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Vitamin D once during pregnancy reduced infant health care costs (300 times ROI) – RCT Dec 2015

Effects of Pre-Natal Vitamin D Supplementation with Partial Correction of Vitamin D Deficiency on Early Life Healthcare Utilisation: A Randomised Controlled Trial.

PLoS One. 2015 Dec 23;10(12):e0145303. doi: 10.1371/journal.pone.0145303. eCollection 2015.

VitaminDWiki Summary

180 women given single dose of 200,000 IU of vitamin D at 27 weeks gestation
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Extensive detail on health care costs. Costs are in UK £
ROI = Return on Investment
Cost differences were not statistically significant after “correcting” for ethnicity
Note: They “corrected” for lower levels of vitamin D in darker skinned women
Probably far more cost effective (>1000 times?) if gave periodic doses to mother AND infant
See also VitaminDWiki

Pregnancy category starts with
483 items in Pregnancy category
 - see also

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Healthy pregnancies need lots of vitamin D has the following summary
Lots of vitamin D improves pregnant mother & child health in 15+ ways

1. Reduces Miscarriage 2.5 times Observation
2. Reduces Pre-eclampsia 3.6 timesRCT*
3. Reduces Gestational Diabetes 3 times RCT*
4. Reduces Depression AFTER pregnancy 1.4 times RCT*
5. Reduces Vaginosis 10 times RCT*
6. Reduces Premature birth 2 times RCT*
7. Reduces C-section - unplanned 1.6 timesObservation
8. Reduces Small for Gestational Age 3 times Observation
9. Infant height, weight, head size
     within normal limits
RCT*
10. Reduces Childhood Wheezing 1.3 times RCT*
11. Reduces Childhood Autism 4 times Intervention
12. Reduces young adult Multiple Sclerosis 1.9 times Observation
13. Reduces Preeclampsia in young adult 3.5 timesRCT*
14. Reduces Childhood Mite allergy 5 times RCT*
15. Reduce Childhood Respiratory Tract visits 2.5 times RCT*

Griffiths M1, Goldring S1, Griffiths C2, Shaheen SO2, Martineau A2, Cross L2, Robinson S3, Warner JO1, Devine A2, Boyle RJ1.
1Department of Paediatrics, Imperial College London, London, United Kingdom.
2Centre for Primary Care and Public Health, Blizard Institute, Queen Mary University of London, London, United Kingdom.
3Department of Endocrinology, Imperial College London, London, United Kingdom.

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A portion of Table 6
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BACKGROUND:
Some observational studies have suggested that higher prenatal Vitamin D intake may be associated with improved health outcomes in childhood. However there have been mixed results in this area with some negative studies, especially for effects on atopic and respiratory outcomes. We examined the effect of prenatal Vitamin D on healthcare utilisation in the first three years of life.

METHODS:
In an ethnically stratified randomised controlled trial conducted at St Mary's Hospital London, 180 women at 27 weeks gestation were allocated to no Vitamin D, 800 IU ergocalciferol daily until delivery, or a single oral bolus of 200,000 IU cholecalciferol. Participants were randomised in blocks of 15 using computer-generated numbers and investigators were blinded to group assignment. Supplementation increased maternal and cord blood 25(OH) vitamin D concentrations, but levels remained lower than current recommendations. Primary health economic outcome was overall cost of unscheduled healthcare utilisation in the first three years of life as documented in the child's electronic health record. Secondary outcomes included cost attributable to: primary and secondary healthcare visits, respiratory and atopic complaints, cost in years 1, 2 and 3 of life and cost and frequency of prescribed medication. All costs were calculated as pounds sterling. Differences between groups were analysed using unpaired t-test or Mann-Whitney U test, and analysis of variance for adjusted analyses.

RESULTS:
We assessed 99/180 (55%) complete electronic health records, control (n = 31), daily (n = 36) and bolus (n = 32). We found no difference in total healthcare utilisation costs between the control and daily (mean difference in costs in pounds sterling 1.02, 95%CI -1.60, 1.65; adjusted 1.07, 95%CI -1.62, 1.86) or control and bolus groups (mean difference -1.58, 95%CI -2.63, 1.06; adjusted -1.40, 95%CI -2.45, 1.24). There were no adverse effects of supplementation reported during the trial.

CONCLUSIONS:
We found no evidence that prenatal vitamin D supplementation from 27 weeks gestation to delivery, at doses which failed to completely correct maternal vitamin D deficiency, influence overall healthcare utilisation in children in the first 3 years.

TRIAL REGISTRATION: Controlled-Trials.com ISRCTN68645785.

PMID: 26698303 PMCID: PMC4689556 DOI: 10.1371/journal.pone.0145303



List of attached files
ID Name desc uploaded Size Downloads Actions
6867 jpg Early Life T6.jpg 09 July, 2016 by admin 29.84 Kb 150 View Download  
6866 jpg Early Life F2.jpg 09 July, 2016 by admin 13.44 Kb 211 View Download  
6865 pdf Early Life Healthcare Utilisation.pdf PDF 2015 09 July, 2016 by admin 470.59 Kb 70 View Download  
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