Vitamin D

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Vitamin D

Postby caryn » Mon Feb 27, 2012 09:02 am

A new study and a review of studies out this month just killed the vitamin D idea. Or at least, they really ought to. I imagine there is still research in the pipeline, but I can't imagine there being a lot of new proposals after these:

http://www.ncbi.nlm.nih.gov/pubmed/22336906
There was no significant difference in the median serum vitamin D MoM or raw values within the outcome groups (P=141 and P=0.231, respectively) whereas the median PAPP-A MoM, uterine PI MoM and MAP MoM were significantly different (P=0.031, P=0.001 and P<0.0001, respectively)...

In other words, our D levels are average at the end of the first trimester. But other stuff is clearly already broken. So it's not causal.

and

http://www.ncbi.nlm.nih.gov/pubmed/22336854
Vitamin D supplementation in a single or continued dose during pregnancy increases serum vitamin D concentrations as measured by 25-hydroxyvitamin D at term.

In other words, *that's the only thing it seems to do*. It doesn't affect rate of onset of anything, it doesn't improve outcomes, but when you check the bloodwork, supplemented women have more vitamin D in the bloodstream.

No one would say this data completely rules out the possibility that supplementing vitamin D might help. But that doesn't mean that it is at all likely to help. It means, instead, that science can't prove a negative. If D were going to be a significant tool in our toolbox, we would see some differences in serum D levels in our population early and raising D levels would lower risk.

I'll probably write up a bit more on this for the main blog in a bit!
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
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Caryn, @carynjrogers, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy
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Re: Vitamin D

Postby alviarin » Thu Mar 08, 2012 11:35 am

I don't know, I haven't given up on vitamin D yet. (Though I should admit I"m probably biased since I found out I was vitamin D deficient).

One small study found woment taking 4000IU/day (higher than any previous study) had lower rates of pregnancy complications and pre-term birth. http://www.cnn.com/2010/HEALTH/04/30/vi ... index.html
I would love to get my hands on the original study, all I can find is http://www.ncbi.nlm.nih.gov/pubmed/21706518.

And please, to anyone else reading this, don't start taking large doses of vitamin D without talking to your doctor and testing for a deficiency first. Since too much vitamin D can be toxic.
Hypothyroid mom to Connor and Claire
(severe pre-e at 38 weeks & "mild" pre-e at 37 weeks)
& baby Annabelle
(chronic HTN & GD, superimposed pre-e @34 weeks, induction @37 weeks)
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Re: Vitamin D

Postby caryn » Thu Mar 08, 2012 12:05 am

What worries me about that one is that better pregnancy outcomes weren't reported as a study finding, in the abstract. A possible difference in frequency between the populations - and the populations were probably too small to have this be statistically significant, given the sample size - got mentioned to the journalist, who wrote all about it in the CNN article. But the science just says that more vitamin D supplementation led to higher levels of serum D.

http://www.ncbi.nlm.nih.gov/pubmed/21040394 Is a study in a high risk population that found no difference in outcomes based on serum D levels. But I am also biased, because my serum D is normal. :D
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies? Lectures from researchers?
A chance to participate in research? For us on Facebook or Twitter?

Caryn, @carynjrogers, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy
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Re: Vitamin D

Postby alviarin » Thu Mar 08, 2012 03:16 pm

Yeah, but how many women were in the study? If n=221 is that the total number? And if 78% of the women in the study were vitamin D "insufficient" it doesn't sound like there were very many women in the sufficient group to compare too.

Definitely an area that needs more study though, imho.
Hypothyroid mom to Connor and Claire
(severe pre-e at 38 weeks & "mild" pre-e at 37 weeks)
& baby Annabelle
(chronic HTN & GD, superimposed pre-e @34 weeks, induction @37 weeks)
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Re: Vitamin D

Postby caryn » Thu Mar 08, 2012 05:22 pm

Yep, n=221 high risk patients - IIRC women with a history of PE - and no differences in PE rate btwn normal, mildly deficient and very deficient patients. The idea was that if vitamin D mattered we'd see differences in outcomes in a high risk population.

Big multi center randomized trials are so expensive that what we really need is a good mechanism. :(
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies? Lectures from researchers?
A chance to participate in research? For us on Facebook or Twitter?

Caryn, @carynjrogers, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy
User avatar
caryn
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Posts: 10110
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