The University of Southampton
University of Southampton Institutional Repository

Determinants of the maternal 25-hydroxyvitamin D response to vitamin D supplementation during pregnancy

Determinants of the maternal 25-hydroxyvitamin D response to vitamin D supplementation during pregnancy
Determinants of the maternal 25-hydroxyvitamin D response to vitamin D supplementation during pregnancy
Context: Current approaches to antenatal vitamin D supplementation do not account for interindividual differences in 25-hydroxyvitamin D (25(OH)D) response.

Objective: We assessed which maternal and environmental characteristics were associated with 25(OH)D after supplementation with cholecalciferol.

Design: Within-randomization-group analysis of participants in the Maternal Vitamin D Osteoporosis Study trial of vitamin D supplementation in pregnancy.

Setting: Hospital antenatal clinics.

Participants: A total of 829 pregnant women (422 placebo, 407 cholecalciferol). At 14 and 34 weeks of gestation, maternal anthropometry, health, and lifestyle were assessed and 25(OH)D measured. Compliance was determined using pill counts at 19 and 34 weeks.

Interventions: 1000 IU/d of cholecalciferol or matched placebo from 14 weeks of gestation until delivery.

Main Outcome Measure: 25(OH)D at 34 weeks, measured in a single batch (Diasorin Liaison).

Results: 25(OH)D at 34 weeks of gestation was higher in the women randomized to vitamin D (mean [SD], 67.7 [21.3] nmol/L) compared with placebo (43.1 [22.5] nmol/L; P < .001). In women randomized to cholecalciferol, higher pregnancy weight gain from 14 to 34 weeks of gestation (kg) (? = ?0.81 [95% confidence interval ?1.39, ?0.22]), lower compliance with study medication (%) (? = ?0.28 [?0.072, ?0.48]), lower early pregnancy 25(OH)D (nmol/L) (? = 0.28 [0.16, 0.40]), and delivery in the winter vs the summer (? = ?10.5 [?6.4, ?14.6]) were independently associated with lower 25(OH)D at 34 weeks of gestation.

Conclusions: Women who gained more weight during pregnancy had lower 25(OH)D in early pregnancy and delivered in winter achieved a lower 25(OH)D in late pregnancy when supplemented with 1000 IU/d cholecalciferol. Future studies should aim to determine appropriate doses to enable consistent repletion of 25(OH)D during pregnancy.
0021-972X
5012-5020
Moon, R.J.
954fb3ed-9934-4649-886d-f65944985a6b
Harvey, N.C.
ce487fb4-d360-4aac-9d17-9466d6cba145
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
D'angelo, S.
13375ecd-1117-4b6e-99c0-32239f52eed6
Crozier, S.R.
9c3595ce-45b0-44fa-8c4c-4c555e628a03
Inskip, H.M.
5fb4470a-9379-49b2-a533-9da8e61058b7
Schoenmakers, I.
64ce38c3-a9df-4426-b01d-dc0ec968038b
Prentice, A.
b103f864-7606-4860-8bf2-125b4be3c0f3
Arden, N.K.
23af958d-835c-4d79-be54-4bbe4c68077f
Bishop, N.J.
5e75c2ff-8269-4da5-b4eb-049aef2041ab
Carr, A.
85c8478c-1212-4d8b-986f-d3c212298807
Dennison, E.M.
ee647287-edb4-4392-8361-e59fd505b1d1
Eastell, R.
1650872d-d27d-4543-a112-d6008810fa25
Fraser, R.
1d2e1003-e025-4cb6-b411-5687fa2f5e0f
Gandhi, S.V.
4be3f670-f99f-4687-8518-1d46c6009c92
Godfrey, K.M.
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Kennedy, S.
d78526a0-8c23-4c94-b25a-c0fa85025f5c
Zulf Mughal, M.
20a55a79-dc9b-41c1-934b-355373e99365
Papageorghiou, A.T.
f99d2e42-8146-4ff2-804a-e68193fef668
Reid, D.M.
80c8f859-f13a-4129-b884-c0fbc46d61b8
Robinson, S.M
ba591c98-4380-456a-be8a-c452f992b69b
Javaid, M.K.
51d3310b-032e-4c15-83ac-b878bce090f3
Moon, R.J.
954fb3ed-9934-4649-886d-f65944985a6b
Harvey, N.C.
ce487fb4-d360-4aac-9d17-9466d6cba145
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
D'angelo, S.
13375ecd-1117-4b6e-99c0-32239f52eed6
Crozier, S.R.
9c3595ce-45b0-44fa-8c4c-4c555e628a03
Inskip, H.M.
5fb4470a-9379-49b2-a533-9da8e61058b7
Schoenmakers, I.
64ce38c3-a9df-4426-b01d-dc0ec968038b
Prentice, A.
b103f864-7606-4860-8bf2-125b4be3c0f3
Arden, N.K.
23af958d-835c-4d79-be54-4bbe4c68077f
Bishop, N.J.
5e75c2ff-8269-4da5-b4eb-049aef2041ab
Carr, A.
85c8478c-1212-4d8b-986f-d3c212298807
Dennison, E.M.
ee647287-edb4-4392-8361-e59fd505b1d1
Eastell, R.
1650872d-d27d-4543-a112-d6008810fa25
Fraser, R.
1d2e1003-e025-4cb6-b411-5687fa2f5e0f
Gandhi, S.V.
4be3f670-f99f-4687-8518-1d46c6009c92
Godfrey, K.M.
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Kennedy, S.
d78526a0-8c23-4c94-b25a-c0fa85025f5c
Zulf Mughal, M.
20a55a79-dc9b-41c1-934b-355373e99365
Papageorghiou, A.T.
f99d2e42-8146-4ff2-804a-e68193fef668
Reid, D.M.
80c8f859-f13a-4129-b884-c0fbc46d61b8
Robinson, S.M
ba591c98-4380-456a-be8a-c452f992b69b
Javaid, M.K.
51d3310b-032e-4c15-83ac-b878bce090f3

Moon, R.J., Harvey, N.C., Cooper, C., D'angelo, S., Crozier, S.R., Inskip, H.M., Schoenmakers, I., Prentice, A., Arden, N.K., Bishop, N.J., Carr, A., Dennison, E.M., Eastell, R., Fraser, R., Gandhi, S.V., Godfrey, K.M., Kennedy, S., Zulf Mughal, M., Papageorghiou, A.T., Reid, D.M., Robinson, S.M and Javaid, M.K. (2016) Determinants of the maternal 25-hydroxyvitamin D response to vitamin D supplementation during pregnancy. Journal of Clinical Endocrinology & Metabolism, 5012-5020. (doi:10.1210/jc.2016-2869). (PMID:27788053)

Record type: Article

Abstract

Context: Current approaches to antenatal vitamin D supplementation do not account for interindividual differences in 25-hydroxyvitamin D (25(OH)D) response.

Objective: We assessed which maternal and environmental characteristics were associated with 25(OH)D after supplementation with cholecalciferol.

Design: Within-randomization-group analysis of participants in the Maternal Vitamin D Osteoporosis Study trial of vitamin D supplementation in pregnancy.

Setting: Hospital antenatal clinics.

Participants: A total of 829 pregnant women (422 placebo, 407 cholecalciferol). At 14 and 34 weeks of gestation, maternal anthropometry, health, and lifestyle were assessed and 25(OH)D measured. Compliance was determined using pill counts at 19 and 34 weeks.

Interventions: 1000 IU/d of cholecalciferol or matched placebo from 14 weeks of gestation until delivery.

Main Outcome Measure: 25(OH)D at 34 weeks, measured in a single batch (Diasorin Liaison).

Results: 25(OH)D at 34 weeks of gestation was higher in the women randomized to vitamin D (mean [SD], 67.7 [21.3] nmol/L) compared with placebo (43.1 [22.5] nmol/L; P < .001). In women randomized to cholecalciferol, higher pregnancy weight gain from 14 to 34 weeks of gestation (kg) (? = ?0.81 [95% confidence interval ?1.39, ?0.22]), lower compliance with study medication (%) (? = ?0.28 [?0.072, ?0.48]), lower early pregnancy 25(OH)D (nmol/L) (? = 0.28 [0.16, 0.40]), and delivery in the winter vs the summer (? = ?10.5 [?6.4, ?14.6]) were independently associated with lower 25(OH)D at 34 weeks of gestation.

Conclusions: Women who gained more weight during pregnancy had lower 25(OH)D in early pregnancy and delivered in winter achieved a lower 25(OH)D in late pregnancy when supplemented with 1000 IU/d cholecalciferol. Future studies should aim to determine appropriate doses to enable consistent repletion of 25(OH)D during pregnancy.

Text
rm delta D MAVIDOS R2 2092016.docx - Accepted Manuscript
Restricted to Repository staff only
Request a copy
Text
rm%20delta%20D%20MAVIDOS%20Revision%2008092016.docx - Accepted Manuscript
Download (212kB)
Text
jcem5012.pdf - Version of Record
Available under License Creative Commons Attribution.
Download (513kB)
Slideshow
JCEM delta D Figure 1.pptx - Other
Download (96kB)
Slideshow
JCEM delta D Figure 2 a and b.pptx - Other
Download (57kB)

Show all 5 downloads.

More information

Accepted/In Press date: 3 October 2016
e-pub ahead of print date: 28 October 2016
Published date: 1 December 2016
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 401211
URI: http://eprints.soton.ac.uk/id/eprint/401211
ISSN: 0021-972X
PURE UUID: 904d31b7-bfaa-4cdc-bf64-1345260a15ca
ORCID for N.C. Harvey: ORCID iD orcid.org/0000-0002-8194-2512
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for S. D'angelo: ORCID iD orcid.org/0000-0002-7267-1837
ORCID for S.R. Crozier: ORCID iD orcid.org/0000-0002-9524-1127
ORCID for H.M. Inskip: ORCID iD orcid.org/0000-0001-8897-1749
ORCID for E.M. Dennison: ORCID iD orcid.org/0000-0002-3048-4961
ORCID for K.M. Godfrey: ORCID iD orcid.org/0000-0002-4643-0618
ORCID for S.M Robinson: ORCID iD orcid.org/0000-0003-1766-7269

Catalogue record

Date deposited: 10 Oct 2016 14:37
Last modified: 18 Feb 2021 17:20

Export record

Altmetrics

Contributors

Author: R.J. Moon
Author: N.C. Harvey ORCID iD
Author: C. Cooper ORCID iD
Author: S. D'angelo ORCID iD
Author: S.R. Crozier ORCID iD
Author: H.M. Inskip ORCID iD
Author: I. Schoenmakers
Author: A. Prentice
Author: N.K. Arden
Author: N.J. Bishop
Author: A. Carr
Author: E.M. Dennison ORCID iD
Author: R. Eastell
Author: R. Fraser
Author: S.V. Gandhi
Author: K.M. Godfrey ORCID iD
Author: S. Kennedy
Author: M. Zulf Mughal
Author: A.T. Papageorghiou
Author: D.M. Reid
Author: S.M Robinson ORCID iD
Author: M.K. Javaid

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×