Preterm birth 4X more likely if very low Vitamin D (Chinese) - Feb 2018

Influent factors of gestational vitamin D deficiency and its relation to an increased risk of preterm delivery in Chinese population.

Sci Rep. 2018 Feb 26;8(1):3608. doi: 10.1038/s41598-018-21944-3.
Chen YH1,2,3, Fu L1, Hao JH1,3, Wang H1, Zhang C1, Tao FB1,3, Xu DX4,5.

VitaminDWiki

Gestational vitamin D status

SufficiencyInsufficiency Deficiency
Adjusted Preterm Risk 1.00 2.14.0
Adjusted Early Preterm Risk1.000.543.0

See also VitaminDWiki

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
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

 Download the PDF from VitaminDWiki

Gestational vitamin D deficiency (VDD) has been linked with adverse pregnant outcomes. To investigate influent factors of gestational VDD and its relation to the incidence of preterm delivery, total 3598 eligible mother-and-singleton-offspring pairs were recruited. For serum 25(OH)D concentration, 941 pregnant women were sufficient, 1260 insufficient, and 1397 deficient. Further analysis showed that VDD was more prevalent in winter than in other seasons. Underweight but not overweight was a risk factor for gestational VDD. Multivitamin use reduced risk of gestational VDD. Interestingly, 8.23% delivered preterm infants among subjects with VDD (adjusted RR: 4.02; 95% CI: 2.33, 6.92) and 3.81% among subjects with gestational vitamin D insufficiency (VDI) (adjusted RR: 2.07; 95% CI: 1.16, 3.71). Moreover, 2.59% delivered early preterm infants among subjects with VDD (adjusted RR: 2.97; 95% CI: 1.41, 6.24) and 0.49% among subjects with VDI (adjusted RR: 0.54; 95% CI: 0.19, 1.51). The incidence of late preterm delivery was 5.64% among subjects with VDD (adjusted RR: 3.90; 95% CI: 2.26, 6.72) and 3.32% among subjects with VDI (adjusted RR: 2.09; 95% CI: 1.17, 3.74). In conclusion, pre-pregnancy BMI, seasonality and multivitamin use are influent factors of gestational vitamin D status. Gestational VDD is associated with an increased risk of preterm delivery in Chinese population.

PMID: 29483547 DOI: 10.1038/s41598-018-21944-3

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