A Longitudinal Study of 25-Hydroxy Vitamin D and Parathyroid Hormone Status throughout Pregnancy and Exclusive Lactation in New Zealand Mothers and Their Infants at 45° S

Wheeler, Benjamin J; Taylor, Barry; Lange, Michel de; Harper, Michelle J.; Jones, Stephanie; Mekhail, Adel; Houghton, Lisa A

doi:10.3390/nu10010086

Cited by 37 publications

(48 citation statements)

References 37 publications

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“…The 25OHD content of breast milk is dependent on 25OHD status of the mother [ 7 ]. Many studies have shown that majority of the pregnant and lactating mothers have less than recommended 25OHD levels [ 8 , 9 ]. The vD deficiency is rampant in womenfolk of south Asia(75-99%) where it is not expected due to ample sun exposure and lower altitude that stimulate cutaneous 25OHD synthesis [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Low vitamin D status in nursing Pakistani mothers in an environment of ample sunshine: a cross-sectional study

Mustafa

Asadi

Iqbal³

2018

BMC Pregnancy Childbirth

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BackgroundThe maternal 25-hydroxy vitamin D (25OHD) insufficiency is related to adverse maternal and neonatal outcome. The 25OHD content of breast milk is dependent on 25OHD status of the mothers. We undertook this study to ascertain the 25OHD status and its determinants in the nursing mothers of the south Punjab, Pakistan.MethodsWe recruited 67 mothers for this cross-sectional study by convenience sampling from August 2010 to June 2011 to ascertain their serum 25OHD level & its determinants. We used SPSS 23.0 for analyses.ResultsThe mean age of the mothers was 25.75 ± 4.4 years. The median age (and mode) was 25 years (range 18-37 years). The majority of mothers were less than 25 years of age (62.7%), uneducated (68.7%), from rural area (70.1%), lived in open houses with ample sun exposure (85.1%) and belonged to low socioeconomic strata (71.6%).Serum 25OHD ranged from 7.2 to 43.8 nmol/L with a mean of 20.87 ± 7.69 nmol/L. The median and mode were 21.8 nmol/L & 24.0 nmol/L, respectively. The proportion of mothers with 25OHD < 20 nmol/L (severe deficiency) was 44.8%, < 30 nmol/L (deficiency) 49.3% and < 50 nmol/L (insufficiency) 5.9%. All had 25OHD below 50 nmol/L. The oral supplementation with vitamin D (vD) was the only significant determinant of vitamin D sufficiency.ConclusionsThe majority of Pakistani mothers in south Punjab are vD deficient & universal vD supplementation is the need of the hour to improve health outcomes in mothers & infants.

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Section: Introductionmentioning

confidence: 99%

Low vitamin D status in nursing Pakistani mothers in an environment of ample sunshine: a cross-sectional study

Mustafa

Asadi

Iqbal³

2018

BMC Pregnancy Childbirth

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“…Recently, Al-Ajlan et al (34) detected VDD (< 50 nmol/l) in about 82.5% of 515 pregnant Saudi women during the 147 1 st trimester. Also, Krieger et al (35) detected 53.4% prevalence of VDD in their sample of pregnant women in Switzerland and Wheeler et al (36) documented that VDD in women in New Zealand is very common during pregnancy and lactation and accounted for a prevalence of 65%.…”

Section: Results:-mentioning

confidence: 97%

“…In line with the reported outcome, Krieger et al (35) documented that VD supplement intake was the most actionable determinant of VD status at the 3 rd trimester and in neonatal cord blood, suggesting that VD-ST during pregnancy should receive more attention in clinical practice. Also, Wheeler et al (36) recommended 1 st trimester maternal VD screening and targeted supplementation for those "at risk".…”

Section: Results:-mentioning

confidence: 99%

Can Vitamin D Supplemental Therapy Improve Pregnancy-Associated Anemia? An Interventional Prospective Clinical Trial.

MD¹,

MD²

2018

IJAR

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Objectives: To evaluate impact of vitamin D supplemental therapy (VD-ST) and iron ST (IST) on hemoglobin concentration (HC) in pregnant women. Patients & Methods: 187 women pregnant were clinically evaluated and gave blood samples at 1 st trimester for estimation of HC and serum 25OH-VD, ferritin concentration (FC), hepcidin (HPC) and interleukin-6 (IL-6). Women were categorized according to the levels of estimated parameters into control and study groups AD. Women of groups A and C received VD-ST alone, group B received IST alone and group D received both ST. At delivery, HC, extent of change and frequency of pregnancy-associated anemia (PAA) were determined. Results: At 1 st trimester, 71.7% women were anemic and 38.5% had hypoferremia, 77% had VD deficiency (VDD) and 59.4% had both VDD and PAA. Serum HPC and IL-6 levels in anemic women especially those had VDD were significantly higher than control women. At delivery, 35% of control women developed PAA and mean HC was significantly lower than 1 st trimester HC with a median deficit of 4.72 gm/dl (IQR: 2.8-6.4) among studied population. Frequency of anemic women in groups B-D was decreased at delivery by 21.7%, 30.8% and 30.6%, respectively. Statistical analyses defined high serum HPC and IL-6 levels at 1 st trimester as specific early predictors for PAA development, but early institution of ST especially VD-ST is one of the best significant predictors for improved HC at time of delivery. Conclusion: VDD, hypoferremia, higher HPC and IL-6 levels constitute a vicious circle entrapping pregnant women and inducing iron deficiency anemia at delivery. Early institution of VD-ST and IST can burst this circle and induce improvement of HC up to normal range in about 30% of women presented by PAA. Thus, early estimation of HC and serum VD can be used as a guide for early institution of ST.

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“…In line with the beneficial effect of VD-ST on pregnancy outcome, Naseh et al 11 suggested promoting consumption of VD-fortified foods and supplements among pregnant women to improve maternal and neonatal outcomes. Also, Krieger et al 37 suggested that VD-ST during pregnancy should receive more attention in clinical practice as it was the most actionable determinant of VD status at the 3 rd trimester and in neonatal cord blood and Wheeler et al 38 recommended 1 st trimester maternal VD screening and targeted supplementation for those "at risk".…”

Section: Discussionmentioning

confidence: 99%

Vitamin D supplemental therapy can explore the interplay circuit between hypovitaminosis D, high serum IL-6 and pregnancy-associated morbidities

Helal

2019

OGIJ

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Objectives: To evaluate the relation between baseline vitamin D (VD) serum levels and incidence and severity of pregnancy-associated morbidities (PAM). Patients & methods: The study included 386 pregnant women attended at the 6th gestational week and after full clinical and obstetric examination, gave fasting blood samples for estimation of fasting blood glucose (FBG) and ELISA estimation of serum VD, insulin and interleukin-6 (IL-6). Insulin resistance (IR) was determined according to homeostasis model assessment IR (HOMA-IR) score that was considered abnormal at score of ≥2. Enrolled women were categorized according to at booking VD level as sufficient (Group A), insufficient (Group B) and deficient (Group C). Women of group C received daily oral VD (1000 IU) supplemental therapy (VD-ST) till delivery. Study outcomes included incidence of PAM and its relation to serum VD levels, and the effect of VD-ST on incidence and severity of PAM. Results: Groups A-C included 86, 130 and 170 women, respectively and 263 women developed 424 PAM. PAM incidence and serum IL-6 levels were significantly higher in group B than other groups. PAM incidence and serum IL-6 levels showed negative significant correlations with serum VD levels. Moreover, PAM incidence showed positive significant correlation with serum IL-6 level. ROC curve analysis defined at booking serum VD as significant specific and serum IL-6 as significant sensitive predictors for PAM development. VD-ST allowed significant reduction of PAM with significant reduction of serum IL-6 and FBG levels and IR. Incidence of PAM was negatively correlated with receiving VD-ST that was found to be significant predictor for decreased PAM incidence. Conclusion: Hypovitaminosis D and high IL-6 serum levels may underlie PAM development. VD-ST improved pregnancy outcome in women with VD deficiency to a level better than in women with insufficient VD levels; thus it is recommended as empirical therapy for pregnant women.

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A Longitudinal Study of 25-Hydroxy Vitamin D and Parathyroid Hormone Status throughout Pregnancy and Exclusive Lactation in New Zealand Mothers and Their Infants at 45° S

Cited by 37 publications

References 37 publications

Low vitamin D status in nursing Pakistani mothers in an environment of ample sunshine: a cross-sectional study

Low vitamin D status in nursing Pakistani mothers in an environment of ample sunshine: a cross-sectional study

Can Vitamin D Supplemental Therapy Improve Pregnancy-Associated Anemia? An Interventional Prospective Clinical Trial.

Vitamin D supplemental therapy can explore the interplay circuit between hypovitaminosis D, high serum IL-6 and pregnancy-associated morbidities

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