Maternal gestational vitamin D supplementation and offspring bone health (MAVIDOS): a multicentre, double-blind, randomised placebo-controlled trial

Cooper, Cyrus; Harvey, Nicholas C.; Bishop, Nicholas; Kennedy, Stephen; Papageorghiou, Aris T.; Schoenmakers, Inez; Fraser, Robert; Gandhi, Saurabh; Carr, Andrew; D’Angelo, Stefania; Crozier, Sarah; Moon, Rebecca J; Arden, N K; Dennison, Elaine; Godfrey, Keith M.; Inskip, Hazel; Prentice, Ann; Mughal, M Zulf; Eastell, Richard; Reid, David M.; Javaid, M K

doi:10.1016/s2213-8587(16)00044-9

Cited by 205 publications

(235 citation statements)

References 37 publications

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“…There is increasing evidence that the early life environment has effects on acquisition of peak bone mass, and that poor growth in early life is associated with reduced bone mass at peak and in old age [40], and with increased risk of hip fracture [41]. The specific environmental influences that might underlie these associations are beginning to be characterised and include factors such as maternal diet, lifestyle and physical activity during pregnancy [42], and maternal gestational 25(OH)-vitamin D concentrations [43,44]. Finally, it is possible that changes in clinical practice may have influenced the ascertainment and reporting of certain fracture types: For example, rib fractures in the UK are now rarely the subject of radiographic confirmation; in contrast, there has been a great deal of effort internationally to increase awareness of vertebral fractures, both clinically and radiographically [45].…”

Section: Discussionmentioning

confidence: 99%

Secular trends in fracture incidence in the UK between 1990 and 2012

et al. 2016

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Introduction-There is increasing evidence of secular changes in age-and sex-adjusted fracture incidence globally. Such observations broadly suggest decreasing rates in developed countries and increasing rates in transitioning populations. Since altered fracture rates have major implications for healthcare provision and planning, we investigated secular changes to age-and sex-adjusted fracture risk amongst the UK population aged 50 years or above from 1990 till 2012.

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Section: Discussionmentioning

confidence: 99%

Secular trends in fracture incidence in the UK between 1990 and 2012

et al. 2016

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“…Most recently, Cooper and Harvey and co-workers (199,200) provided preliminary results of the MAVIDOS study from the United Kingdom. The 900 women who completed the study randomly received either 1,000 IU vitamin D or placebo beginning at 14 wk of pregnancy.…”

Section: Yu Etmentioning

confidence: 99%

“…Baseline 25OHD was ϳ45 nM (18 ng/ml), did not change in placebo-treated women, and rose to 68 nM (27 ng/ml) near term in the vitamin D-supplemented women. During the oral and poster presentation of results (199,200), the study was revealed to be negative in its primary outcome (neonatal bone area, bone mineral content, and bone mineral density within the first 14 days after birth) and secondary outcome 23), suggested a possible benefit on bone mineral content of winter-born babies. If the apparent benefit on winter-born babies is real and not a chance result, it may not be an indication of an effect on the fetus but instead a postnatal effect, since (as noted earlier) the neonatal skeleton should gain 100 mg calcium per day over the first 14 days after birth.…”

Section: Yu Etmentioning

confidence: 99%

Maternal Mineral and Bone Metabolism During Pregnancy, Lactation, and Post-Weaning Recovery

Kovacs

2016

Physiological Reviews

362

524

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During pregnancy and lactation, female physiology adapts to meet the added nutritional demands of fetuses and neonates. An average full-term fetus contains ϳ30 g calcium, 20 g phosphorus, and 0.8 g magnesium. About 80% of mineral is accreted during the third trimester; calcium transfers at 300-350 mg/day during the final 6 wk. The neonate requires 200 mg calcium daily from milk during the first 6 mo, and 120 mg calcium from milk during the second 6 mo (additional calcium comes from solid foods). Calcium transfers can be more than double and triple these values, respectively, in women who nurse twins and triplets. About 25% of dietary calcium is normally absorbed in healthy adults. Average maternal calcium intakes in American and Canadian women are insufficient to meet the fetal and neonatal calcium requirements if normal efficiency of intestinal calcium absorption is relied upon. However, several adaptations are invoked to meet the fetal and neonatal demands for mineral without requiring increased intakes by the mother. During pregnancy the efficiency of intestinal calcium absorption doubles, whereas during lactation the maternal skeleton is resorbed to provide calcium for milk. This review addresses our current knowledge regarding maternal adaptations in mineral and skeletal homeostasis that occur during pregnancy, lactation, and post-weaning recovery. Also considered are the impacts that these adaptations have on biochemical and hormonal parameters of mineral homeostasis, the consequences for long-term skeletal health, and the presentation and management of disorders of mineral and bone metabolism.

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“…The provided daily dose of supplemental vitamin D goes in hand with that previously documented in literature; where Cooper et al, (2016) found supplementation of women with cholecalciferol 1000 IU/day during pregnancy is sufficient to ensure that most pregnant women are vitamin D replete, and it is safe. Ceccaldi et al, (2017) documented that despite national guidelines on vitamin D supplementation, the rates are currently insufficient and the recommended 100,000 IU single dose helps to limit deficiency in newborns, but it fails to cover infant's needs for optimal status.…”

mentioning

confidence: 86%

Hypovitaminosis D Deleteriously Affect Pregnancy Outcome: A Proposed Role for Daily Vitamin D Supplementation to Improve Outcome.

Sherbeny¹,

Mohammed²

2017

IJAR

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Objectives: To estimate serum 25-hydroxy vitamin D (25OHD) levels in newly pregnant women and to evaluate its relation to development of gestational diabetes mellitus (GDM) and maternal and fetal outcome. Patients & Methods: The study included 328 pregnant women, and at 6 th week gestational age (GA), women's clinical and obstetric data were collected and blood samples were obtained for estimation of baseline blood glucose (BG) and serum 25OHD levels. Studied women were divided into two equal groups: Group A included pregnant women received supplemental vitamin D3 in a daily dose of 1000 IU oral capsule starting since 6 th week GA till delivery. Group B included pregnant women who completed their pregnancy without vitamin D supplementation. All women underwent the 75g Oral Glucose Tolerance Test (75-OGTT) at the 20 th , 28 th and 36 th week for detection of GDM. All women were followed up till delivery and maternal and neonatal outcome. Results: Serum 25OHD levels were sufficient, insufficient and deficient in 42, 142 and 144 women, respectively. Forty-three women (13.1%) developed GDM and 62 women (18.9%) had emergency and 23 women had elective CS. Moreover, 48 neonates (14.6%) required NICU admission; 15 for respiratory-aid, 22 for phototherapy and 11 neonates for management of sepsis, but 4 neonates died. Women of group A showed significantly lower frequency of GDM with significantly lower BG levels, significantly lower frequency of CS especially emergency CS and significantly lower frequency of NICU admission. Conclusion: Low serum 25OHD levels are a widespread problem among pregnant women and are associated with higher frequency of GDM, CS delivery especially emergency ones and NICU admission rate. Supplemental vitamin D therapy did well for reducing the frequencies of these events. Supplemental daily dose of 1000 IU appears appropriate and convenient as it was taken in the form of oral capsules.

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Maternal gestational vitamin D supplementation and offspring bone health (MAVIDOS): a multicentre, double-blind, randomised placebo-controlled trial

Abstract: Arthritis Research UK, Medical Research Council, Bupa Foundation, and National Institute for Health Research.

Cited by 205 publications

References 37 publications

Secular trends in fracture incidence in the UK between 1990 and 2012

Secular trends in fracture incidence in the UK between 1990 and 2012

Maternal Mineral and Bone Metabolism During Pregnancy, Lactation, and Post-Weaning Recovery

Hypovitaminosis D Deleteriously Affect Pregnancy Outcome: A Proposed Role for Daily Vitamin D Supplementation to Improve Outcome.

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