maternal and perinatal outcomes
WHO allows 200 IU to be given only if the pregnant women has a proven Vitamin D deifciency

VitaminDWiki

Example of problems with their references - ignored
1) Dose size
2) When it was given during pregnancy
3) How often the dose was given (daily, weekly, monthly, or a single time)
4) If Calcium was also given

Problem
ReducesEvidence
0. Chance of not conceiving3.4 times Observe
1. Miscarriage 2.5 times Observe
2. Pre-eclampsia 3.6 timesRandomized Controlled Trial
3. Gestational Diabetes 3 times Randomized Controlled Trial
4. Good 2nd trimester sleep quality 3.5 times Observe
5. Premature birth 2 times Randomized Controlled Trial
6. C-section - unplanned 1.6 timesObserve
     Stillbirth - OMEGA-3 4 timesRCT - Omega-3
7. Depression AFTER pregnancy 1.4 times Randomized Controlled Trial
8. Small for Gestational Age 1.6 times meta-analysis
9. Infant height, weight, head size
     within normal limits
Randomized Controlled Trial
10. Childhood Wheezing 1.3 times Randomized Controlled Trial
11. Additional child is Autistic 4 times Intervention
12.Young adult Multiple Sclerosis 1.9 timesObserve
13. Preeclampsia in young adult 3.5 timesRandomized Controlled Trial
14. Good motor skills @ age 31.4 times Observe
15. Childhood Mite allergy 5 times Randomized Controlled Trial
16. Childhood Respiratory Tract visits 2.5 times Randomized Controlled Trial

The articles in Pregnancy AND Intervention are here:


The articles in Pregnancy AND Meta-analysis are here:


WHO recommendation of 200 IU during pregnancy was reduced to 0 IU (by 2018)

Image

 Download the PDF from VitaminDWiki
Remarks

  • This recommendation supersedes the previous WHO recommendation found in the 2012 Guideline: vitamin D supplementation in pregnant women (1).
  • Pregnant women should be advised that sunlight is the most important source of vitamin D. The amount of time needed in the sun is not known and depends on many variables, such as the amount of skin exposed, the time of day, latitude and season, skin pigmentation (darker skin pigments synthesize less vitamin D than lighter pigments) and sunscreen use (1).
  • Pregnant women should be encouraged to receive adequate nutrition, which is best achieved through consumption of a healthy, balanced diet, and to refer to WHO guidance on healthy eating (2).
  • For pregnant women with documented vitamin D deficiency, vitamin D supplements may be given at the current recommended nutrient intake (RNI) of 200 IU (5 µg) per day.
  • According to the Cochrane review, there are 23 ongoing or unpublished studies on vitamin D supplementation in pregnancy (3). Evidence from these trials should help to clarify the current uncertainties regarding vitamin D effects, particularly the effect on preterm birth, and any other associated benefits or harms of vitamin D when combined with other vitamins and minerals, particularly calcium.

* This is an extract from the relevant guideline (4). Additional guidance information can be found in these documents.

References


Vitamin D supplementation during pregnancy Dec 17, 2018

Evidence – go to above website to get more hyperlinks
Systematic reviews used to develop the guidelines
Vitamin D supplementation for women during pregnancy
De-Regil LM, Palacios C, Lombardo LK, Peña-Rosas JP.
Cochrane Database of Systematic Reviews 2016, Issue 1. Art. No.: CD008873.
Summary of this review
Podcast (Cochrane)
Related systematic reviews
Effect of vitamin D supplementation during pregnancy on maternal and neonatal outcomes: a systematic review and meta-analysis of randomized controlled trials
Pérez-López FR, Pasupuleti V, Mezones-Holguin E, Benites-Zapata VA, Thota P, Deshpande A, Hernandez AV.
Fertility and Sterility. 2015; 103(5):1278-88.e4.  Download the PDF from VitaminDWiki
Comment by VitaminDWiki: This old study ignored
Dose size
When it was given during pregnancy
How often the dose was given (daily, weekly, monthly, or a single time)
If Calcium was also given

Vitamin D during pregnancy and maternal, neonatal and infant health outcomes: a systematic review and meta-analysis
Thorne-Lyman A, Fawzi WW.Paediatric and Perinatal Epidemiology. 2012; 26(s1):75–90.
Clinical trials
Current and ongoing clinical trials relating to vitamin D supplementation during pregnancy



Created by admin. Last Modification: Sunday January 6, 2019 11:29:41 GMT-0000 by admin. (Version 36)

Attached files

ID Name Comment Uploaded Size Downloads
11136 WHO 2001.jpg admin 03 Jan, 2019 03:45 51.96 Kb 107
11135 WHO 2001.pdf admin 03 Jan, 2019 03:38 6.20 Mb 34
11133 recommendations - with WHO.jpg admin 02 Jan, 2019 16:30 39.14 Kb 181
11127 Pérez-López.pdf admin 01 Jan, 2019 13:02 1.81 Mb 35
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