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Pregnant women may benefit from customized vitamin D supplementation
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Women at risk for vitamin D deficiency in early pregnancy and those who gain more weight during pregnancy or deliver in winter can benefit from a higher level of vitamin D supplementation vs. pregnant women without those factors, according to findings from a randomized study.
“It is critical for pregnant women to have sufficient levels of vitamin D for the health of their baby,” Nicholas C. Harvey, MA, MB, BChir, MRCP, PhD, professor of rheumatology and clinical epidemiology at the University of Southampton, United Kingdom, said in a press release. “Our study findings suggest that in order to optimize vitamin D concentrations through pregnancy, the supplemental dose given may need to be tailored to a woman’s individual circumstances, such as the anticipated season of delivery.”
Harvey and colleagues analyzed data from 829 pregnant women participating in the Maternal Vitamin D Osteoporosis study, a multicenter, randomized, double blind, placebo-controlled trial of vitamin D supplementation in pregnancy. Women completed health and lifestyle questionnaires and provided blood samples for vitamin D measurements at 14 weeks’ gestation before being randomly assigned to 1,000 IU per day oral vitamin D (n = 407) or matching placebo (n = 422). Vitamin D levels were measured again at 34 weeks’ gestation. Compliance was determined using pill counts at 19 and 34 weeks. All women continued with standard antenatal care and could continue self-administration of dietary supplements containing up to 44 IU per day of vitamin D. The primary outcome was 25-hydroxyvitamin D measurements at 34 weeks’ gestation.
Women assigned cholecalciferol had a greater mean maternal 25-(OH)D concentration at 34 weeks’ gestation vs. women assigned placebo (67.7 nmol/L vs. 43.1 nmol/L; P < .0001). Among women assigned cholecalciferol, 83.3% achieved vitamin D replete status vs. 35.6% of women in the placebo group. In both groups, the proportion of women who were vitamin D replete at 34 weeks’ gestation was lower in those delivering in winter, according to researchers.
In multiple linear regression analysis, researchers found that women assigned cholecalciferol had several maternal factors associated with greater 25-(OH)D level at 34 weeks’ gestation, including lower pregnancy weight gain (beta = –0.81; 95% CI, –1.39 to –0.22), higher compliance (beta = 0.28; 95% CI, 0.072-0.48), a higher early pregnancy vitamin D level (beta = 0.28; 95% CI, 0.16-0.4) and a summer delivery (beta = 10.51; 95% CI, 6.4-14.63).
“Our findings of varied responses to vitamin D supplementation according to individual attributes can be used to tailor approaches to prenatal care,” Cyrus Cooper, OBE, MA, DM, FRCP, FFPH, FMedSci, director of the MRC Lifecourse Epidemiology Unit at University of Southampton, said in the release. “This work will inform the development of strategies to enhance bone development across generations.” – by Regina Schaffer
Disclosure: Cooper reports receiving personal fees from ABBH, Amgen, Eli Lilly, GlaxoSmithKline, Medtronic, Merck, Novartis, Pfizer, Roche, Servier and Takeda. Harvey reports receiving personal fees, lecture fees, honoraria or consultant fees from Alliance for Better Bone Health, Amgen, Consilient Healthcare, Internis Pharma, MSD, Eli Lilly, Servier and Shire. Please see the full study for the other authors’ relevant financial disclosures.
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