Cost-effectiveness of a Vitamin D supplementation programme in pregnant women and children to prevent rickets in the UK

2019 ◽  
Author(s):  
Vilius Floreskul ◽  
Fatima Juma ◽  
Anjali Daniel ◽  
Imran Zamir ◽  
Zulf Mughal ◽  
...  
Keyword(s):  
Vitamin D ◽  
Cost Effectiveness ◽  
Pregnant Women ◽  
Vitamin D Supplementation ◽  
Women And Children ◽  
The Uk

scholarly journals Influence of vitamin D binding protein polymorphism, demographics and lifestyle factors on vitamin D status of healthy Malaysian pregnant women

2020 ◽  
Author(s):  
Siew-Siew Lee ◽  
King-Hwa Ling ◽  
Maiza Tusimin ◽  
Raman Subramaniam ◽  
Kartini Farah Rahim ◽  
...  
Keyword(s):  
Vitamin D ◽  
Gene Polymorphism ◽  
Pregnant Women ◽  
Binding Protein ◽  
Lifestyle Factors ◽  
Vitamin D Supplementation ◽  
Dietary Vitamin ◽  
Vitamin D Binding Protein ◽  
Significant Positive Association ◽  
Cross Sectional

Abstract Background: Vitamin D deficiency (VDD) has been related to vitamin D binding protein (GC) gene polymorphism, demographics and lifestyle factors in different populations. However, previous studies only focused on demographic and lifestyle factors or genetic factors alone. Therefore, this cross-sectional study aimed to assess the association between GC gene polymorphism, demographics and lifestyle factors with VDD among Malaysian pregnant women. Method: Information on demographic characteristics, dietary vitamin D intake from supplement and food, time spent outdoors, skin type and clothing were collected using questionnaire. Plasma total 25-hydroxyvitamin D (25OHD) levels were measured using a Ultra-High-Performance Chromatography (UHPLC). Maternal GC single nucleotide polymorphisms (SNPs) (rs4588 and rs7041) were determined using restriction fragment length polymorphism (RFLP) technique. Results: Results showed that 50.2% of pregnant women were vitamin D deficient (25OHD <30 nmol/L). VDD (25OHD <30 nmol/L) was significantly associated with age, veiled clothing, maternal vitamin D intakes, from both food and supplements, and GC rs7041(and GC diplotypes). In contrast to previous studies that reported for non-pregnant population, significant positive association was found between CC genotype for SNP GC rs7041, GC 1s-1s and GC If-2 with risk of VDD (25OHD <30 nmol/L). Conclusions: The high prevalence of maternal VDD found in this study suggests the need for urgent development and implementation of vitamin D supplementation or fortification strategies to reduce VDD among pregnant women. The discrepancy in the association between GC rs7041 gene polymorphism and VDD reflects the variation in the factors associated with VDD in pregnancy compared to non-pregnant state

scholarly journals Vitamin D status and its determinants in Pre Diabetic pregnant mothers attending tertiary care centre in Tamilnadu, India

2020 ◽  
Vol 11 (1) ◽  
pp. 617-622
Author(s):  
Kavitha Durairaj ◽  
Muthulakshmi M ◽  
Venkataraman P ◽  
Murali R ◽  
Rukumani J ◽  
...  
Keyword(s):  
Vitamin D ◽  
Pregnant Women ◽  
Infection Type ◽  
Tertiary Care ◽  
Challenge Test ◽  
Vitamin D Supplementation ◽  
Ultraviolet B ◽  
Oral Glucose ◽  
College Hospital ◽  
The Impact

Vitamin D is a vital nutrient factor in the healthiness of the mother and infant. Vitamin D is mainly amalgamated in the skin following exposure to ultraviolet B radiation. Insufficiency of vitamin D in Pregnancy had been related to various sicknesses, such as respiratory infection, type 1 diabetes mellitus, high risk of childhood wheezing. The aim of this study was to investigate the impact of Vitamin D supplementation on the incidence of pregestational diabetes in pregnant women referred to antenatal clinics in SRM Medical College hospital, Tamilnadu, India. 200 pregnant women were recruited, and oral glucose challenge test (OGCT), serum calcium and 25(OH) D were determined. Participants were in the age group of 18 to 35 years, with a mean age of 26.29. Among the participants, 59% were multiparous. The present study showed that a high prevalence of vitamin D deficiency (61.5%) and insufficiency (34%) in pregnant women before supplementation with a mean of 16.84. Vitamin D supplementation during the early weeks of pregnancy might help in the improvement of maternal and child health.

scholarly journals PREVALENCE, ASSOCIATED FACTORS AND ROLE OF VITAMIN D AND GLUTATHIONE REDUCTASE OF PRE-ECLAMPSIA IN PREGNANT WOMEN

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Simerpreet Kukreja
Keyword(s):  
Fatty Acids ◽  
Vitamin D ◽  
Pregnant Women ◽  
Glutathione Reductase ◽  
Gestational Hypertension ◽  
Multiple Pregnancy ◽  
Vitamin D Supplementation ◽  
Research Centre ◽  
Biochemical Basis

Introduction: In maternal and neonatal cases, preeclampsia is a multi-organ, heterogeneous pregnancy condition associated with significant morbidity and mortality. Since preeclampsia is a progressive disease, in some cases, delivery is necessary to stop the progression to the benefit of the mother and foetus. However, the need for early delivery has adverse effects on significant neonatal outcomes that are not limited to the most premature babies. The results include oxidative stress in the disease and invoke the biochemical basis for antioxidant clinical trials to prevent and treat hypertension caused by pregnancy. In the management of preeclampsia, supplementation of antioxidants along with polyunsaturated fatty acids, particularly omega-3 fatty acids, may be useful. This describes vitamin Ds potential role in the pathogenesis of preeclampsia. However, the role of vitamin D supplementation and dosing is controversial in preventing preeclampsia. Method: The study was carried out from March 2019 to April 2020 at Shalinitai Meghe Hospital and Research Centre using institutional-based cross-sectional study design among women whose age was greater than or equal to eighteen. Data were collected using a standardised and pretested questionnaire from 150 participants by face-to - face interview technique. Using Chemiluminiscent Immunoassay (CLIA), vitamin D estimation was performed. The behaviour of Glutathione Reductase was calculated according to the Goldberg et al 1983 procedure. To classify the factors associated with the development of preeclampsia, logistic regression analysis was used. Result: With a mean age of 30.28, a total of 150 participants were enrolled in the study. Evaluation of vitamin D and glutathione levels The prevalence of preeclampsia among current pregnant women attending ANC at Shalinitai Meghe Hospital was 16 with a 95 % CI. The current preeclampsia was significantly correlated with predictive variables such as the age of the respondents, current multiple pregnancy, and history of diabetes mellitus. Conclusion: The findings of this study showed that preeclampsia was present in a large proportion of women. For both urban and rural residents, health seeking actions towards pregnant women should be promoted, offering an opportunity to detect preeclampsia as early as possible and preventing the coming complication of preeclampsia. The role of antioxidants is controversial in the prevention of preeclampsia. Vitamin D deficiency is associated with preeclampsia in a major way. To document the role of vitamin D supplementation in the prevention of preeclampsia, further studies are required.  Keywords: Gestational hypertension, Pre-eclampsia, Vitamin D, GSH

Can Iron and Folic Acid-IFA and Ca & Vitamin D Supplementation in Pregnancy be Fitted into Habitual Pattern of Three Meals A Day?

2019 ◽  
Vol 56 (4) ◽  
pp. 341
Author(s):  
Prema Ramachandran ◽  
Amrita Pramanik ◽  
K. Kalaivani
Keyword(s):  
Vitamin D ◽  
Folic Acid ◽  
Side Effects ◽  
Pregnant Women ◽  
Ferrous Sulphate ◽  
Vitamin D Supplementation ◽  
Meal Pattern ◽  
Iron And Folic Acid ◽  
Habitual Pattern ◽  
In Pregnancy

In India prevalence of anaemia and vitamin D deficiency in pregnancy are widespread. National programmes recommend that two tablets of iron and folic acid (IFA) and two tablets of calcium and vitamin D (Ca &amp; Vit D) to be given every day from second trimester till delivery. To minimize the side effects and increase compliance, it is advised that each tablet should be taken after a meal. Most households follow a three meal pattern. A study was taken up to find out how IFA and Ca &amp; Vit D supplementations can be fitted into the habitual three meal pattern. A short term crossover supplementation study was carried out on 38 pregnant women to assess side effects following consumption after lunch of one or two tablets containing 500mg elemental calcium (as calcium carbonate) and 250 IU vitamin D or 60 mg of elemental iron as ferrous sulphate. Prevalence of side effects was higher in women who received iron supplements as compared to Ca &amp; Vit D supplements. Taking two tablets of Ca &amp; Vit D together after meal was associated with significantly higher prevalence of side effects as compared to taking one tablet after meal. Taking two tablets of iron together after meal was not associated with any significant increase in prevalence of side effects as compared to one tablet. Giving two tablets of iron together after one meal and giving one tablet of calcium and vitamin after two meals is feasible option for providing two tablets each of iron and Ca &amp; Vit D to pregnant women who habitually follow a three meal pattern.

scholarly journals 3532 Vitamin D assay utilization and outcomes in pregnant women in an urban safety net medical center: a retrospective cohort study

2019 ◽  
Vol 3 (s1) ◽  
pp. 30-30
Author(s):  
Grace Hyojung Yoon ◽  
Michael Holick ◽  
Arash Hossein
Keyword(s):  
Vitamin D ◽  
Pregnant Women ◽  
Low Income ◽  
Medical Center ◽  
Safety Net ◽  
Vitamin D Supplementation ◽  
Vitamin D Levels ◽  
Urban Safety ◽  
Study Population ◽  
Boston Medical

OBJECTIVES/SPECIFIC AIMS: The goals of this retrospective cohort study is threefold: 1) to assess how many pregnant women at Boston Medical Center from 2012 to 2017 have had their vitamin D status checked prior to and during pregnancy, 2) determine associations between vitamin D levels, birth outcomes and demographics and 3) assess how many of those found to have lower than satisfactory vitamin D levels (<30ng/mL) received interventions, including receiving vitamin D supplementation and/or being referred to an appropriate specialist such as an endocrinologist or a nutritionist. METHODS/STUDY POPULATION: Our study population is mothers over age 18 who received care at Boston Medical Center during their pregnancy from 2012 to 2017. Our primary outcomes are vitamin D utilization rates and associations between vitamin D levels with clinical outcomes during pregnancy and at birth. Secondary outcomes are demographic predictors of mothers who receive vitamin D testing and those who have complications associated with low vitamin D. We will conduct multiple linear regressions to check for associations between vitamin D levels, birth outcomes and demographic variables. We will adjust vitamin D levels with maternal BMI. De-identified clinical data was gathered from Boston University Medical Center’s (BUMC) Clinical Data Warehouse. This retrospective study was approved with a HIPAA waiver by the BUMC Institutional Data Warehouse. All statistical analysis was completed using SAS version 9.4 and was primarily done by the student PI and reviewed by Dr. Hossein, the co-investigator who is trained as a statistician and geneticist. The team also utilized Boston University’s Biostatistics, Epidemiology & Research Design (BERD) team to check the feasibility of the statistical methods. RESULTS/ANTICIPATED RESULTS: We anticipate that our descriptive demographic data will reflect the medical center’s predominantly black/Hispanic and low-income profile. Based on previous literature, we expect low vitamin D levels to have positive associations with gestational diabetes, pre-eclampsia, and preterm birth. Analyses are currently actively in progress and we expect to have results before the ACTS conference date in March, 2019. DISCUSSION/SIGNIFICANCE OF IMPACT: Vitamin D is an essential part of the human body system. It is well documented in current literature that vitamin D is correlated with bone health, mental health and maternal health. Moreover, there is evidence that maternal vitamin D supplementation prevents vitamin D deficiency in newborns. Previous literature suggests that low vitamin D may be associated with gestational diabetes, pre-eclampsia, and pre-term births. Boston Medical Center is Massachusetts’ largest urban medical center and acts as its only safety-net hospital, serving predominantly low-income and socially marginalized patient populations. There is limited existing research on assessment of maternal vitamin D in urban hospital settings. Pregnant women rarely receive vitamin D screenings as part of their prenatal checkups as current national and regional guidelines do not require pregnant women to be screened for vitamin D deficiency or insufficiency. The results will demonstrate the potential effects vitamin D supplementation, or lack thereof, in expectant mothers living in urban, safety net communities. We hope to inform prenatal care practices and attitudes of vitamin D supplementation in maternal health with the results of our study.

scholarly journals Opinions and Practice of US-Based Obstetrician-Gynecologists regarding Vitamin D Screening and Supplementation of Pregnant Women

2016 ◽  
Vol 2016 ◽  
pp. 1-7
Author(s):  
Sara A. Mohamed ◽  
Ayman Al-Hendy ◽  
Jay Schulkin ◽  
Michael L. Power
Keyword(s):  
Vitamin D ◽  
Pregnant Women ◽  
Patient Population ◽  
Vitamin D Insufficiency ◽  
Vitamin D Supplementation ◽  
Institute Of Medicine ◽  
Vitamin D Status ◽  
Online Questionnaire ◽  
Endocrine Society ◽  
Hydroxyvitamin D

Vitamin D deficiency/insufficiency is prevalent among pregnant women. Recommendations for adequate levels of circulating 25-hydroxyvitamin D and appropriate vitamin D supplementation during pregnancy differ between the Institute of Medicine and the Endocrine Society. Obstetrician-gynecologists must make clinical decisions in this environment of uncertain guidance. An online questionnaire regarding physician practice patterns for screening and supplementing pregnant women was administered to 225 randomly selected practicing obstetrician-gynecologists of whom 101 (45%) completed the questionnaire. A majority indicated that vitamin D insufficiency was a problem in their patient population (68.4%) and that most of their pregnant patients would benefit from vitamin D supplementation (66.3%). Half (52.5%) would recommend vitamin D supplementation during pregnancy to some patients, but only 16.8% to all. Only one in four (25.8%) routinely screen their pregnant patients for vitamin D status. Physicians who indicated that vitamin D status was a problem in their patient population were more likely to screen routinely (32.8% versus 9.7%,P=0.002) and believe their patients would benefit from supplementation (91.2% versus 16.1%,P=0.001). Opinion regarding supplementation levels and indicators of adequacy were split between the two competing recommendations, suggesting that clinical practice will likely remain variable across physicians, with uncertain public health consequences.

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