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    Does prenatal vitamin D boost bone in neonates?

    A study by UK researchers shows that taking 1000 IU/day of vitamin D is safe and effective for pregnant women but does not increase bone mineral content (BMC) in their offspring. However, the results of dual-energy x-ray absorptiometry (DXA) in the infants also hint at the intriguing possibility that babies born during the winter may get some benefit from the supplements taken by their mothers.

    Published in The Lancet, the findings are from the Maternal Vitamin D Osteoporosis Study (MAVIDOS), a multicenter, double-blind, randomized, placebo-controlled trial performed at three sites in UK. The women who participated were aged 18 or older and had singleton gestations <17 weeks and serum 25-hydroxyvitamin D (252[OD]D) concentrations of 25-100 nmol/L at 10 to 17 weeks’ gestation.

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    Randomization was to either 1000 IU/day of vitamin D or placebo, taken orally from 14 weeks’ gestation (or as soon as possible before 17 weeks’ gestation) until delivery. The whole-body BMC of the women’s offspring was assessed within 2 weeks of birth with DXA. The authors also assessed the safety of the vitamin supplementation.

    A total of 1134 women participated in the study, 565 of whom received vitamin D and 569 of whom received placebo. DXA scans were performed on 367 (65%) of the infants born to the women in the vitamin D group and 370 (65%) of the infants born to the women in the placebo group.

    No significant differences were seen between the BMC of infants whose mothers had taken vitamin D and those who mothers took placebo (61.6 g [95% CI 60.3-62.8] vs 60.5 g [95% CI 59.3-61.7], respectively; P=0.21). More women in the placebo group (96 [17%]) than in the vitamin D group (65 [12%]) had severe postpartum hemorrhage but there were no other differences in safety outcomes. 

    In a secondary analysis, interestingly, the authors found an interaction between the effect of supplementation with vitamin D and the season in which the infants were born. “For births in the winter,” the researchers said, “neonatal BMC, bone area, BMD, and body fat, but not birthweight or birth length, were greater in offspring of mothers who had received cholecalciferol than in the offspring of mothers who had not.” The finding, they said, is biologically plausible and consistent with previous data but further study in larger populations is necessary to determine its public health significance.

    Judith M. Orvos, ELS
    Judith M. Orvos, ELS, is a a BELS-certified medical writer and editor and an editorial consultant for Contemporary OB/GYN.
    Miranda Hester
    Ms. Hester is Content Specialist with Contemporary OB/GYN and Contemporary Pediatrics.

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