Vitamin D supplementation: Recommendations for Canadian mothers and infants

Godel, John C.; Nations, Inuit First

doi:10.1093/pch/12.7.583

Cited by 259 publications

(70 citation statements)

References 42 publications

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“…Thus, the question of whether maternal supplementation alone protects against low infant serum 25(OH)D in breastfed infants remains unanswered. The primary aim of this trial was to determine and compare the effect of 3 doses of maternal vitamin D 3 (10, 25, and 50 mg/d) starting in midpregnancy (13-24 wk) on infant serum 25(OH)D concentration at 8 wk and to assess the prevalence of infant 25(OH)D deficiency by using cutoffs at 8 wk of age: 30 nmol/L (below which individuals are classified as deficient), 40 nmol/L (the estimated average requirement), 50 nmol/L (suggested to meet or exceed the needs of most individuals) (20), and 75 nmol/L (as recommended by the Canadian Paediatric Society) (21).…”

Section: Introductionmentioning

confidence: 99%

Maternal vitamin D3 supplementation at 50 μg/d protects against low serum 25-hydroxyvitamin D in infants at 8 wk of age: a randomized controlled trial of 3 doses of vitamin D beginning in gestation and continued in lactation

March

Chen

Karakochuk

et al. 2015

The American Journal of Clinical Nutrition

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Section: Introductionmentioning

confidence: 99%

Maternal vitamin D3 supplementation at 50 μg/d protects against low serum 25-hydroxyvitamin D in infants at 8 wk of age: a randomized controlled trial of 3 doses of vitamin D beginning in gestation and continued in lactation

March

Chen

Karakochuk

et al. 2015

The American Journal of Clinical Nutrition

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“…The UL was doubled from 2000 IU/day, as recommended by the IOM in 1997 [10], despite a lack of new pregnancy trial safety data published between 1997 and 2010. Uncertainty surrounding vitamin D requirements in pregnancy has led to divergent dose recommendations; for example, the UNICEF antenatal micronutrient formulation contains 200 IU/day [11], the Canadian Paediatric Society has suggested 2000 IU/day [12], and Hollis et al advised an intake of 4000 IU/day [13]. Similarly, the 25(OH)D threshold to define vitamin D sufficiency is debated; the IOM set 50 nmol/L as a lower limit of sufficiency [7], yet other expert bodies such as the American Academy of Pediatrics have suggested that pregnant women attain serum 25(OH)D >80 nmol/L [14].…”

Section: Introductionmentioning

confidence: 99%

Randomized placebo-controlled trial of high-dose prenatal third-trimester vitamin D3 supplementation in Bangladesh: the AViDD trial

Roth

Mahmud

Raqib

et al. 2013

Nutr J

100

121

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BackgroundAntenatal vitamin D status may be associated with the risk of adverse pregnancy and neonatal outcomes; however, the benefits of vitamin D supplementation during pregnancy remain unknown.MethodsWe conducted a double-blind placebo-controlled randomized trial to evaluate the effect of high-dose prenatal 3rd trimester vitamin D3 supplementation on maternal and neonatal (cord blood) serum 25-hydroxyvitamin D (25(OH)D) concentration (primary biochemical efficacy outcome) and maternal serum calcium concentration (primary safety measure). Eligibility criteria were pregnant women aged 18 to <35 years, at 26 to 29 weeks gestation, and residing in Dhaka, Bangladesh. 160 women were randomized by 1:1 allocation to one of two parallel intervention groups; placebo (n = 80) or 35,000 IU/week of vitamin D3 (n = 80) until delivery. All participants, study personnel and study investigators were blind to treatment allocation.ResultsMean maternal 25(OH)D concentration was similar in the vitamin D and placebo groups at baseline (45 vs. 44 nmol/L; p = 0.66), but was significantly higher in the vitamin D group vs. placebo group among mothers at delivery (134 vs. 38 nmol/L; p < 0.001) and newborns (cord blood: 103 vs. 39; p < 0.001). In the vitamin D group, 95% of neonates and 100% of mothers attained 25(OH)D >50 nmol/L, versus 21% mothers and 19% of neonates in the placebo group. No participants met criteria for hypercalcemia, there were no known supplement-related adverse events, and major pregnancy outcomes were similar between groups.ConclusionsAntenatal 3rd-trimester vitamin D3 supplementation (35,000 IU/week) significantly raised maternal and cord serum 25(OH)D concentrations above 50 nmol/L in almost all participants without inducing hypercalcemia or other observed safety concerns. Doses up to 35,000 IU/week may be cautiously used in further research aimed at establishing the clinical effects and safety of vitamin D3 supplementation in pregnancy.Trial registrationThis trial was registered at ClinicalTrials.gov (NCT01126528).

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“…On the other hand, the Endocrine Society recognized that at least 1,500-2,000 IU/day of vitamin D may be needed to maintain the serum 25(OH)D level above 30 ng/ml [19] . The differences in recommended vitamin D doses for pregnant women among the recommended authorities are not only seen in USA; the national policies (recommended range from 400 to 2,000 IU/ [19,25,26,[37][38][39] . We should keep in mind the risk factors of vitamin D deficiency (winter-spring season, low sun exposure, obesity and multiple gestation) to consider measurements of serum 25(OH)D level to assess individual needs ('tailor-made' therapy).…”

Section: Discussionmentioning

confidence: 99%

Determinants of Postpartum Vitamin D Status in the Caucasian Mother-Offspring Pairs at a Latitude of 52°N: A Cross-Sectional Study

Czech‐Kowalska

Gruszfeld²,

Jaworski³

et al. 2015

Ann Nutr Metab

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Background: High prevalence of vitamin D deficiency in pregnancy is recorded. Aim: To establish determinants of postpartum 25-hydroxyvitamin D (25(OH)D) levels on mothers and offspring. Methods: 25(OH)D level was measured in cord blood and maternal blood collected ≤3 weeks postpartum. Maternal socioeconomic status, vitamin D intake, sun exposure during pregnancy and maternal and neonatal fat mass (FM; dual X-ray absorptiometry) were assessed within 3 weeks postpartum. Results: A total of 174 mother-offspring pairs were enrolled. Maternal 25(OH)D <20 ng/ml was seen in 32 (51%) of summer and 82 (74%) of winter deliveries. Women with 25(OH)D <20 ng/ml had a 2-fold lower percentage of vitamin D intake of ≥800 IU/day than women with 25(OH)D ≥20 ng/ml (p = 0.02). FM (%) was comparable between groups (p > 0.05). Multiple regression analysis revealed the delivery season, prenatal vitamin D intake ≥800 IU/day and duration of supplementation to be the determinants of maternal 25(OH)D level (R² = 0.26, p < 0.001). Maternal 25(OH)D level, season of birth and duration of maternal supplementation explained 83% of the variance in cord blood 25(OH)D level (R² = 0.83, p < 0.001). Conclusions: The key determinants of higher maternal vitamin D status were the summer-autumn season of delivery and prenatal use of ≥800 IU/day of vitamin D. The cord blood 25(OH)D level was mainly determined by maternal 25(OH)D level and season of birth.

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Vitamin D supplementation: Recommendations for Canadian mothers and infants

Cited by 259 publications

References 42 publications

Maternal vitamin D3 supplementation at 50 μg/d protects against low serum 25-hydroxyvitamin D in infants at 8 wk of age: a randomized controlled trial of 3 doses of vitamin D beginning in gestation and continued in lactation

Maternal vitamin D3 supplementation at 50 μg/d protects against low serum 25-hydroxyvitamin D in infants at 8 wk of age: a randomized controlled trial of 3 doses of vitamin D beginning in gestation and continued in lactation

Randomized placebo-controlled trial of high-dose prenatal third-trimester vitamin D3 supplementation in Bangladesh: the AViDD trial

Determinants of Postpartum Vitamin D Status in the Caucasian Mother-Offspring Pairs at a Latitude of 52°N: A Cross-Sectional Study

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