Vitamin D Deficiency Clinical Trial
Official title:
Evaluation of Vitamin D Requirements During Pregnancy
The purpose of this study is to determine the effectiveness of vitamin D supplementation during pregnancy starting at the beginning of the second trimester. Mothers will be randomized to one of three vitamin D dosing groups: 400, 2,000 or 4,000 international units per day. It is hypothesized that the highest dosing regimen will result in a better vitamin D status of women regardless of their ethnicity or race.
The prevalence of hypovitaminosis D in reproductive aged African-American women occurs at a
rate of > 40%. Two factors have contributed to this public health problem: an inadequate DRI
for vitamin D and avoidance of sun exposure/use of sunscreen. This startling rate of
hypovitaminosis D requires that the DRI for vitamin D in pregnancy be evaluated in a
detailed manner. The Cochrane Library (2002) released a report stating that there is
insufficient data to evaluate the effects of vitamin D supplementation during pregnancy.
Recently, the safety of prolonged supplementation with up to 25x's DRI (10,000 IU/day) was
demonstrated in nonpregnant adults. It is essential to determine what dose of vitamin D is
required to eliminate hypovitaminosis D during pregnancy and provide the fetus/neonate with
adequate vitamin D stores during development and growth, particularly in darkly pigmented
individuals. The aim of this research proposal, then, is to determine the efficacy,
effectiveness, and safety of maternal vitamin D supplementation (as a function of ethnicity
and UV exposure) in the prevention of hypovitaminosis D in the pregnant mother and her
fetus/neonate. We hypothesize that darkly pigmented mothers will require substantially
higher oral supplementation with vitamin D to eliminate hypovitaminosis D as compared to
their Caucasian counterparts. We propose a comprehensive clinical trial to test our
hypothesis. Mothers at 12 weeks' gestation will be randomized to one of three vitamin D
treatment groups:
1. Control, 400-,
2. 2,000-, or
3. 4,000 IU/day to be continued throughout pregnancy.
Calcium and vitamin D homeostasis and skeletal remodeling in the mother will be monitored
closely throughout the pregnancy. Bone density of the mother will be measured at 12 weeks'
gestation and one-month postpartum. Follow-up growth and skeletal integrity assessments of
the infant will be performed at birth, 1, 6 and 12 months stratified by infant feeding
regime. Through these proposed studies, the prevalence of hypovitaminosis D among mothers,
their developing fetuses and neonates, and the utility of maternal therapeutic intervention
with vitamin D for both mother and fetus/infant will be assessed.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Prevention
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