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Maternal vitamin D supplementation in pregnancy and offspring outcomes: a double-blind randomized placebo-controlled trial

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Abstract

We studied bone mineral content (BMC), bone mineral density (BMD), and body composition in offspring of women supplemented with vitamin D during pregnancy. Pregnant women were randomized to receive oral cholecalciferol 60,000 units 4 weekly (group 1), 8 weekly (group 2), or placebo (group 3). All received 1 g calcium daily (groups 1 and 2 without, and group 3 with 400 units vitamin D). Offspring at 12–16 months underwent dual-energy X-ray absorptiometry. Maternal hypovitaminosis D at recruitment was common (serum 25OHD <50 nmol/L in 88 %) and severe (25OHD <25 nmol/L in 46 %). Groups 1 and 2 (n = 23 and 13, median age 14 months) had higher cord blood 25OHD (47.8 ± 13.8 and 31.0 ± 14.0 nmol/L) versus group 3 (n = 16, median age 16 months, 17.8 ± 13.5 nmol/L, p < 0.001). Babies in group 3 had higher whole-body BMC (250.8 ± 42.5 gm) and BMD (0.335 ± 0.033 gm/cm2) compared to group 1 (213.1 ± 46.2 gm and 0.295 ± 0.041 gm/cm2) and group 2 (202.9 ± 29.9 gm and 0.287 ± 0.023 gm/cm2) (p = 0.006 and 0.001, respectively). In multivariate analysis, age, weight z score, and lean body mass remained significant contributors to BMC. Parameters of body composition were comparable among the groups. Vitamin D supplementation to pregnant women with severe deficiency in doses that improved cord blood 25OHD did not result in improved bone health or body composition in offspring at 12–16 months, compared to a dose too small to improve 25OHD levels.

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Acknowledgments

SKS was responsible for planning, conduct of the study, offspring recruitment and assessment, and manuscript writing. KKK was responsible recruitment of mothers and their assessment. VD and AA were responsible for conception and design of the study, while VB was responsible for conception, design and planning of the study, data analysis and drafting, revision and final approval of the manuscript. We acknowledge the grant support from Department of Biotechnology (BT/PR/13985/SPD/11/1297/2010) to V. Bhatia, intramural grant to S. K. Sahoo and V. Bhatia from SGPGIMS, Indian Council for Medical Research grant (manpower development scheme) to S. K. Sahoo. We thank Dr Joshua Richman, UAB School of Medicine, Birmingham, USA and Dr Ashish Awasthi, Department of Biostatistics, SGPGIMS, Lucknow for helpful discussions in statistical analysis. We extend our thanks to Arjun Singh, Pallavi Tiwari, Manoj Dubey and Rajesh Srivastava for their technical support in this project.

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Authors and Affiliations

  1. Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India

    Saroj Kumar Sahoo, Kishore Kumar Katam & Vijayalakshmi Bhatia

  2. King George’s Medical University, Lucknow, India

    Vinita Das & Anjoo Agarwal

  3. Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, India

    Vijayalakshmi Bhatia

Authors
  1. Saroj Kumar Sahoo
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  2. Kishore Kumar Katam
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Correspondence to Vijayalakshmi Bhatia.

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Additional information

The study protocol can be found at http://www.icmr.nic.in/ and http://ctri.nic.in/Clinicaltrials/login.php.

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Sahoo, S.K., Katam, K.K., Das, V. et al. Maternal vitamin D supplementation in pregnancy and offspring outcomes: a double-blind randomized placebo-controlled trial. J Bone Miner Metab 35, 464–471 (2017). https://doi.org/10.1007/s00774-016-0777-4

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  • DOI: https://doi.org/10.1007/s00774-016-0777-4

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