Effect of prolonged hospitalization for threatened preterm labor on maternal and fetal vitamin D levels.
J Obstet Gynaecol Res. 2018 Mar 23. doi: 10.1111/jog.13620. Epub ahead of print
Yonetani N1, Kaji T1, Hichijo A1, Nakayama S1, Maeda K1,2, Irahara M1.
At 3rd trimester 14 ng if PTL, 18 ng if normal labor
No statistical difference at 2nd trimeter nor in umbilical cord
See also Vitamin D Life
Preterm births are VERY costly – Feb 2017 contains this cost-analysis
Assumptions: additional $50,000 per premature birth, $100 for education & supplements per pregnancy
| Net savings per birth After subtract all costs | # needed to eliminate 1 preterm | Cost of educ, supp per pregnancy | Total cost Educ/supp. | Cost of test per pregnancy | Total test costs | Net savings after subtract costs | |
| Vitamin D (5,000 IU avg) | $4,300 | 20 | $100 | $2,000 | $200%%%(2 tests) | $4,000 | $43,000 |
| Omega-3 | $646 | 67 | $100 | $6,700 | $0 | $0 | $43,300 |
| Vitamin C reduces early rupture | $646 | 67 | $100 | $6,700 | $0 | $0 | $43,300 |
| Iodine | $320 | 100 | $100 | $10,000 | $80 | $8,000 | $32,000 |
Does not include additional savings to infant beyond the first year
such as reductions in Autism, MS, Respiratory Tract Infection, Asthma, Allergies
Does not include additional savings to mother
such as reduction in preeclampsia, miscarriage, gestational diabetes, depression
nor does it assign any costs for anguish of possible premie death, stillbirth, time off from work, job productivity
Healthy pregnancies need lots of vitamin D has the following summary
Problem | Reduces | Evidence | |||||
| 0. Chance of not conceiving | 3.4 times | Observe | |||||
| 1. Miscarriage | 2.5 times | Observe | |||||
| 2. Pre-eclampsia | 3.6 times | RCT | |||||
| 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 times | Observe | |||||
| Stillbirth - OMEGA-3 | 4 times | RCT - 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 times | Observe | |||||
| 13. Preeclampsia in young adult | 3.5 times | RCT | |||||
| 14. Good motor skills @ age 3 | 1.4 times | Observe | |||||
| 15. Childhood Mite allergy | 5 times | RCT | |||||
| 16. Childhood Respiratory Tract visits | 2.5 times | RCT | |||||
RCT = Randomized Controlled Trial
AIM: We aimed to evaluate the effect of prolonged hospitalization for threatened preterm labor (TPL) on maternal and fetal vitamin D status.
METHODS:
This was a retrospective cohort study, spanning 4 years, including 18 women with TPL and 36 women with normal pregnancy who received prenatal care for a singleton pregnancy at our center. TPL cases were women who were admitted to our hospital after the second trimester test for at least 28 days, during which time the third trimester test was also performed. Controls were randomly sampled from women matched for age as well as the season during which the third trimester test was performed. Serum 25-hydroxyvitamin D (25(OH)D) concentration in maternal blood was compared between the two groups at second trimester, third trimester and in the umbilical cord blood at delivery.
RESULTS:
The mean ± SD of maternal serum 25(OH)D concentration in the TPL group (14.0 ± 3.0 ng/mL) was significantly lower than that in the control group (17.8 ± 5.9 ng/mL) (P < 0.01) in the third trimester, although there was no significant difference in the second trimester (P = 0.30). There was a significant reduction (P < 0.01) in the maternal serum 25(OH)D from the second to third trimester in the TPL group, compared to the control group (P = 0.60). There was no significant difference between the two groups in umbilical cord blood 25(OH)D concentrations at delivery (P = 0.41).
CONCLUSION: Prolonged hospitalization for TPL reduced the maternal vitamin D status but did not influence the neonatal status at delivery.
PMID: 29570909 DOI: 10.1111/jog.13620