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Might multiple pregnancy need even more vitamin D

Several items from the internet

This item got me thinking on the topic Physorg Oct 2010

The complication rate during pregnancy with twins is about 40%. Women with multiple pregnancies often develop pre-eclampsia, gestational diabetes, and hemorrhages during the term of their pregnancy.

14 in 1000 pregnancies will be multiple pregnancies. The average term for multiple pregnancies is notably shorter (for twins, 36 weeks; for triplets, 32 weeks; and for quadruplets, 30 weeks).

Made me wonder if the problems might be due to increased nutrient needs during multiple pregnancy, such as vitamin D. Unable to find anything conclusive quickly on the internet. Did find the following old abstract, Would be nice to see graphs of the vitamin D levels for multiple pregnancies with vs. without complications.

Bone turnover and mineral metabolism in the last trimester of pregnancy: effect of multiple gestation.

Obstet Gynecol. 1996 Aug;88(2):168-73.
Okah FA, Tsang RC, Sierra R, Brady KK, Specker BL.
Children's Hospital Research Foundation, Perinatal Research Institute, University of Cincinnati Medical Center, Ohio, USA.

OBJECTIVE: To test the hypothesis that maternal bone turnover and mineral stress are greater in multiple pregnancy than in singleton pregnancy.

METHODS: We measured serum markers of bone turnover and mineral stress in 17 multiple and 30 singleton pregnancies during the third trimester.
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Strange: serum vitamin D was 61 ng in women with a multiple pregnancy. Is the body kicking into overdrive to produce Calcium?

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RESULTS: Serum 25(OH) vitamin D, a marker of vitamin D intake, was higher (61 +/- 5 versus 39 +/- 2 ng/mL, P < .001), and 1,25(OH)2 vitamin D was lower (50 (95% confidence interval (CI) 24-102) versus 64 pg/mL (95% CI 30-135), P = .03) in multiple than in singleton pregnancy. Carboxyterminal telopeptide of type I collagen, a marker of bone resorption, increased with gestational duration and was higher in multiple gestation (5.8 (95% CI 3.3-10.1) versus 4.4 ng/mL (95% CI 2.5-7.8), P = .005). Carboxyl-terminal propeptide of type 1 procollagen, a marker of bone formation, increased with gestational duration and was not different between groups (110 (95% CI 36-337) versus 99 ng/mL (95% CI 34-286), P = .5). Calcitonin increased with gestational duration and was not different between groups (7.0 (95% CI 3.7-13.0) versus 7.8 pg/mL (95% CI 4.0-15.4), P = .37). Parathyroid hormone was not different between groups and decreased with increasing maternal age.

CONCLUSION: Bone turnover indices increased with gestational duration. The bone resorption index was greater in multiple than in singleton gestation. Serum 25(OH) vitamin D was greater and 1,25(OH)2 vitamin D was lower in multiple gestation, presumably because of greater consumption of vitamin D and minerals by women carrying more than one fetus. PMID: 8692495

See also VitaminDWiki

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