Maternal 25(OH)D concentrations >40 ng/mL associated with 60% lower preterm birth risk among general obstetrical patients at an urban medical center
PLoS ONE 12(7): e0180483. https://doi.org/10.1371/journal.pone.0180483
1,064 pregnant women at Medical University of South Carolina 9/2015 to 12/2016
Typically prescribed 5,000 IU of vitamin D daily
Without a loading dose, the Vitamin D levels probably took 3 months after conception to plateau (and provide a benefit)
A second vitamin D test in the first portion of 2nd trimester was used to increase the dosing (half of the women had vitamin D levels < 39 ng)
Suspect that much more than 5,000 IU would be needed to get most (say 97.5%) of the women > 40 ng
Also: 80% lower risk of recurrent PTB with >40 ng/mL compare to those <20 ng/mL
See also VitaminDWiki
- Vitamin D intervention reduces preterm births and low birth weight by 60 percent – Cochrane Reviews – Nov 2017
- Low birth weight far more likely if African-American (low vitamin D) – 1997, Aug 2018
- Preterm birth 9 X more likely if fetus had a poor Vitamin D Receptor and previous miscarriage – Aug 2017
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- Healthy pregnancies need lots of vitamin D
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Healthy pregnancies need lots of vitamin D has the following summary
ProblemVit. D
ReducesEvidence 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 limitsRCT 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
 Download the PDF from VitaminDWikiSharon L. McDonnell1, Keith A. Baggerly2, Carole A. Baggerly1, Jennifer L. Aliano1, Christine B. French1 christine@grassrootshealth.org, Leo L. Baggerly1, Myla D. Ebeling3, Charles S. Rittenberg3, Christopher G. Goodier3, Julio F. Mateus Nino3, Rebecca J. Wineland3, Roger B. Newman3, Bruce W. Hollis3, Carol L. Wagner3
1 GrassrootsHealth, Encinitas, California, USA,
2 Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
3 Medical University of South Carolina Children’s Hospital, Charleston, South Carolina, USABackground
Given the high rate of preterm birth (PTB) nationwide and data from RCTs demonstrating risk reduction with vitamin D supplementation, the Medical University of South Carolina (MUSC) implemented a new standard of care for pregnant women to receive vitamin D testing and supplementation.Objectives
To determine if the reported inverse relationship between maternal 25(OH)D and PTB risk could be replicated at MUSC, an urban medical center treating a large, diverse population.Methods
Medical record data were obtained for pregnant patients aged 18-45 years between September 2015 and December 2016. During this time, a protocol that included 25(OH)D testing at first prenatal visit with recommended follow-up testing was initiated. Free vitamin D supplements were offered and the treatment goal was >40 ng/mL. PTB rates (<37 weeks) were calculated, and logistic regression and locally weighted regression (LOESS) were used to explore the association between 25(OH)D and PTB. Subgroup analyses were also conducted.Results
Among women with a live, singleton birth and at least one 25(OH)D test during pregnancy (N = 1,064), the overall PTB rate was 13%. The LOESS curve showed gestational age rising with increasing 25(OH)D. Women with 25(OH)D >40 ng/mL had a 62% lower risk of PTB compared to those <20 ng/mL (p<0.0001). After adjusting for socioeconomic variables, this lower risk remained (OR = 0.41, p = 0.002). Similar decreases in PTB risk were observed for PTB subtypes (spontaneous: 58%, p = 0.02; indicated: 61%, p = 0.006), by race/ethnicity (white: 65%, p = 0.03; non-white: 68%, p = 0.008), and among women with a prior PTB (80%, p = 0.02). Among women with initial 25(OH)D <40 ng/mL, PTB rates were 60% lower for those with >40 vs. <40 ng/mL on a follow-up test (p = 0.006); 38% for whites (p = 0.33) and 78% for non-whites (p = 0.01).Conclusions
Maternal 25(OH)D concentrations >40 ng/mL were associated with substantial reduction in PTB risk in a large, diverse population of women.
Supect that the removal of single outlier at 100 ng would greatly reduce the increased risk for vitamin D levels > 60 ng
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