Curtis, Elizabeth, Moon, Rebecca, D'angelo, Stefania, Crozier, Sarah, Bishop, Nicholas J., Gopal-Kothandapani, Jaya Sujatha, Kennedy, Stephen, Papageorghiou, Aris T., Fraser, Robert, Gandhi, Saurabh V., Schoenmakers, Inez, Prentice, Ann, Inskip, Hazel, Godfrey, Keith, Javaid, M. Kassim, Eastell, Richard, Cooper, Cyrus and Harvey, Nicholas (2022) Pregnancy vitamin D supplementation and childhood bone mass at age 4 years: Findings from the MAVIDOS Randomised Controlled Trial. Journal of Bone and Mineral Research.
Abstract
In the MAVIDOS randomised trial, vitamin D supplementation in pregnancy did not lead to greater neonatal bone mass across the trial as a whole, but, in a prespecified secondary analysis by season of birth, led to greater neonatal bone mass amongst winter-born babies. Demonstrating persistence of this effect into childhood would increase confidence in a long-term benefit of this intervention. We investigated whether antenatal vitamin D supplementation increases offspring bone mineralisation in early childhood in a prespecified, single-centre follow-up of a double-blinded, multicentre, randomised controlled clinical trial based in the UK (MAVIDOS).
1123 women in early pregnancy with a baseline 25-hydroxyvitamin D level 25-100 nmol/l from three research centres (2008-2014) were randomised to 1000 IU/day cholecalciferol or matched placebo from 14 weeks' gestation to delivery. Offspring born at the Southampton, UK research centre were assessed at age 4 years (2013-2018). Anthropometry and dual-energy x-ray absorptiometry (DXA) were performed [yielding whole body less head (WBLH) bone mineral content (BMC), areal bone mineral density (aBMD), bone area (BA) and body composition].
564/723 (78.0%) children attended the 4-year visit, of whom 452 had a useable DXA. Maternal vitamin D supplementation led to greater WBLH aBMD in the children compared with placebo [mean (95%CI): supplemented group: 0.477 (0.472, 0.481)g/cm2; placebo group: 0.470 (0.466, 0.475)g/cm2, p=0.048]. Associations were consistent for BMC and lean mass, and in age and sex adjusted models. Effects were observed across the whole cohort irrespective of season of birth. Maternal-child interactions were observed, with a greater effect size amongst children with low milk intake and low levels of physical activity. Child weight, height and BMI were similar by maternal randomisation group.
These findings suggest a sustained beneficial effect of maternal vitamin D supplementation in pregnancy on offspring aBMD at age 4 years but will require replication in other trials.
More information
Identifiers
Catalogue record
Export record
Contributors
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.