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Monthly 120,000 IU Vitamin D plus daily Calcium was great during pregnancies – RCT Sept 2017

A randomized double blind controlled trial to investigate the effects of vitamin D supplementation on maternal and new-born baby’s vitamin D status in Asian-Indian subjects

Osteoporosis and Sarcopenia, Vol 3, Issue 3, Suppl. Sept 2017, Pages S38–S39, https://doi.org/10.1016/j.afos.2017.08.073

ParameterGroup 1Group 2Group 3Group 4
Dose of Vit D600 IU/Day1000 IU/Day2000 IU/Day4000 IU/Day
Baseline S. Vit D9.09±5.697.51± 3.9110.63±7.678.89±7.4
S. vit D 24-28 wks11.87±7.7919.03±6.8722.38±7.5230.68±10.67
S. vit D at delivery11.4±9.9520.34±8.6627.45±10.6437.17±12.4
Cord blood S.vit D12.49±12.9522.114±9.1730.67±14.1541.38±14.71
Cord blood
deficiency (< 20 ng)
78%41%18%6%
VitaminDWiki

With ~6 monthly doses of 120,000 IU Vitamin D: 94% deficiency ==> 6%
Cord blood ==> 41 ng
VitaminDWiki doubts that the daily Calcium was needed
Far more important than Calcium is the addition of Omega-3 during pregnancy

See also VitaminDWiki

Items in both categories Pregnancy and Non-daily intervention are listed here:

Healthy pregnancies need lots of vitamin D has the following summary

Problem
ReducesProof
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
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*

Tarang Gupta, Harshna Sharma, Jaya Bajpai, Garima Kachhawa, Vidushi Kulshreshtha, Rajesh Khadgawat, Nandita Gupta, V. Sreenivas, Arul Selvi, Vandana Jain

Introduction: High prevalence of vitamin D deficiency (VDD) has been well documented during pregnancy. Maternal vitamin D status has been linked to maternal and fetal outcomes. It is hypothesized that supplementation of vitamin D during pregnancy may improve these outcomes. We planned a study to investigate the efficacy of vitamin D supplementation, given in early stage of pregnancy, on maternal, fetal and newborn parameters.

Material & method: This randomized double blind active controlled clinical trial was carried out in pregnant subjects attending antenatal clinic, AIIMS. The inclusion criteria were age between 18-40 years, singleton pregnancy with gestational age between 12-16 weeks. Any subject who had high risk pregnancy, or any systemic disease, or received vitamin D supplementation in doses exceeding 600 IU in last three months, on any medication known to affect metabolism of vitamin D were excluded. Similarly, after screening, any subject with serum vitamin D level (S.VitD) >100 ng/ml or serum calcium more than upper limit of normal were also excluded. Sample size for this study was calculated based on primary outcome of improvement of vitamin D status of mother at the time of delivery.
Subjects randomized into four groups in ratio of 1:1:1:1(

  • Group 1 - active control group received 600 units of vitamin D per day;
  • Group 2 – 1000 units/day;
  • Group 3 – 2000 units/day;
  • Group 4 - 4000 units per day).

All groups received 1000 mg of elemental calcium (in two divided doses), and similar nutritional and lifestyle advice for standard management of pregnancy. Doses of vitamin D were calculated on daily basis but given orally, once a month, supervised in hospital. The primary outcome of the study was changes in vitamin D status of mother and newborn. Secondary outcomes of the study were weight gain during pregnancy, blood pressure, preterm labor, pre-eclampsia, fetal growth, newborn’s anthropometry, and insulin resistance in mother as well as in cord blood. Safety of intervention was assessed by regular monitoring of urinary calcium creatinine ration and serum calcium levels

Results: Total 243 subjects completed the study and were analyzed. High prevalence of vitamin D deficiency was seen in study population. Of total 243 subjects, 93.6% of subjects had VDD (S.VitD <20 ng/ml) while 97.5% subjects had S.VitD level <30 ng/ml. No significant difference was seen in S.VitD level among all four groups. Improvement in S.VitD level after supplementation is shown in Table -1. Among cord S.VitD status, 77.8% babies in group 1, 47.1% in group 2, 17.8% in group 3 and 6.2% in group 4 were VDD. Apart from S.VitD level, no significant difference was observed among all four groups in any other maternal, fetal and newborn parameters (maternal wt gain, pre-eclampsia, fetal growth, newborn’s anthropometry, and insulin resistance in mother as well as in cord blood).

Conclusion: Our study shows that supplementation of vitamin D in mother improves vitamin D status of newborn. However, vitamin D supplementation during pregnancy did not shown any effect on any other maternal, fetal and newborn parameter.

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