Does antenatal cholecalciferol supplementation affect the mode or timing of delivery? Post hoc analyses of the MAVIDOS randomized controlled trial

Moon, Rebecca J., D'Angelo, Stefania, Crozier, Sarah R., Curtis, Elizabeth M., Fernandes, Michelle, Kermack, Alexandra J., Davies, Justin H., Godfrey, Keith M., Bishop, Nicholas J., Kennedy, Stephen H., Prentice, Ann, Schoenmakers, Inez, Fraser, Robert, Gandhi, Saurabh V., Inskip, Hazel M., Javaid, Muhammad Kassim, Papageorghiou, Aris T., Cooper, Cyrus and Harvey, Nicholas C. (2023) Does antenatal cholecalciferol supplementation affect the mode or timing of delivery? Post hoc analyses of the MAVIDOS randomized controlled trial. Journal of Public Health, 45 (3). pp. 738-747. ISSN 1741-3842

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Background: Observational studies relating maternal 25-hydroxyvitamin D status to timing and mode of delivery have reported inconsistent results. We assessed the effect of antenatal cholecalciferol supplementation on the incidence of preterm birth, delivery mode and post-partum haemorrhage (PPH).   Methods: MAVIDOS was a randomized, double-blind, placebo-controlled trial of 1000 IU/day cholecalciferol from 14 weeks’ gestation until delivery. Gestational age, mode of delivery [categorized as spontaneous vaginal delivery (SVD), instrumental (including forceps and vacuum extraction) or Caesarean section] and PPH (>500 ml estimated blood loss) were determined from medical records.   Results: A total of 965 women participated in the study until delivery. Gestation at birth and incidence of preterm birth (cholecalciferol 5.7%, placebo 4.5%, P = 0.43) were similar between the two treatment groups. SVD (versus instrumental or Caesarean delivery) was more likely in women randomized to cholecalciferol [Relative Risk (RR) 1.13, 95% confidence interval (CI) 1.02,1.25] due to lower instrumental (RR 0.68, 95%CI 0.51,0.91) but similar risk of Caesarean delivery (RR 0.94, 95%CI 0.74,1.19). PPH was less common in women randomized to cholecalciferol [32.1% compared with placebo (38.1%, P = 0.054) overall], but similar when stratified by delivery mode.   Conclusions: Antenatal cholecalciferol supplementation did not alter timing of birth or prevalence of preterm birth but demonstrated a possible effect on the likelihood of SVD.

Item Type: Article
Additional Information: Funding: This work was supported by grants from the Arthritis Research UK (17702), Medical Research Council (MC_PC_21003; MC_PC_21001), Bupa Foundation, National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust and NIHR Musculoskeletal Biomedical Research Unit, University of Oxford. I.S. and A.P. were funded by the MRC (programme code U105960371). The work leading to these results was supported by the European Union’s Seventh Framework Programme (FP7/2007-2013), projects EarlyNutrition and ODIN under grant agreements numbers 289346 and 613977.
Uncontrolled Keywords: 25-hydroxyvitamin d,caesarean,cholecalciferol,delivery,labour,post-partum haemorrhage,pregnancy,preterm birth,public health, environmental and occupational health ,/dk/atira/pure/subjectarea/asjc/2700/2739
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Musculoskeletal Medicine
Faculty of Medicine and Health Sciences > Research Groups > Nutrition and Preventive Medicine
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Depositing User: LivePure Connector
Date Deposited: 09 Jan 2023 09:33
Last Modified: 11 Sep 2023 08:30
DOI: 10.1093/pubmed/fdac160

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