Weekly High Dose Versus Daily Low Dose Vitamin D3 in Treatment of Vitamin D3 Deficiency in Pregnancy: A Randomized Controlled Clinical Trial
Objective: To compare administration of weekly high dose versus daily low dose vitamin D3 in treatment of vitamin D3 deficiency in pregnancy.
Materials and methods: A randomized controlled clinical trial was performed between July 2016 until 2 July 2017 on 215 pregnant women with vitamin D3 deficiency (serum levels < 30 ng/ml) and gestational age less than 14 weeks. The participants were randomly assigned to 2 treatment groups of A: receiving 1000 unit vitamin D3 daily, and B: 50,000 units weekly for 10 weeks. At 24-28 weeks of gestation, serum levels of vitamin D3 were measured again. Data entry and statistical analysis were performed by SPSS software v. 20 and P value less than 0.05 was considered as statistically significant level.
Results: Primary mean serum vitamin D3 level in group A was: 17.3 ± 6.8 and in group B: 15.2 ± 7.3 ng/ml while mean serum vitamin D3 level after treatment in group A was significantly lower than group B
(31.9 ± 118 B vs. 42.9 ± 15.5, p-value: < 0.001); both groups were successfully treated, no remarkable side effects were observed in either groups.
Conclusion: As both regimens treat vitamin D deficiency successfully and consuming weekly high dose vitamin D3 makes more acceptable serum levels for mothers with no apparent side effects weekly high dose vitamin D3 can be safely administered for vitamin D3 deficiency in pregnancy, if further studies show similar results.
Dawodu A, Davidson B, Woo JG, Peng YM, Ruiz-Palacios GM, de Lourdes Guerrero M, et al. Sun exposure and vitamin D supplementation in relation to vitamin D status of breastfeeding mothers and infants in the global exploration of human milk study. Nutrients. 2015;7(2):1081-93. https://www.ncbi.nlm.nih.gov/pubmed/21691184
Saraf R, Morton S, Camargo CA, Grant CC. Global summary of maternal and newborn vitamin D status–a systematic review. Maternal & child nutrition. 2016;12(4):647-68. https://onlinelibrary.wiley.com/doi/abs/10.1111/mcn.12210
Kovacs CS. Maternal mineral and bone metabolism during pregnancy, lactation, and post-weaning recovery. Physiological reviews. 2016;96(2):449-547. https://academic.oup.com/ajcn/article/88/2/520S/4650015
Vandevijvere S, Amsalkhir S, Van Oyen H, Moreno-Reyes R. High prevalence of vitamin D deficiency in pregnant women: a national cross-sectional survey. PloS one. 2012;7(8):e43868. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0043868
Makgoba M, Nelson SM, Savvidou M, Messow C-M, Nicolaides K, Sattar N. First-trimester circulating 25-hydroxyvitamin D levels and development of gestational diabetes mellitus. Diabetes Care. 2011;34(5):1091-3. http://care.diabetesjournals.org/content/early/2011/03/30/dc10-2264.short
Naghshineh E, Sheikhaliyan S. Effect of vitamin D supplementation in the reduce risk of preeclampsia in nulliparous women. Advanced biomedical research. 2016;5:7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4770602
Hensel KJ, Randis TM, Gelber SE, Ratner AJ. Pregnancy-specific association of vitamin D deficiency and bacterial vaginosis. American Journal of Obstetrics and Gynecology. 2011;204(1):41.e1-.e9. http://www.sciencedirect.com/science/article/pii/S0002937810010021
Dror DK. Vitamin D status during pregnancy: maternal, fetal, and postnatal outcomes. Current opinion in obstetrics & gynecology. 2011;23(6):422-6. https://journals.lww.com/co-obgyn/Abstract/2011/12000/Vitamin_D_status_during_pregnancy___maternal,.5.aspx
Cashman KD, Dowling KG, Skrabakova Z, Gonzalez-Gross M, Valtuena J, De Henauw S, et al. Vitamin D deficiency in Europe: pandemic? Am J Clin Nutr. 2016;103(4):1033-44. https://academic.oup.com/ajcn/article/103/4/1033/4662891
Hamilton SA, McNeil R, Hollis BW, Davis DJ, Winkler J, Cook C, et al. Profound vitamin D deficiency in a diverse group of women during pregnancy living in a sun-rich environment at latitude 32 N. International journal of endocrinology. 2010;2010. https://www.hindawi.com/journals/ije/2010/917428/abs/
Johnson DD, Wagner CL, Hulsey TC, McNeil RB, Ebeling M, Hollis BW. Vitamin D deficiency and insufficiency is common during pregnancy. American journal of perinatology. 2011;28(01):007-12. https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0030-1262505
El-Hajj Fuleihan G. Vitamin D Deficiency in the Middle East and its Health Consequences for Children and Adults. Clinical Reviews in Bone and Mineral Metabolism. 2009;7(1):77-93. https://doi.org/10.1007/s12018-009-9027-9
Pirdehghan A, Vakili M, Dehghan R, Zare F. High Prevalence of Vitamin D Deficiency and Adverse Pregnancy Outcomes in Yazd, a Central Province of Iran. Journal of reproduction & infertility. 2016;17(1):34-8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4769853/
Maghbooli Z, Hossein-Nezhad A, Shafaei AR, Karimi F, Madani FS, Larijani B. Vitamin D status in mothers and their newborns in Iran. BMC pregnancy and childbirth. 2007;7:1. https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-7-1
Kazemi A, Sharifi F, Jafari N, Mousavinasab N. High prevalence of vitamin D deficiency among pregnant women and their newborns in an Iranian population. Journal of women's health (2002). 2009;18(6):835-9. https://www.liebertpub.com/doi/abs/10.1089/jwh.2008.0954
Practice ACoO. ACOG Committee Opinion No. 495: Vitamin D: Screening and supplementation during pregnancy. Obstetrics and gynecology. 2011;118(1):197. https://www.ncbi.nlm.nih.gov/pubmed/21691184
Shakiba M, Iranmanesh MR. Vitamin D requirement in pregnancy to prevent deficiency in neonates: a randomised trial. Singapore Med J. 2013;54(5):285-8. https://pdfs.semanticscholar.org/b6ad/7d771dd45b4e7347044bc83a1fb81068a743.pdf
Chakhtoura M, Nassar A, Arabi A, Cooper C, Harvey N, Mahfoud Z, et al. Effect of vitamin D replacement on maternal and neonatal outcomes: a randomised controlled trial in pregnant women with hypovitaminosis D. A protocol. BMJ open. 2016;6(3). https://bmjopen.bmj.com/content/6/3/e010818?cpetoc=&utm_source=TrendMD&utm_medium=cpc&utm_campaign=BMJOp_TrendMD-%25SPONSORED%25
women[http://www.rcog.org.uk/what-we-do/campaigning-and-opinions/statement/rcog-statementvitamin-d-supplementation-pregnant-women RsovDsfp. vitamin D in pregnancy. Scientific Impact Paper No 43. 20`14.
UpToDate B Dawson-Hughes - UpToDate W, MA. Accessed, . Vitamin D deficiency in adults: Definition, clinical manifestations, and treatment. 2014. https://www.uptodate.com/contents
Cooper C, Harvey NC, Bishop NJ, Kennedy S, Papageorghiou AT, Schoenmakers I, et al. Maternal gestational vitamin D supplementation and offspring bone health (MAVIDOS): a multicentre, double-blind, randomised placebo-controlled trial. The Lancet Diabetes & Endocrinology. 2016;4(5):393-402. https://www.sciencedirect.com/science/article/pii/S2213858716000449
Holick MF. Vitamin D: a D-Lightful health perspective. Nutrition reviews. 2008;66(suppl_2):S182-S94. https://academic.oup.com/nutritionreviews/article-abstract/66/suppl_2/S182/1856240
Saadi HF, Dawodu A, Afandi BO, Zayed R, Benedict S, Nagelkerke N. Efficacy of daily and monthly high-dose calciferol in vitamin D-deficient nulliparous and lactating women. Am J Clin Nutr. 2007;85(6):1565-71. https://academic.oup.com/ajcn/article/85/6/1565/4633018
Dawodu A, Saadi HF, Bekdache G, Javed Y, Altaye M, Hollis BW. Randomized controlled trial (RCT) of vitamin D supplementation in pregnancy in a population with endemic vitamin D deficiency. The Journal of clinical endocrinology and metabolism. 2013;98(6):2337-46. https://academic.oup.com/jcem/article/98/6/2337/2537038
Hollis BW, Wagner CL, Howard CR, Ebeling M, Shary JR, Smith PG, et al. Maternal versus infant vitamin D supplementation during lactation: a randomized controlled trial. Pediatrics. 2015:peds. 2015-1669. http://pediatrics.aappublications.org/content/early/2015/09/22/peds.2015-1669
Hollis BW. Vitamin D Requirement During Pregnancy and Lactation. Journal of Bone and Mineral Research. 2007;22(S2):V39-V44. http://dx.doi.org/10.1359/jbmr.07s215
Mahdy S, Al-Emadi SA, Khanjar IA, Hammoudeh MM, Sarakbi HA, Siam A, et al. Vitamin D status in health care professionals in Qatar. Saudi Med J. 2010;31(1):74-7. https://pdfs.semanticscholar.org/8a71/87b3a8b0f7aa9da4233bf5618933ca113a7f.pdf
Siam A, Hammoudeh M, Khanjer I, Bener A, Sarakbi H, Mehdi S. Vitamin D Defficiency in Rheumatology Clinic Practice in Qatar. Qatar Medical Journal. 2006;2006(1):17. http://www.qscience.com/doi/abs/10.5339/qmj.2006.1.17
Al Emadi S, Hammoudeh M. Vitamin D study in pregnant women and their babies. Qatar medical journal. 2013:7. http://www.qscience.com/doi/abs/10.5339/qmj.2013.7
Hashemipour S, Ziaee A, Javadi A, Movahed F, Elmizadeh K, Javadi EH, et al. Effect of treatment of vitamin D deficiency and insufficiency during pregnancy on fetal growth indices and maternal weight gain: a randomized clinical trial. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2014;172:15-9. http://www.qscience.com/doi/abs/10.5339/qmj.2013.7
Barker M, D’Angelo S, Ntani G, Lawrence W, Baird J, Jarman M, et al. The relationship between maternal self-efficacy, compliance and outcome in a trial of vitamin D supplementation in pregnancy. Osteoporosis International. 2017;28(1):77-84. https://link.springer.com/article/10.1007/s00198-016-3721-5
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|Pregnancy Vitamin D Deficiency Treatment|
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