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Preterm birth rate reduced by vitamin D – 78 percent if non-white, 39 percent if white – July 2017

Maternal 25(OH)D concentrations >40 ng/mL associated with 60% lower preterm birth risk among general obstetrical patients at an urban medical center

PLoS ONE 12(7): e0180483. https://doi.org/10.1371/journal.pone.0180483

Vitamin D Life Summary

1,064 pregnant women at Medical University of South Carolina 9/2015 to 12/2016
Typically prescribed 5,000 IU of vitamin D daily
Without a loading dose, the Vitamin D levels probably took 3 months after conception to plateau (and provide a benefit)
A second vitamin D test in the first portion of 2nd trimester was used to increase the dosing (half of the women had vitamin D levels < 39 ng)
Suspect that much more than 5,000 IU would be needed to get most (say 97.5%) of the women > 40 ng
Also: 80% lower risk of recurrent PTB with >40 ng/mL compare to those <20 ng/mL

See also Vitamin D Life

Pregnancy category starts with

751 items in Pregnancy category

 - see also

Healthy pregnancies need lots of vitamin D has the following summary

Problem
ReducesEvidence
0. Chance of not conceiving3.4 times Observe
1. Miscarriage 2.5 times Observe
2. Pre-eclampsia 3.6 timesRCT
3. Gestational Diabetes 3 times RCT
4. Good 2nd trimester sleep quality 3.5 times Observe
5. Premature birth 2 times RCT
6. C-section - unplanned 1.6 timesObserve
     Stillbirth - OMEGA-3 4 timesRCT - Omega-3
7. Depression AFTER pregnancy 1.4 times RCT
8. Small for Gestational Age 1.6 times meta-analysis
9. Infant height, weight, head size
     within normal limits
RCT
10. Childhood Wheezing 1.3 times RCT
11. Additional child is Autistic 4 times Intervention
12.Young adult Multiple Sclerosis 1.9 timesObserve
13. Preeclampsia in young adult 3.5 timesRCT
14. Good motor skills @ age 31.4 times Observe
15. Childhood Mite allergy 5 times RCT
16. Childhood Respiratory Tract visits 2.5 times RCT

RCT = Randomized Controlled Trial


 Download the PDF from Vitamin D Life

Sharon L. McDonnell1, Keith A. Baggerly2, Carole A. Baggerly1, Jennifer L. Aliano1, Christine B. French1 christine at grassrootshealth.org, Leo L. Baggerly1, Myla D. Ebeling3, Charles S. Rittenberg3, Christopher G. Goodier3, Julio F. Mateus Nino3, Rebecca J. Wineland3, Roger B. Newman3, Bruce W. Hollis3, Carol L. Wagner3
1 GrassrootsHealth, Encinitas, California, USA,
2 Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
3 Medical University of South Carolina Children’s Hospital, Charleston, South Carolina, USA

Background
Given the high rate of preterm birth (PTB) nationwide and data from RCTs demonstrating risk reduction with vitamin D supplementation, the Medical University of South Carolina (MUSC) implemented a new standard of care for pregnant women to receive vitamin D testing and supplementation.

Objectives
To determine if the reported inverse relationship between maternal 25(OH)D and PTB risk could be replicated at MUSC, an urban medical center treating a large, diverse population.

Methods
Medical record data were obtained for pregnant patients aged 18-45 years between September 2015 and December 2016. During this time, a protocol that included 25(OH)D testing at first prenatal visit with recommended follow-up testing was initiated. Free vitamin D supplements were offered and the treatment goal was >40 ng/mL. PTB rates (<37 weeks) were calculated, and logistic regression and locally weighted regression (LOESS) were used to explore the association between 25(OH)D and PTB. Subgroup analyses were also conducted.

Results
Among women with a live, singleton birth and at least one 25(OH)D test during pregnancy (N = 1,064), the overall PTB rate was 13%. The LOESS curve showed gestational age rising with increasing 25(OH)D. Women with 25(OH)D >40 ng/mL had a 62% lower risk of PTB compared to those <20 ng/mL (p<0.0001). After adjusting for socioeconomic variables, this lower risk remained (OR = 0.41, p = 0.002). Similar decreases in PTB risk were observed for PTB subtypes (spontaneous: 58%, p = 0.02; indicated: 61%, p = 0.006), by race/ethnicity (white: 65%, p = 0.03; non-white: 68%, p = 0.008), and among women with a prior PTB (80%, p = 0.02). Among women with initial 25(OH)D <40 ng/mL, PTB rates were 60% lower for those with >40 vs. <40 ng/mL on a follow-up test (p = 0.006); 38% for whites (p = 0.33) and 78% for non-whites (p = 0.01).

Conclusions
Maternal 25(OH)D concentrations >40 ng/mL were associated with substantial reduction in PTB risk in a large, diverse population of women.


Supect that the removal of single outlier at 100 ng would greatly reduce the increased risk for vitamin D levels > 60 ng

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Preterm birth rate reduced by vitamin D – 78 percent if non-white, 39 percent if white – July 2017        
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8215 Outlier.jpg admin 26 Jul, 2017 21:50 35.55 Kb 245
8214 extrapulation.jpg admin 26 Jul, 2017 21:49 30.24 Kb 266
8213 40 ng pregnancy July 2017.pdf PDF 2017 admin 26 Jul, 2017 21:49 2.07 Mb 249
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