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Pregnancy vitamin D supplementation and childhood bone mass at age 4 years: Findings from the MAVIDOS Randomised Controlled Trial

Pregnancy vitamin D supplementation and childhood bone mass at age 4 years: Findings from the MAVIDOS Randomised Controlled Trial
Pregnancy vitamin D supplementation and childhood bone mass at age 4 years: Findings from the MAVIDOS Randomised Controlled Trial
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.
0884-0431
Curtis, Elizabeth
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Moon, Rebecca
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D'angelo, Stefania
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Crozier, Sarah
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Bishop, Nicholas J.
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Gopal-Kothandapani, Jaya Sujatha
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Kennedy, Stephen
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Papageorghiou, Aris T.
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Fraser, Robert
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Gandhi, Saurabh V.
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Schoenmakers, Inez
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Prentice, Ann
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Inskip, Hazel
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Godfrey, Keith
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Javaid, M. Kassim
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Eastell, Richard
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Cooper, Cyrus
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Harvey, Nicholas
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Curtis, Elizabeth
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Moon, Rebecca
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D'angelo, Stefania
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Crozier, Sarah
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Bishop, Nicholas J.
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Gopal-Kothandapani, Jaya Sujatha
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Kennedy, Stephen
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Papageorghiou, Aris T.
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Fraser, Robert
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Gandhi, Saurabh V.
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Schoenmakers, Inez
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Prentice, Ann
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Inskip, Hazel
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Godfrey, Keith
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Javaid, M. Kassim
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Eastell, Richard
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Cooper, Cyrus
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Harvey, Nicholas
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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.

Record type: Article

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.

Text
MAVIDOS 4 yr JBMR+ revision 2 06042022 no tracked changes - Accepted Manuscript
Restricted to Repository staff only until 28 April 2023.
Request a copy
Text
JBMR Plus - 2022 - Curtis - Pregnancy vitamin D supplementation and childhood bone mass at age 4 years Findings from the - Accepted Manuscript
Restricted to Repository staff only until 28 April 2023.
Request a copy

More information

Accepted/In Press date: 28 April 2022
Published date: 22 May 2022

Identifiers

Local EPrints ID: 457248
URI: http://eprints.soton.ac.uk/id/eprint/457248
ISSN: 0884-0431
PURE UUID: 9c784c87-175d-4380-ab89-0771ffec9a7f
ORCID for Elizabeth Curtis: ORCID iD orcid.org/0000-0002-5147-0550
ORCID for Stefania D'angelo: ORCID iD orcid.org/0000-0002-7267-1837
ORCID for Sarah Crozier: ORCID iD orcid.org/0000-0002-9524-1127
ORCID for Hazel Inskip: ORCID iD orcid.org/0000-0001-8897-1749
ORCID for Keith Godfrey: ORCID iD orcid.org/0000-0002-4643-0618
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for Nicholas Harvey: ORCID iD orcid.org/0000-0002-8194-2512

Catalogue record

Date deposited: 27 May 2022 16:50
Last modified: 03 Sep 2022 01:56

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Contributors

Author: Rebecca Moon
Author: Stefania D'angelo ORCID iD
Author: Sarah Crozier ORCID iD
Author: Nicholas J. Bishop
Author: Jaya Sujatha Gopal-Kothandapani
Author: Stephen Kennedy
Author: Aris T. Papageorghiou
Author: Robert Fraser
Author: Saurabh V. Gandhi
Author: Inez Schoenmakers
Author: Ann Prentice
Author: Hazel Inskip ORCID iD
Author: Keith Godfrey ORCID iD
Author: M. Kassim Javaid
Author: Richard Eastell
Author: Cyrus Cooper ORCID iD
Author: Nicholas Harvey ORCID iD

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