Vitamin D in your pregnancy diet Vitamin D in your child's diet 4 key nutrients you may be missing 10 healthy snacks for pregnancy The lowdown on children's vitamins Is it safe to eat meat while pregnant? Dealing with unfair treatment at work while pregnantHigh Doses of Vitamin D May Cut Pregnancy Risks Study Shows 4,000 IU a Day of Vitamin D May Reduce Preterm Birth and Other Risks May 4, 2010 -- Women who take high doses of vitamin D during pregnancy have a greatly reduced risk of complications, including gestational diabetes, preterm birth, and infection, new research suggests. Based on the findings, study researchers are recommending that pregnant women take 4,000 international units (IU) of vitamin D every day -- at least 10 times the amount recommended by various health groups. Women in the study who took 4,000 IU of the vitamin daily in their second and third trimesters showed no evidence of harm, but they had half the rate of pregnancy-related complications as women who took 400 IU of vitamin D every day, says neonatologist and study co-researcher Carol L. Wagner, MD, of the Medical University of South Carolina.
Wagner acknowledges the recommendation may be controversial because very high doses of vitamin D have long been believed to cause birth defects. "Any doctor who hasn't followed the literature may be wary of telling their patients to take 4,000 IU of vitamin D," she says. "But there is no evidence that vitamin D supplementation is toxic, even at levels above 10,000 IU." Fewer Complications With High Vitamin D Doses Most prenatal vitamins have around 400 IU of vitamin D, and most health groups recommend taking no more than 2,000 IU of the vitamin in supplement form daily. Wagner says it took months to get permission to do a study in which pregnant women were given doses of the vitamin that were twice as high as this. The study included about 500 women in Charleston, S.C., who were in their third or fourth months of pregnancy. The women took 400 IU, 2,000 IU, or 4,000 IU of vitamin D daily until they delivered. Not surprisingly, women who took the highest doses of vitamin D were the least likely to have deficient or insufficient blood levels of the vitamin, as were their babies.
These women also had the lowest rate of pregnancy-related complications. Compared to women who took 400 IU of vitamin D daily, those who took 4,000 IU were half as likely to develop gestational diabetes, pregnancy-related high blood pressure, or preeclampsia, Wagner says. They were also less likely to give birth prematurely. The research was presented over the weekend at the annual meeting of the Pediatric Academic Societies in Vancouver, British Columbia. Infants with very low vitamin D levels are at increased risk for soft bones, or rickets -- a condition that is now rare in the U.S. But over the last decade, more and more studies suggest that vitamin D also protects against immune system disorders and other diseases, Wagner says. Fortified milk and fatty fish are common food sources of vitamin D, but most people get only a small fraction of the vitamin D they need through food, Wagner says. Instead, the body makes vitamin D from sunlight. But even in sunny climates like Charleston, few people are now getting adequate levels of vitamin D from sun exposure.
At the start of the study, deficient or insufficient levels of vitamin D were seen in 94% of the African-American women, 66% of Hispanic women, and 50% of white women who participated. Vitamin D and Pregnancy: Is More Better? University of Rochester professor of pediatrics Ruth Lawrence, MD, has been recording vitamin D levels in new mothers and their infants for three years. She did not take part in the new study. Lawrence, who chairs the breastfeeding committee of the American Academy of Pediatrics, says exclusively breastfed babies whose mothers have low vitamin D levels and who don't take vitamin supplements are most likely to be deficient. "It is clear that both for mothers and their babies, vitamin D levels are low," she tells WebMD. "This is true in northern areas like Rochester and in sunny climates like Charleston." Lawrence sees no problem with the recommendation that women take 4,000 IU of vitamin D daily during pregnancy, although she says the impact of high doses of vitamin D on pregnancy-related complications remains to be proven.
"Four thousand IU may sound outrageous to some, but I believe it is really not unreasonable," she says. "We have been searching for the causes of preeclampsia and premature birth for many years. It is reassuring that the risk of these complications are lower for women taking extra vitamin D, but it is premature to say it is the cause." The independent health policy group the Institute of Medicine recommends 200 IU to 400 IU of vitamin D a day for everyone, including pregnant women, but this recommendation is under review. Revised guidelines are expected late this summer. Hashemipour S, Lalooha F, Zahir Mirdamadi S, Ziaee A, Dabaghi Ghaleh T. Metabolic Diseases Research Center, Qazvin University of Medical Science, Qazvin, Iran. Measure Control50,000 IU weekly Body weight3.26 kg3.42 kg Maternal weight gain11.7 kg13.7 kg There are several studies in which a correlation between maternal vitamin D deficiency and serum mineral disorders in the mother and the newborn has been reported.
The present randomised clinical trial was designed to investigate the effect of vitamin D administration on maternal and fetal Ca and vitamin D status. The trial was carried out on 160 pregnant women. Vitamin D-deficient (25-hydroxyvitamin D (25(OH)D) < 30 ng/ml) pregnant women were recruited at 26-28 weeks of pregnancy. In the control group, a multivitamin supplement containing 400 IU vitamin D3/d was given. Patients in the treatment group were treated with 50 000 IU vitamin D3 weekly for a total duration of 8 weeks. At delivery, maternal and fetal Ca and 25(OH)D levels in both groups were compared. In total, 81 % of pregnant women were vitamin D deficient. At the time of delivery, Ca and vitamin D levels were higher in the treatment group compared with the control group (92 (sd 3) v. 85 (sd 4) mg/l, respectively, P= 0·001 for serum Ca; 47·8 (sd 11·1) v. 15·9 (sd 6·6) ng/ml, respectively, P< 0·001 for vitamin D). At the time of delivery, 32·7 % of women in the control group had hypocalcaemia, while no hypocalcaemic case was detected in the vitamin D-treated group.
Mean neonatal serum 25(OH)D was higher in the treatment group compared with the control group (27·7 (sd 5·2) v.10·9 (sd 4·4) ng/ml, respectively, P< 0·01). The neonatal Ca level in the treatment group was significantly higher than that of the control group (99 (sd 3) v. 91 (sd 3) mg/l, respectively, P< 0·001). The administration of vitamin D to pregnant women with vitamin D deficiency improves both maternal and neonatal Ca levels. Effect of treatment of vitamin D deficiency and insufficiency during pregnancy on fetal growth indices and maternal weight gain: a randomized clinical trial. Eur J Obstet Gynecol Reprod Biol. 2013 Oct 19. Hashemipour S, Ziaee A, Javadi A, Movahed F, Elmizadeh K, Javadi EH, Lalooha F. OBJECTIVE: To determine whether treatment of low serum vitamin D in pregnant women improves fetal growth indices. STUDY DESIGN: In this open-label randomized clinical trial, 130 Iranian pregnant women (24-26 weeks of gestation) with vitamin D deficiency or insufficiency [25(OH)D <30ng/ml] were divided at random into an intervention group and a control group.
The control group received 200mg calcium plus a multivitamin (containing vitamin D3 400U) each day, and the intervention group received 200mg calcium plus a multivitamin (containing vitamin D3 400U) each day, plus vitamin D3 (50,000U) each week for 8 weeks. At delivery, maternal and cord blood 25(OH)D levels, maternal weight gain, neonatal length, neonatal weight and neonatal head circumference were compared between two groups. Serum vitamin D was measured using enzyme-linked immunosorbent assay. A multivariate regression analysis was performed to examine the independent effect of maternal vitamin D level on fetal growth indices. were higher in the intervention group compared with the control group. Mean maternal weight gain was higher in the intervention group compared with the control group (13.3±2.4kg vs 11.7±2.7kg; p=0.006). Multivariate regression analysis for showed an independent correlation with maternal vitamin D level. CONCLUSION: Treatment of low serum vitamin D during pregnancy improves fetal growth indices and maternal weight gain.