Impact evaluation of the efficacy of different doses of vitamin D supplementation during pregnancy on pregnancy and birth outcomes: A randomised, controlled, dose comparison trial in Pakistan

Authors

Sidrah Nausheen, Aga Khan UniversityFollow
Atif Habib, Aga Khan UniversityFollow
Maria Asif Bhura, Aga Khan UniversityFollow
Arjumand Rizvi, Aga Khan UniversityFollow
Fariha Shaheen, Aga Khan UniversityFollow
Kehkashan Begum, Aga Khan UniversityFollow
Junaid Iqbal, Aga Khan UniversityFollow
Shabina Ariff, Aga Khan UniversityFollow
Lumaan Sheikh, Aga Khan UniversityFollow
Syed Shamim Raza, Aga Khan University
Sajid Bashir Soofi, Aga Khan UniversityFollow

Document Type

Article

Department

Obstetrics and Gynaecology; Paediatrics and Child Health; Centre of Excellence in Women and Child Health

Abstract

Background: Vitamin D deficiency during pregnancy is a public health problem in Pakistan and is prevalent among most women of reproductive age in the country. Vitamin D supplementation during pregnancy is suggested to prevent adverse pregnancy outcomes and vitamin D deficiency in both the mother and her newborn.
Methods: We conducted a double-blinded, randomised controlled trial in Karachi, Pakistan to evaluate the effect of different doses of vitamin D supplementation during pregnancy on biochemical markers (serum 25(OH)D, calcium, phosphorus and alkaline phosphatase) in women and neonates, and on pregnancy and birth outcomes (gestational diabetes, pre-eclampsia, low birth weight, preterm births and stillbirths).
Results: Pregnant women (N=350) in their first trimester were recruited and randomised to three treatment groups of vitamin D supplementation: 4000 IU/day (group A, n=120), 2000 IU/day (group B, n=115) or 400 IU/day (group C, n=115). Women and their newborn in group A had the lowest vitamin D deficiency at endline (endline: 75.9%; neonatal: 64.9%), followed by group B (endline: 84.9%; neonatal: 73.7%) and then the control group (endline: 90.2%; neonatal: 91.8%). Vitamin D deficiency was significantly lower in group A than in group C (p=0.006) among women at endline and lower in both groups A and B than in the control group (p=0.001) in neonates. Within groups, serum 25(OH)D was significantly higher between baseline and endline in group A and between maternal baseline and neonatal levels in groups A and B. Participant serum 25(OH)D levels at the end of the trial were positively correlated with those in intervention group A (4000 IU/day) (β=4.16, 95% CI 1.6 to 6.7, p=0.002), with food group consumption (β=0.95, 95% CI 0.01 to 1.89, p=0.047) and with baseline levels of serum 25(OH)D (β=0.43, 95% CI 0.29 to 0.58, p<0.0001).
Conclusion: The evidence provided in our study indicates that vitamin D supplementation of 4000 IU/day was more effective in reducing vitamin D deficiency among pregnant women and in improving serum 25(OH)D levels in mothers and their neonates compared with 2000 IU/day and 400 IU/day.
Trial registration number NCT02215213.

Publication (Name of Journal)

BMJ Nutrition, Prevention & Health

DOI

https://doi.org/10.1136/bmjnph-2021-000304

Recommended Citation

Nausheen, S., Habib, A., Bhura, M. A., Rizvi, A., Shaheen, F., Begum, K., Iqbal, J., Ariff, S., Sheikh, L., Raza, S. S., Soofi, S. (2021). Impact evaluation of the efficacy of different doses of vitamin D supplementation during pregnancy on pregnancy and birth outcomes: A randomised, controlled, dose comparison trial in Pakistan. BMJ Nutrition, Prevention & Health, 4(2), 425-434.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_women_childhealth_obstet_gynaecol/266

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License