Effectiveness of Prenatal Vitamin D Deficiency Screening and Treatment Program: A Stratified Randomized Field Trial

Rostami, Maryam; Tehrani, Fahimeh Ramezani; Simbar, Masoumeh; Yarandi, Razieh Bidhendi; Minooee, Sonia; Hollis, Bruce W.; Hosseinpanah, Farhad

doi:10.1210/jc.2018-00109

Cited by 116 publications

(78 citation statements)

References 41 publications

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“…Interestingly, the maximum change is achieved 6-8 weeks after initiating the treatment, likely exerting the genomic actions of vitamin D [81][82][83]. Three major adverse pregnancy outcomes appear to improve with vitamin D supplementation: a 60% reduction in preeclampsia, a 50% reduction in gestational diabetes, and a 40% reduction in preterm delivery [84]. These data are consistent with previous work on the topic [82].…”

Section: Pregnancysupporting

confidence: 85%

Vitamin D deficiency 2.0: an update on the current status worldwide

et al. 2020

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Vitamin D testing and the use of vitamin D supplements have increased substantially in recent years. Currently, the role of vitamin D supplementation, and the optimal vitamin D dose and status, is a subject of debate, because large interventional studies have been unable to show a clear benefit (in mostly vitamin D replete populations). This may be attributed to limitations in trial design, as most studies did not meet the basic requirements of a nutrient intervention study, including vitamin D-replete populations, too small sample sizes, and inconsistent intervention methods regarding dose and metabolites. Vitamin D deficiency (serum 25-hydroxyvitamin D [25(OH)D] < 50 nmol/L or 20 ng/ml) is associated with unfavorable skeletal outcomes, including fractures and bone loss. A 25(OH)D level of >50 nmol/L or 20 ng/ml is, therefore, the primary treatment goal, although some data suggest a benefit for a higher threshold. Severe vitamin D deficiency with a 25(OH)D concentration below <30 nmol/L (or 12 ng/ml) dramatically increases the risk of excess mortality, infections, and many other diseases, and should be avoided whenever possible. The data on a benefit for mortality and prevention of infections, at least in severely deficient individuals, appear convincing. Vitamin D is clearly not a panacea, and is most likely efficient only in deficiency. Given its rare side effects and its relatively wide safety margin, it may be an important, inexpensive, and safe adjuvant therapy for many diseases, but future large and well-designed studies should evaluate this further. A worldwide public health intervention that includes vitamin D supplementation in certain risk groups, and systematic vitamin D food fortification to avoid severe vitamin D deficiency, would appear to be important. In this narrative review, the current international literature on vitamin D deficiency, its relevance, and therapeutic options is discussed.

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Section: Pregnancysupporting

confidence: 85%

Vitamin D deficiency 2.0: an update on the current status worldwide

et al. 2020

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“…This finding suggests that vitamin D deficiency during pregnancy alone is a risk factor for RDS. We and others have demonstrated an association between vitamin D deficiency and preterm birth, 6–12 and Al‐Biltagi et al, 1 provide compelling evidence that among those infants who are preterm of similar gestational ages, those with vitamin D deficiency have a greater risk of RDS, reaffirming the earlier findings of Mohamed Hegazy et al 3 Identifying the problem is important, but to offer a potentially effective therapy that might change the trajectory of the disease or syndrome is paramount.…”

mentioning

confidence: 56%

Editorial for the article entitled, “Vitamin D status in preterm neonates and the effects of its supplementation on respiratory distress syndrome,” Al‐Biltagi, et al

Wagner

2020

Pediatric Pulmonology

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“…Women who were identified as vitamin D deficient using IOM guidelines (<20 ng/mL) were placed into 8 different intervention arms based on their baseline 25(OH)D concentrations and were compared with a placebo group that had baseline 25(OH)D concentrations measured but not treated. Pregnant women in the composite treatment group (pooled 8 intervention groups) had a preterm birth risk that was reduced by 40% when compared with the placebo group (odds ratio [OR], 0.6; 95% CI, 0.4‐0.8) . This study provides an example of the importance of individualizing vitamin D supplementation based on baseline 25(OH)D status early in gestation.…”

Section: Vitamin D Preterm Birth and Preeclampsiamentioning

confidence: 95%

Section: Vitamin D Preterm Birth and Preeclampsiamentioning

confidence: 99%

“…The 4 studies that have been published and not included in the most recent meta‐analysis found a significant association between maternal vitamin D deficiency and preterm birth risk. For example, in the study by Rostami et al, pregnant Iranian women enrolled at less than 14 weeks’ gestation received vitamin D supplementation based on their baseline 25(OH)D . Women who were identified as vitamin D deficient using IOM guidelines (<20 ng/mL) were placed into 8 different intervention arms based on their baseline 25(OH)D concentrations and were compared with a placebo group that had baseline 25(OH)D concentrations measured but not treated.…”

Section: Vitamin D Preterm Birth and Preeclampsiamentioning

confidence: 99%

See 1 more Smart Citation

Evidence of an Association Between Vitamin D Deficiency and Preterm Birth and Preeclampsia: A Critical Review

Woo

Giurgescu

Wagner

2019

J Midwife Womens Health

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Vitamin D deficiency has been associated with adverse pregnancy and birth outcomes such as increased risk for preterm birth and preeclampsia. This state of the science review analyzed recently published meta-analyses and relevant studies that have evaluated the association between vitamin D deficiency and preeclampsia or preterm birth. The results suggest that a positive association between vitamin D deficiency and preterm birth exists. However, the findings of the relationship between vitamin D deficiency and preeclampsia were inconclusive, possibly because of the need for supplementation to occur prior to placentation. This may be because of a lack of studies with ethnic minority populations, who are more likely to experience vitamin D deficiency, and inadequate supplementation doses used for treatment of vitamin D deficiency. Health care providers should screen pregnant women at risk for vitamin D deficiency and supplement women accordingly based on their vitamin D status. Lastly, well-designed and standardized clinical trials need to include large cohorts of minority pregnant women to establish the impact of vitamin D supplementation on improving preterm birth and preeclampsia risk in pregnancy.

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Effectiveness of Prenatal Vitamin D Deficiency Screening and Treatment Program: A Stratified Randomized Field Trial

Abstract: A prenatal vitamin D screening and treatment program is an effective approach in detecting deficient women, improving 25(OH)D levels, and decreasing pregnancy adverse outcomes.

Cited by 116 publications

References 41 publications

Vitamin D deficiency 2.0: an update on the current status worldwide

Vitamin D deficiency 2.0: an update on the current status worldwide

Editorial for the article entitled, “Vitamin D status in preterm neonates and the effects of its supplementation on respiratory distress syndrome,” Al‐Biltagi, et al

Evidence of an Association Between Vitamin D Deficiency and Preterm Birth and Preeclampsia: A Critical Review

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