Third trimester Vitamin D levels were lower if pre-term labor was expected – March 2018

Effect of prolonged hospitalization for threatened preterm labor on maternal and fetal vitamin D levels.

J Obstet Gynaecol Res. 2018 Mar 23. doi: 10.1111/jog.13620. Epub ahead of print
Yonetani N1, Kaji T1, Hichijo A1, Nakayama S1, Maeda K1,2, Irahara M1.

VitaminDWiki

At 3rd trimester 14 ng if PTL, 18 ng if normal labor
No statistical difference at 2nd trimeter nor in umbilical cord


See also VitaminDWiki

Preterm births are VERY costly – Feb 2017 contains this cost-analysis

Assumptions: additional $50,000 per premature birth, $100 for education & supplements per pregnancy

Net savings
per birth
After subtract
all cost
s
# needed
to eliminate
1 preterm
Cost of
educ, supp
per pregnancy
Total cost
Educ/supp.
Cost of
test per
pregnancy
Total
test
costs
Net savings after
subtract costs
Vitamin D
(5,000 IU avg)
$4,30020$100$2,000$200%%%(2 tests)$4,000$43,000
Omega-3 $64667 $100$6,700$0 $0 $43,300
Vitamin C
reduces early rupture
$64667$100$6,700$0$0 $43,300
Iodine $320100$100$10,000$80$8,000$32,000

Does not include additional savings to infant beyond the first year
   such as reductions in Autism, MS, Respiratory Tract Infection, Asthma, Allergies
Does not include additional savings to mother
   such as reduction in preeclampsia, miscarriage, gestational diabetes, depression
   nor does it assign any costs for anguish of possible premie death, stillbirth, time off from work, job productivity

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


AIM: We aimed to evaluate the effect of prolonged hospitalization for threatened preterm labor (TPL) on maternal and fetal vitamin D status.

METHODS:
This was a retrospective cohort study, spanning 4 years, including 18 women with TPL and 36 women with normal pregnancy who received prenatal care for a singleton pregnancy at our center. TPL cases were women who were admitted to our hospital after the second trimester test for at least 28 days, during which time the third trimester test was also performed. Controls were randomly sampled from women matched for age as well as the season during which the third trimester test was performed. Serum 25-hydroxyvitamin D (25(OH)D) concentration in maternal blood was compared between the two groups at second trimester, third trimester and in the umbilical cord blood at delivery.

RESULTS:
The mean ± SD of maternal serum 25(OH)D concentration in the TPL group (14.0 ± 3.0 ng/mL) was significantly lower than that in the control group (17.8 ± 5.9 ng/mL) (P < 0.01) in the third trimester, although there was no significant difference in the second trimester (P = 0.30). There was a significant reduction (P < 0.01) in the maternal serum 25(OH)D from the second to third trimester in the TPL group, compared to the control group (P = 0.60). There was no significant difference between the two groups in umbilical cord blood 25(OH)D concentrations at delivery (P = 0.41).

CONCLUSION: Prolonged hospitalization for TPL reduced the maternal vitamin D status but did not influence the neonatal status at delivery.

PMID: 29570909 DOI: 10.1111/jog.13620

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