Vitamin D and fetal-neonatal calcium homeostasis: Findings from a randomized controlled trial of high-dose antenatal vitamin D supplementation

Jennifer Harrington, Nandita Perumal, Abdullah Al Mahmud, Abdullah Baqui, Daniel E. Roth

Research output: Contribution to journalArticle

Abstract

Background: There is current interest in the maternal-fetal effects of antenatal vitamin D supplementation, yet little data regarding vitamin D's role in neonatal calcium homeostasis. We determined to assess the effect of high-dose antenatal vitamin D supplementation on fetal and neonatal calcium concentrations. Methods: In a double-blinded, placebo-controlled trial in Bangladesh, 160 pregnant women were randomized to oral vitamin D3 (35,000 IU/wk) or placebo from 26 to 29 wk of gestation. Results: Total serum calcium (Ca) was higher in cord blood of those supplemented vs. placebo (2.66 ± 0.1 vs. 2.61 ± 0.2 mmol/l; P = 0.04), but the difference in albumin-adjusted calcium was not statistically significant. Change in Ca concentration from birth to day 3 of life was attenuated by vitamin D (-0.10 ± 0.17) compared with placebo (-0.22 ± 0.18 mmol/l; P = 0.02). Maternal 25-hydroxyvitamin D (25(OH)D) (P = 0.04) and cord 25(OH)D (P <0.01) were associated with day 3 infant Ca, suggesting that the effect of supplementation was mediated by change in maternal-infant vitamin D status. Six infants in each of the supplemented and placebo groups had transient hypercalcemia/hypercalcuria; in all the hypercalcemia/hypercalcuria was asymptomatic, spontaneously resolved, and unassociated with nephrocalcinosis at 1 mo of life. Conclusion: High-dose antenatal third-trimester vitamin D supplementation attenuated the early postnatal calcium nadir, without increasing the risk of postnatal hypercalcemia.

Original languageEnglish (US)
Pages (from-to)302-309
Number of pages8
JournalPediatric Research
Volume76
Issue number3
DOIs
StatePublished - 2014

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Vitamin D
Homeostasis
Randomized Controlled Trials
Calcium
Placebos
Hypercalcemia
Mothers
Nephrocalcinosis
Bangladesh
Cholecalciferol
Third Pregnancy Trimester
Fetal Blood
Vitamins
Pregnant Women
Albumins
Parturition
Pregnancy
Serum

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)

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Vitamin D and fetal-neonatal calcium homeostasis : Findings from a randomized controlled trial of high-dose antenatal vitamin D supplementation. / Harrington, Jennifer; Perumal, Nandita; Al Mahmud, Abdullah; Baqui, Abdullah; Roth, Daniel E.

In: Pediatric Research, Vol. 76, No. 3, 2014, p. 302-309.

Research output: Contribution to journalArticle

Harrington, Jennifer ; Perumal, Nandita ; Al Mahmud, Abdullah ; Baqui, Abdullah ; Roth, Daniel E. / Vitamin D and fetal-neonatal calcium homeostasis : Findings from a randomized controlled trial of high-dose antenatal vitamin D supplementation. In: Pediatric Research. 2014 ; Vol. 76, No. 3. pp. 302-309.
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