Regimens of vitamin D supplementation for women during pregnancy

Palacios, Cristina; Trak-Fellermeier, María Angélica; Martinez, Ricardo X; Lopez-Perez, Lucero; Lips, Paul; Salisi, James A.; John, Jessica C; Peña-Rosas, Juan Pablo

doi:10.1002/14651858.cd013446

Cited by 49 publications

(54 citation statements)

References 120 publications

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“…In 2019, two Cochrane analyses on vitamin D and pregnancy were published. They suggested that vitamin D supplementation may reduce gestational diabetes, low birthweight, and preeclampsia, but a higher than currently recommended dose appeared to have no additional benefit except for possible further reduction of gestational diabetes [74,75]. However, several studies in recent years have highlighted that women are at high risk for vitamin D deficiency, and this is associated with adverse pregnancy outcomes, including preeclampsia and gestational diabetes [76][77][78][79][80].…”

Section: Pregnancymentioning

confidence: 99%

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: Pregnancymentioning

confidence: 99%

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

et al. 2020

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“…In a recent Cochrane review, a reduction in the risk of GDM was reported in women supplemented with more than 600 IU/day compared to that for women receiving lower doses (Relative Risk-RR: 0.54; 95% CI: 0.34 to 0.86; five randomized clinical trial (RCT); n = 1846 women). In studies evaluating the effect on the risk of preeclampsia, preterm birth, or low birth weight, a minimal or no difference was observed in the risk of these outcomes, with 600 IU/day or more of vitamin D. When evaluating supplementation with much higher doses (>4000 vs. 4000 IU/day or lower), there was no effect on GDM risk or other complications [16].…”

Section: Discussionmentioning

confidence: 99%

“…In Mexico, the recommended intake in pregnancy is also 200 IU/day [15]. Most multivitamins on the market contain 200 or 400 IU of vitamin D. Recent clinical trials have shown that supplementation with >600 IU/day may decrease GDM [16]. The American College of Obstetrics and Gynecology considers doses of up to 1000 IU/day as safe during pregnancy [17].…”

Section: Introductionmentioning

confidence: 99%

Vitamin D Deficiency in Mexican Pregnant Women: Is Supplementation with ≤400 IU/day Enough?

et al. 2020

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Controversy remains surrounding vitamin D routine supplementation in healthy pregnancy, and the doses are unclear. The aim of this study was to describe maternal vitamin D status throughout pregnancy in a group of Mexican women and evaluate the effect of frequently prescribed doses of vitamin D3 on longitudinal 25-OH-D concentrations, adjusting for obesity, season, and other factors. We conducted a cohort study (Instituto Nacional de Perinatología-INPer) (2017–2020)) of healthy pregnant women without complications. Pregestational overweight/obesity (body mass index ≥ 25), vitamin D3 supplementation (prescribed by physician; 0–250, 250–400, and >400 IU/day), and serum 25-OH-D concentrations (ELISA) were evaluated in each trimester of pregnancy. Vitamin D deficiency or insufficiency was computed (<20 and <30 ng/mL, respectively). We studied 141 adult women; 58.5% had pregestational obesity or overweight. In the first trimester, 45.8% of the women were supplemented with vitamin D3; 51.4% had vitamin D insufficiency and 37.3%, deficiency. In the third trimester, 75.4% of the women were supplemented, and 20% of them still had deficiency. The final general mixed linear model showed that 25-OH-D significantly increased throughout pregnancy (p < 0.001); the highest increase was observed in the third trimester in women with doses >400 IU/day of vitamin D3 (+4 ng/mL, 95% CI: 1.72–8.11 ng/mL). In winter/autumn, 25-OH-D concentrations were also lower (p ≤ 0.05). In this group of pregnant Mexican women, the prevalence of vitamin D deficiency and insufficiency was high. A higher increase in 25-OH-D concentrations during pregnancy was observed when the women were supplemented with >400 IU/day. Common supplementation doses of 250–400 IU/day were insufficient for achieving an adequate maternal vitamin D status.

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“…En relación con el déficit de vitamina D, cuatro metaanálisis (que incluyeron de seis a 31 estudios observacionales) encontraron un aumento significativo en el riesgo de diabetes gestacional (Aghajafari 2013; Christesen 2012; Poel 2012; Wei 2013), mientras que solo uno (con dos estudios) no encontró asociación significativa (Thorne-Lyman 2012) 45 .…”

Section: Micronutrientes • Hierrounclassified

Tratamiento Médico Nutricional en La Mujer Embarazada Con Diabetes

Tapia

Houssay

Vanoli

et al. 2020

Rev. Soc. Argent. Diabetes

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Introducción: se ha observado un incremento en el diagnóstico de diabetes gestacional (DG) en mujeres embarazadas a nivel mundial durante los últimos años, siendo la prevalencia estimada de 14% a nivel global y de 10,36% en Argentina según el criterio diagnóstico de la Asociación Latinoamericana de Diabetes (ALAD). El plan de alimentación adecuado y el cambio en el estilo de vida asociados al automonitoreo de la glucemia capilar (AMGC) constituyen pilares fundamentales para alcanzar el objetivo glucémico en dos tercios de los casos de DG. A pesar de su importancia y de su recomendación en la práctica clínica, existe información científica limitada respecto de cuál es la prescripción alimentaria óptima para mejorar los resultados tanto en la madre como en el niño.Objetivos: analizar el componente nutricional en el tratamiento de la mujer embarazada con diabetes y conocer cuáles podrían ser las recomendaciones para lograr los objetivos mencionados a través del análisis de la evidencia científica actual. La información proveniente de estudios randomizados y controlados es heterogénea, pero de dichos estudios surge que la intervención temprana con dieta, ejercicio y consejos sobre cambio de estilo de vida durante el primer trimestre o al inicio del segundo puede disminuir el riesgo de DG.El tratamiento médico nutricional en DG se basa en el control de la cantidad y la distribución de los hidratos de carbono para obtener el control glucémico óptimo sin hipoglucemias ni cetosis. El otro componente esencial es la ingesta calórica para la adecuada ganancia de peso.

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Regimens of vitamin D supplementation for women during pregnancy

Cited by 49 publications

References 120 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

Vitamin D Deficiency in Mexican Pregnant Women: Is Supplementation with ≤400 IU/day Enough?

Tratamiento Médico Nutricional en La Mujer Embarazada Con Diabetes

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