ClinicSpeak: vitamin D supplementation during pregnancy

Are you planning to fall pregnant? Have you had advice about vitamin D? #ClinicSpeak #MSBlog #MSResearch

"This small study from Iran shows that supplementing pregnant women with 50,000 IU/week of vD3 significantly raised levels compared to standard of care. Is this important? Yes, very important. In Iran there is an epidemic of MS that appears to be partly driven by a deficiency of vD (covering up, make-up, pollution, etc). The ratio of females to males with MS in Iran is 5:1; to the best of my knowledge the highest MS sex ratio in the world. Epidemiological studies suggest that some risk of autoimmunity is driven by imprinting in utero on the developing immune system. We think the process is due to epigenetic factors; in other words the environment in the womb alters the way the genome functions and this puts you at risk of developing MS and other autoimmune diseases later in life. Low vD levels in the womb may affect how the immune system develops; we think the thymus malfunctions and does not educate the developing immune system properly. This is why we recommend that all female MSers try and keep themselves vD replete during pregnancy. To do this you probably need ~10,000U vD3 per day. Please note this recommendation is based on a scientific rationale and not a clinical studies. We have yet to start a vD prevention study to prove the hypothesis that vD supplementation in utero and in life reduces the incidence of MS and other autoimmune diseases."

Etemadifar & Janghorbani. Efficacy of high-dose vitamin D3 supplementation in vitamin D deficient pregnant women with multiple sclerosis: Preliminary findings of a randomized-controlled trial. Iran J Neurol. 2015 ;14(2):67-73

BACKGROUND: The aim of this preliminary study was to assess the safety and efficacy of high-dose oral vitamin D3 supplementation during pregnancy in women with MS in Isfahan, Iran.

METHODS: In a single center open-label randomized, controlled clinical Phase I/II pilot study, 15 pregnant women with confirmed MS with low serum 25-hydroxyvitamin D (25(OH)D) levels were randomly allocated to receive either 50,000 IU/week vitamin D3 or routine care from 12 to 16 weeks of gestation till delivery. The main outcome measures were mean change in serum 25(OH)D levels, expanded disability status scale (EDSS) score, and number of relapse events during pregnancy and within 6 months after delivery.

RESULTS: Average serum 25(OH)D level at the end of trial in vitamin D3 supplemented group was higher than routine care group (33.7 ng/mL vs. 14.6 ng/ml, P < 0.050). In vitamin D3 group, the mean EDSS did not changed 6 months after delivery (P > 0.050), whereas in routine care group, the mean EDSS increased from 1.3 (0.4) to 1.7 (0.6) (P < 0.070). Women in vitamin D3 group appeared to have fewer relapse events during pregnancy and within 6 months after delivery. No significant adverse events occurred.

CONCLUSION: Adding high dose vitamin D3 supplementation during pregnancy to routine care of women with MS had significant effect on the serum 25(OH)D levels, EDSS and number of relapse events during pregnancy and within 6 months after delivery.

Labels: , ,