Abstract
Objective
To determine whether treatment of low serum vitamin D in pregnant women improves fetal
growth indices.
Study design
In this open-label randomized clinical trial, 130 Iranian pregnant women (24–26 weeks
of gestation) with vitamin D deficiency or insufficiency [25(OH)D <30 ng/ml] were divided at random into an intervention group and a control group. The
control group received 200 mg calcium plus a multivitamin (containing vitamin D3 400 U) each day, and the intervention group received 200 mg calcium plus a multivitamin (containing vitamin D3 400 U) each day, plus vitamin D3 (50,000 U) each week for 8 weeks. At delivery, maternal and cord blood 25(OH)D levels, maternal
weight gain, neonatal length, neonatal weight and neonatal head circumference were
compared between two groups. Serum vitamin D was measured using enzyme-linked immunosorbent
assay. A multivariate regression analysis was performed to examine the independent
effect of maternal vitamin D level on fetal growth indices.
Results
Mean (±standard deviation) length (intervention group: 49 ± 1.6 cm; control group: 48.2 ± 1.7 cm; p = 0.001), head circumference (intervention group: 35.9 ± 0.7 cm; control group: 35.3 ± 1.0 cm; p = 0.001) and weight (intervention group: 3429 ± 351.9 g; control group: 3258.8 ± 328.2 g; p = 0.01) were higher in the intervention group compared with the control group. Mean
maternal weight gain was higher in the intervention group compared with the control
group (13.3 ± 2.4 kg vs 11.7 ± 2.7 kg; p = 0.006). Multivariate regression analysis for maternal weight gain, neonatal length,
neonatal weight and neonatal head circumference showed an independent correlation
with maternal vitamin D level.
Conclusion
Treatment of low serum vitamin D during pregnancy improves fetal growth indices and
maternal weight gain.
Keywords
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References
- Maternal-fetal calcium and bone metabolism during pregnancy, puerperium, and lactation.Endocr Rev. 1997; 18: 832-872
- Vitamin D requirements during pregnancy.Am J Clin Nutr. 2004; 80: 1740S-1747S
- The efficiency of intestinal calcium absorption is increased in late pregnancy but not in established lactation.Calcif Tissue Int. 1991; 48: 293-295
- Vitamin D in pregnancy and lactation: maternal, fetal, and neonatal outcomes from human and animal studies.Am J Clin Nutr. 2008; 88: 520S-528S
- Vitamin D supplementation during pregnancy: double-blind, randomized clinical trial of safety and effectiveness.J Bone Miner Res. 2011; 26: 2341-2357
- Occult osteomalacia amongst healthy and pregnant women in Pakistan.Lancet. 1976; 2: 1211-1213
- High prevalence of vitamin D and calcium deficiency among pregnant women and their newborns in Chengdu, China.World J Pediatr. 2010; 6: 265-267
- Vitamin D status in pregnant Omanis: a disturbingly high proportion of patients with low vitamin D stores.Sultan Qaboos Univ Med J. 2011; 11: 52-55
- Vitamin D status of mothers and their neonates in Kuwait.Pediatr Int. 2005; 47: 649-652
- High prevalence of vitamin D deficiency among pregnant women and their newborns in an Iranian population.J Womens Health. 2009; 18: 835-839
- Changes in calcium, 25(OH) vitamin D3 and other biochemical factors during pregnancy.J Endocrinol Invest. 2006; 29: 303-307
- Maternal vitamin D deficiency increases the risk of preeclampsia.J Clin Endocrinol Metab. 2007; 92: 3517-3522
- Vitamin D and fertility: a systematic review.Eur J Endocrinol. 2012; 166: 765-778
- Bone turnover and maternal 25(OH) vitamin D3 levels during pregnancy and the postpartum period: should routine vitamin D supplementation be increased in pregnant women?.Eur J Obstet Gynecol Reprod Biol. 2011; 158: 24-27
- Vitamin D status during pregnancy: maternal, fetal, and postnatal outcomes.Curr Opin Obstet Gynecol. 2011; 23: 422-426
- 25(OH) D levels in diabetic pregnancies relation with neonatal hypocalcemia.Horm Metab Res. 1991; 23: 38-41
- Craniotabes in normal newborns: the earliest sign of subclinical vitamin D deficiency.J Clin Endocrinol Metab. 2008; 93: 1784-1788
- Vitamin D, PTH and calcium levels in pregnant women and their neonates.Clin Endocrinol (Oxf). 2009; 70: 372-377
- Maternal 25-hydroxyvitamin D and parathyroid hormone concentrations and offspring birth size.J Clin Endocrinol Metab. 2006; 91: 906-912
- Maternal vitamin D status determines bone variables in the newborn.J Clin Endocrinol Metab. 2010; 95: 1749-1757
- Vitamin D insufficiency is common in Indian mothers but is not associated with gestational diabetes or variation in newborn size.Eur J Clin Nutr. 2009; 63: 646-652
- Estimated maternal ultraviolet B exposure levels in pregnancy influence skeletal development of the child.J Clin Endocrinol Metab. 2009; 94: 765-771
- The correlation between third-trimester maternal and newborn serum 25-hydroxy-vitamin D in a selected South Australian group of newborn samples.BMJ Open. 2011; 1: e000236
- Osteoblast differentiation and control by vitamin D and vitamin D metabolites.Curr Pharm. 2004; 10: 2535-2555
- PTH/PTHrP activity and the programming of skeletal development in utero.J Bone Miner Res. 2004; 19: 177-182
- Effect of vitamin D supplementation during pregnancy on neonatal mineral homeostasis and anthropometry of the newborn and infant.Br J Nutr. 2012; 3: 1-7
- Effects of vitamin D supplementation in pregnancy.Gynecol Obstet Invest. 1981; 12: 155-161
- Vitamin D supplementation in pregnancy: a controlled trial of two methods.Obstet Gynecol. 1986; 68: 300-304
- Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline.J Clin Endocrinol Metab. 2011; 96: 1911-1930
Article info
Publication history
Published online: October 28, 2013
Accepted:
October 8,
2013
Received in revised form:
September 4,
2013
Received:
March 6,
2013
Identification
Copyright
© 2013 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
