Basal Vitamin D Status and Supplement Dose Are Primary Contributors to Maternal 25-Hydroxyvitamin D Response to Prenatal and Postpartum Cholecalciferol Supplementation. Issue 11 (24th July 2021)

• Record Type: Journal Article
• Authors: Levy, Benjamin; O'Callaghan, Karen M; Qamar, Huma; Mahmud, Abdullah Al; Gernand, Alison D; Islam, M Munirul; Roth, Daniel E
• Is Part Of: Journal of nutrition. Volume 151:Issue 11(2021)
• Page Start: 3361
• Page End: 3378
• Publication Date: 2021-07-24
• Subjects: 25-hydroxyvitamin D -- dose–response -- infancy -- pregnancy -- randomized controlled trial -- vitamin D; Nutrition -- Periodicals; Diet -- Periodicals; 613.205
• DOI: 10.1093/jn/nxab265
• Languages: English
• ISSNs: 0022-3166

Abstract

ABSTRACT: Background: Variability in the 25-hydroxyvitamin D [25(OH)D] response to prenatal and postpartum vitamin D supplementation is an important consideration for establishing vitamin D deficiency prevention regimens. Objectives: We aimed to examine interindividual variation in maternal and infant 25(OH)D following maternal vitamin D supplementation. Methods: In a randomized trial of maternal vitamin D supplementation (Maternal Vitamin D for Infant Growth Trial), healthy pregnant women ( n = 1300) received a prenatal cholecalciferol (vitamin D-3) dose of 0, 4200, 16, 800, or 28, 000 IU/wk from 17 to 24 wk of gestation followed by placebo to 6 mo postpartum. A fifth group received 28, 000 IU cholecalciferol/wk both prenatally and postpartum. In a subset of participants, associations of 25(OH)D with hypothesized explanatory factors were estimated in women at delivery ( n = 655) and 6 mo postpartum ( n = 566), and in their infants at birth ( n = 502) and 6 mo of age ( n = 215). Base models included initial 25(OH)D and supplemental vitamin D dose. Multivariable models were extended to include other individual characteristics and specimen-related factors. The model coefficient of determination (R 2 ) was used to express the percentage of total variance explained. Results: Supplemental vitamin D intake and initial 25(OH)D accounted for the majority of variance in maternal 25(OH)D at delivery and postpartum (R 2 = 70% and 79%, respectively). Additional characteristics, including BMI, contributed negligibly to remaining variance (<5% increase in R 2 ). Variance in neonatal 25(OH)D was explained mostly by maternal delivery 25(OH)D and prenatal vitamin D intake (R 2 = 82%). Variance in 25(OH)D in later infancy could only partly be explained by numerous biological, sociodemographic, and laboratory-related characteristics, including feeding practices (R 2 = 43%). Conclusions: Presupplementation 25(OH)D and vitamin D supplemental dose are the major determinants of the response to maternal prenatal vitamin D intake. Vitamin D dosing regimens to prevent maternal and infant vitamin D deficiency should take into consideration the mean 25(OH)D concentration of the target population.