Pregnancy vitamin D supplementation and offspring bone mineral density in childhood: Follow-up of a randomised controlled trial

Moon, Rebecca J., D'Angelo, Stefania, Curtis, Elizabeth M., Ward, Kate A., Crozier, Sarah R., Schoenmakers, Inez, Javaid, M. Kassim, Bishop, Nicholas J., Godfrey, Keith M., Cooper, Cyrus and Harvey, Nicholas C. and the MAVIDOS Trial Group (2024) Pregnancy vitamin D supplementation and offspring bone mineral density in childhood: Follow-up of a randomised controlled trial. The American Journal of Clinical Nutrition, 120 (5). pp. 1134-1142. ISSN 0002-9165

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Abstract

Background: Findings from the Maternal Vitamin D Osteoporosis Study (MAVIDOS) trial demonstrated a positive effect of gestational cholecalciferol supplementation on offspring bone mineral density (BMD) at age 4 y. Demonstrating the persistence of this effect is important to understanding whether maternal vitamin D supplementation could be a useful public health strategy to improving bone health. Objectives: We investigated whether gestational vitamin D supplementation increases offspring BMD at ages 6–7 y in an exploratory post-hoc analysis of an existing trial. Methods: In the MAVIDOS randomized controlled trial, pregnant females <14 wk’ gestation with a singleton pregnancy and serum 25-hydroxyvitamin D 25–100nmol/l at 3 United Kingdom hospitals (Southampton, Sheffield, and Oxford) were randomly assigned to either 1000 IU/d cholecalciferol or placebo from 14 to 17-wk gestation until delivery. Offspring born at term to participants recruited in Southampton were invited to the childhood follow-up at ages 4 and 6–7 y. The children had a dual-energy X-ray absorptiometry (DXA, Hologic discovery) scan of whole-body-less-head (WBLH) and lumbar spine, from which bone area, bone mineral content (BMC), BMD, and bone mineral apparent density (BMAD) were derived. Linear regression was used to compare the 2 groups adjusting for age, sex, height, weight, duration of consumption of human milk, and vitamin D use at 6–7 y. Results: A total of 454 children were followed up at ages 6–7 y, of whom 447 had a usable DXA scan. Gestational cholecalciferol supplementation resulted in higher WBLH BMC [0.15 SD, 95% confidence interval (CI): 0.04, 0.26], BMD (0.18 SD, 95% CI: 0.06, 0.31), BMAD (0.18 SD, 95% CI: 0.04, 0.32), and lean mass (0.09 SD, 95% CI: 0.00, 0.17) compared with placebo. The effect of pregnancy cholecalciferol on bone outcomes was similar at ages 4 and 6–7 y. Conclusions: Supplementation with cholecalciferol 1000 IU/d during pregnancy resulted in greater offspring BMD and lean mass in mid-childhood compared with placebo in this exploratory post-hoc analysis. These findings suggest that pregnancy vitamin D supplementation may be an important population health strategy to improve bone health. Trial registration number: This trial was registered at the ISRCTN (https://doi.org/10.1186/ISRCTN82927713) as 82927713 and EUDRACT (https://www.clinicaltrialsregister.eu/ctr-search/trial/2007-001716-23/results) as 2007-001716-23.

Item Type: Article
Additional Information: Data sharing plan: Data described in the manuscript, code book, and analytic code will be made available upon request pending application to and approval by the trial steering committee. Proposals should be directed to nch@mrc.soton.ac.uk. To gain access, data requestors will need to sign a data access agreement. Rights Retention Statement: For the purpose of Open Access, the author has applied a Creative Commons Attribution (CC BY) licence to any Author Accepted Manuscript version arising from this submission. Funding information: This work was supported by Versus Arthritis UK (17702), Medical Research Council [MC_PC_21003; MC_PC_21001], Bupa Foundation, and National Institute for Health and Care Research National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, and NIHR Biomedical Research Centre, University of Oxford. IS and AP were funded by the Medical Research Council (MRC) (programme code U105960371). RM and EMC are/were supported by NIHR Academic Clinical Lectureships. EMC was supported by a Wellcome Trust Clinical Research Fellowship. KMG is supported by the NIHR (NIHR Senior Investigator NF-SI-0515-10042) and Alzheimer’s Research UK (ARUK-PG2022A-008. 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. We are extremely grateful to Merck GmbH for the kind provision of the Vigantoletten supplement. Merck GmbH had no role in the trial execution, data collection, analysis or manuscript preparation. The original protocol incorporated suggestions from the Arthritis Research UK Clinical Trials Collaboration. The funders had no other role in the study and the corresponding author had full access to all of the data and the final responsibility to submit for publication.
Uncontrolled Keywords: bone mineral density,cholecalciferol,developmental programming,pregnancy,randomized controlled trial,vitamin d,nutrition and dietetics,medicine (miscellaneous),sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2900/2916
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: 24 Sep 2024 12:56
Last Modified: 22 Nov 2024 01:40
URI: https://ueaeprints.uea.ac.uk/id/eprint/96803
DOI: 10.1016/j.ajcnut.2024.09.014

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