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Observational Study of Third-Trimester Vitamin D3 Supplementation and Implications for Mothers and Neonates at Term

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Abstract

Objective

To determine 25-hydroxyvitamin D (25OHD) levels in pregnant women at 28 weeks and supplement based on these levels and check maternal and neonatal levels after delivery at term.

Design

This is a prospective observational study wherein pregnant women aged 18–35 years received cholecalciferol from 28 weeks till delivery at term. Women with 25OHD levels ≥ 75 nmol/L received 12.5 μg/day, those with levels 50–74.9 nmol/L received 100 μg/day and those with  levels ≤ 49.9 nmol/L received 1500 μg/week.

Results

Of 555, 532 women (95.8%) completed the study. Of 532, 77 (14.5%) women had 25OHD ≥ 75 nmol/L at 28 weeks; 34/77 (44.15%) became deficient at term, and the mean 25OHD reduced from 99 ± 29.9 to 77 ± 30.4 nmol/L (p < 0.0001). One hundred and seventy-one women had 25OHD 50–74.9 nmol/L at 28 weeks; in 99 (57.89%), levels normalised at term, and mean 25OHD increased from 60.5 ± 7.5 to 78.2 ± 21.9 nmol/L (p < 0.0001). Two hundred and nineteen women had 25OHD 25–49.9 nmol/L at 28 weeks; in 135 (61.64%), levels normalised at term, and mean 25OHD increased from 36.6 ± 7.5 to 83.3 ± 32.7 nmol/L (p < 0.0001). Sixty-five women had 25OHD < 25 nmol/L at 28 weeks; In 39 (60.94%), levels normalised at term, and the mean 25OHD increased from 17.9 ± 5 to 80.6 ± 34.1 nmol/L (p < 0.0001). Seven neonates (1.3%) had cord blood ionised calcium values < 1 mmol/L, and all these had 25OHD < 50 nmol/L (mean 22.2 ± 2.5 nmol/L).

Conclusions

Standard 12.5 μg/day supplementation in women with normal 25OHD levels at 28 weeks leads to deficiency in 44% women by term. Cholecalciferol in doses of 100 μg/day and 1500 μg/week leads to a significant increase in 25OHD levels in vitamin D-deficient pregnant women though nearly 40% may still have deficient levels at term along with their newborns. Only 1.3% of newborns had hypocalcaemia.

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Acknowledgements

We thank all the nurses and hospital staff who helped in collecting the study samples.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Cloudnine Hospital, Old Airport Road, Bangalore, 560017, India

    Namrata Nagendra, Praveena Shenoi & Modhulika Bhattacharya

  2. Department of Neonatology, Cloudnine Hospital, Old Airport Road, Bangalore, 560017, India

    Amitoj Singh Chhina & Arvind Shenoi

  3. Department of Neonatology, Cloudnine Hospital, Jayanagar, Bangalore, 560047, India

    R. Kishore Kumar

Authors
  1. Namrata Nagendra
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  2. Amitoj Singh Chhina
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  3. Praveena Shenoi
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  4. Arvind Shenoi
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  5. Modhulika Bhattacharya
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  6. R. Kishore Kumar
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Corresponding author

Correspondence to Arvind Shenoi.

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Conflict of interest

All authors declare that they have no conflict of interest

Human Rights

All procedures were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments and comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Namrata Nagendra is a Junior Consultant, Department of Obstetrics and Gynaecology, Cloudnine Hospital, Jayanagar, Bangalore, India. Amitoj Chhina is an International Training Fellow, Department of Neonatology, Royal Victoria Infirmary, Newcastle upon Tyne, UK. Praveena Shenoi is a Consultant, Department of Obstetrics and Gynaecology, Cloudnine Hospital, Old Airport Road, Bangalore, India. Modhulika Bhattacharya is a Consultant, Department of Obstetrics and Gynaecology, Cloudnine Hospital, Old Airport Road, Bangalore, India. Arvind Shenoi is a Consultant, Department of Neonatology, Cloudnine Hospital, Old Airport Road, Bangalore, India. R Kishore Kumar is a Consultant, Department of Neonatology, Cloudnine Hospital, Jayanagar, Bangalore, India.

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Nagendra, N., Chhina, A.S., Shenoi, P. et al. Observational Study of Third-Trimester Vitamin D3 Supplementation and Implications for Mothers and Neonates at Term. J Obstet Gynecol India 69 (Suppl 2), 89–94 (2019). https://doi.org/10.1007/s13224-018-1095-7

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  • DOI: https://doi.org/10.1007/s13224-018-1095-7

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