title: Vitamin D and fetal-neonatal calcium homeostasis: findings from a randomized controlled trial of high-dose antenatal vitamin D supplementation.
abstract: BACKGROUND
  There is current interest in the maternal-fetal effects of antenatal vitamin D supplementation, yet little data regarding vitamin D's role in neonatal calcium homeostasis. We determined to assess the effect of high-dose antenatal vitamin D supplementation on fetal and neonatal calcium concentrations.
  
  
  METHODS
  In a double-blinded, placebo-controlled trial in Bangladesh, 160 pregnant women were randomized to oral vitamin D3 (35,000 IU/wk) or placebo from 26 to 29 wk of gestation.
  
  
  RESULTS
  Total serum calcium (Ca) was higher in cord blood of those supplemented vs. placebo (2.66 ± 0.1 vs. 2.61 ± 0.2 mmol/l; P = 0.04), but the difference in albumin-adjusted calcium was not statistically significant. Change in Ca concentration from birth to day 3 of life was attenuated by vitamin D (-0.10 ± 0.17) compared with placebo (-0.22 ± 0.18 mmol/l; P = 0.02). Maternal 25-hydroxyvitamin D (25(OH)D) (P = 0.04) and cord 25(OH)D (P < 0.01) were associated with day 3 infant Ca, suggesting that the effect of supplementation was mediated by change in maternal-infant vitamin D status. Six infants in each of the supplemented and placebo groups had transient hypercalcemia/hypercalcuria; in all the hypercalcemia/hypercalcuria was asymptomatic, spontaneously resolved, and unassociated with nephrocalcinosis at 1 mo of life.
  
  
  CONCLUSIONS
  High-dose antenatal third-trimester vitamin D supplementation attenuated the early postnatal calcium nadir, without increasing the risk of postnatal hypercalcemia.
authors.affiliation: Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Harrington
authors.affiliation: Centre for Global Child Health, The Hospital for Sick Children, Toronto, University of Toronto, Ontario, Canada.
authors.forename: Nandita
authors.initials: N
authors.lastname: Perumal
authors.affiliation: International Center for Diarrhoeal Disease Research, Dhaka, Bangladesh.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Al Mahmud
authors.affiliation: 1] International Center for Diarrhoeal Disease Research, Dhaka, Bangladesh [2] International Center for Maternal and Newborn Health, Department of International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Baqui
authors.affiliation: 1] Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada [2] Centre for Global Child Health, The Hospital for Sick Children, Toronto, University of Toronto, Ontario, Canada [3] International Center for Diarrhoeal Disease Research, Dhaka, Bangladesh.
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Roth
mesh_terms: D000284:Administration, Oral; D015415:Biomarkers / Q000097:blood; D002118:Calcium / Q000097:blood / Q000378:metabolism*; D002762:Cholecalciferol / Q000008:administration & dosage* / Q000009:adverse effects / Q000378:metabolism; D019587:Dietary Supplements / Q000009:adverse effects; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D005312:Fetal Blood / Q000378:metabolism; D005333:Fetus / Q000187:drug effects* / Q000378:metabolism; D005865:Gestational Age; D006706:Homeostasis; D006801:Humans; D006934:Hypercalcemia / Q000097:blood / Q000139:chemically induced; D053565:Hypercalciuria / Q000139:chemically induced / Q000652:urine; D007194:India / Q000453:epidemiology; D007231:Infant, Newborn; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011295:Prenatal Care; D015995:Prevalence; D013997:Time Factors; D016896:Treatment Outcome; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D014807:Vitamin D; D002762:Cholecalciferol; C104450:25-hydroxyvitamin D; D002118:Calcium