Vitamin D Supplementation in Pregnancy and Lactation and Infant Growth
Roth DE, Morris SK, Zlotkin S, Gernand AD, Ahmed T, Shanta SS, Papp E, Korsiak J, Shi J, Islam MM, Jahan I, Keya FK, Willan AR, Weksberg R, Mohsin M, Rahman QS, Shah PS, Murphy KE, Stimec J, Pell LG, Qamar H, Al Mahmud A
The New England journal of medicine · 160 citations
How it was studied
- Design
- Randomized controlled trial (indexed by PubMed)
- Studied in
- People
- Main outcome
- Health markers and function
Who paid for it
- Funding
- Independent funding
- Nonprofit
- Bill and Melinda Gates Foundation
- University or hospital
- Hospital for Sick Children
- Government
- Ministry of Health and Family Welfare
- Grants
- Bill and Melinda Gates Foundation (OPP1066764)
Based on 3 listed funder(s) and full-text disclosure statement.
Publication
- Published
- 2018-08-08 · N Engl J Med · vol. 379 · issue 6 · pp. 535–546
- Publisher
- Massachusetts Medical Society
- Cited
- 267 citations · more than 100% of similar papers · 18.5× the field average
- Impact
- Top 10% most cited in its field
- References
- 29 works
- Access
- Open access (hybrid journal) · CC-BY
- Research areas
- Vitamin D Research Studies · Birth, Development, and Health · Gestational Diabetes Research and Management
- Keywords
- Medicine, Pregnancy, Prenatal care, Placebo, Anthropometry, Obstetrics, Vitamin D and neurology, Vitamin, Gestation, Lactation, Birth weight, Randomized controlled trial, Pediatrics, Population, Endocrinology, Internal medicine, Biology
- MeSH
- humans, pregnancy complications, fetal growth retardation, vitamin d deficiency, vitamins, vitamin d, body height, prenatal care, double-blind method, growth, postpartum period, lactation, pregnancy, dose-response relationship, drug, developing countries, dietary supplements, adult, infant, infant, newborn, bangladesh, female
22 authors
From CA, US, BD, GB
- Daniel E. RothUniversity of Toronto; Centre for Global Health Research
- Shaun K. MorrisUniversity of Toronto; Centre for Global Health Research
- Stanley Howard ZlotkinUniversity of Toronto; Centre for Global Health Research
- Alison D. GernandPennsylvania State University; State University of Bangladesh
- Tahmeed AhmedInternational Centre for Diarrhoeal Disease Research
- Shaila Sharmeen ShantaInternational Centre for Diarrhoeal Disease Research
Abstract
Background
It is unclear whether maternal vitamin D supplementation during pregnancy and lactation improves fetal and infant growth in regions where vitamin D deficiency is common.
Methods
We conducted a randomized, double-blind, placebo-controlled trial in Bangladesh to assess the effects of weekly prenatal vitamin D supplementation (from 17 to 24 weeks of gestation until birth) and postpartum vitamin D supplementation on the primary outcome of infants' length-for-age z scores at 1 year according to World Health Organization (WHO) child growth standards. One group received neither prenatal nor postpartum vitamin D (placebo group). Three groups received prenatal supplementation only, in doses of 4200 IU (prenatal 4200 group), 16,800 IU (prenatal 16,800 group), and 28,000 IU (prenatal 28,000 group). The fifth group received prenatal supplementation as well as 26 weeks of postpartum supplementation in the amount of 28,000 IU (prenatal and postpartum 28,000 group).
Results
Among 1164 infants assessed at 1 year of age (89.5% of 1300 pregnancies), there were no significant differences across groups in the mean (±SD) length-for-age z scores. Scores were as follows: placebo, -0.93±1.05; prenatal 4200, -1.11±1.12; prenatal 16,800, -0.97±0.97; prenatal 28,000, -1.06±1.07; and prenatal and postpartum 28,000, -0.94±1.00 (P=0.23 for a global test of differences across groups). Other anthropometric measures, birth outcomes, and morbidity did not differ significantly across groups. Vitamin D supplementation had expected effects on maternal and infant serum 25-hydroxyvitamin D and calcium concentrations, maternal urinary calcium excretion, and maternal parathyroid hormone concentrations. There were no significant differences in the frequencies of adverse events across groups, with the exception of a higher rate of possible hypercalciuria among the women receiving the highest dose.
Conclusions
In a population with widespread prenatal vitamin D deficiency and fetal and infant growth restriction, maternal vitamin D supplementation from midpregnancy until birth or until 6 months post partum did not improve fetal or infant growth. (Funded by the Bill and Melinda Gates Foundation; ClinicalTrials.gov number, NCT01924013 .).
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).
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