Maternal Vitamin D3 Supplementation during the Third Trimester of Pregnancy: Effects on Infant Growth in a Longitudinal Follow-Up Study in Bangladesh

Roth, Daniel; Perumal, Nandita; Mahmud, Abdullah Al; Baqui, Abdullah H

doi:10.1016/j.jpeds.2013.07.030

Cited by 69 publications

(99 citation statements)

References 27 publications

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“…There was no effect on maternal serum calcium, but a borderline significant increase in albumin-adjusted calcium and decrease in PTH were found (779). There was no effect on mode of delivery, C-section rates, adverse events, live versus stillbirths, or gestational age at delivery.…”

Section: Yu Etmentioning

confidence: 77%

Maternal Mineral and Bone Metabolism During Pregnancy, Lactation, and Post-Weaning Recovery

Kovacs

2016

Physiological Reviews

383

524

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During pregnancy and lactation, female physiology adapts to meet the added nutritional demands of fetuses and neonates. An average full-term fetus contains ϳ30 g calcium, 20 g phosphorus, and 0.8 g magnesium. About 80% of mineral is accreted during the third trimester; calcium transfers at 300-350 mg/day during the final 6 wk. The neonate requires 200 mg calcium daily from milk during the first 6 mo, and 120 mg calcium from milk during the second 6 mo (additional calcium comes from solid foods). Calcium transfers can be more than double and triple these values, respectively, in women who nurse twins and triplets. About 25% of dietary calcium is normally absorbed in healthy adults. Average maternal calcium intakes in American and Canadian women are insufficient to meet the fetal and neonatal calcium requirements if normal efficiency of intestinal calcium absorption is relied upon. However, several adaptations are invoked to meet the fetal and neonatal demands for mineral without requiring increased intakes by the mother. During pregnancy the efficiency of intestinal calcium absorption doubles, whereas during lactation the maternal skeleton is resorbed to provide calcium for milk. This review addresses our current knowledge regarding maternal adaptations in mineral and skeletal homeostasis that occur during pregnancy, lactation, and post-weaning recovery. Also considered are the impacts that these adaptations have on biochemical and hormonal parameters of mineral homeostasis, the consequences for long-term skeletal health, and the presentation and management of disorders of mineral and bone metabolism.

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Section: Yu Etmentioning

confidence: 77%

Maternal Mineral and Bone Metabolism During Pregnancy, Lactation, and Post-Weaning Recovery

Kovacs

2016

Physiological Reviews

383

524

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“…the mother on outcomes of birth size and early growth (54)(55)(56) . The length determinations often come from community workers trained and equipped to perform anthropometry for the studies, and up to 48 to 72 h postpartum is often allowed as a margin for measurement.…”

Section: Discussionmentioning

confidence: 99%

Stunting at birth: recognition of early-life linear growth failure in the western highlands of Guatemala

Solomons¹,

Vossenaar²,

Chomat

et al. 2014

Public Health Nutr.

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Objective: Measurements of length at birth, or in the neonatal period, are challenging to obtain and often discounted for lack of validity. Hence, classical 'under-5' stunting rates have been derived from surveys on children from 6 to 59 months of age. Guatemala has a high prevalence of stunting (49·8 %), but the age of onset of growth failure is not clearly defined. The objective of the study was to assess length-for-age within the first 1·5 months of life among Guatemalan infants. Design: As part of a cross-sectional observational study, supine length was measured in young infants. Mothers' height was measured. Length-for-age Z-scores (HAZ) were generated and stunting was defined as HAZ < − 2 using WHO growth standards. Setting: Eight rural, indigenous Mam-Mayan villages (n 200, 100 % of Mayan indigenous origin) and an urban clinic of Quetzaltenango (n 106, 27 % of Mayan indigenous origin), Guatemala. Subjects: Three hundred and six newborns with a median age of 19 d. Results: The median rural HAZ was − 1·56 and prevalence of stunting was 38 %; the respective urban values were − 1·41 and 25 %. Linear regression revealed no relationship between infant age and HAZ (r = 0·101, r 2 = 0·010, P = 0·077). Maternal height explained 3 % of the variability in HAZ (r = 0·171, r 2 = 0·029, P = 0·003). Conclusions: Stunting must be carried over from in utero growth retardation in short-stature Guatemalan mothers. As linear growth failure in this setting begins in utero, its prevention must be linked to maternal care strategies during gestation, or even before. A focus on maternal nutrition and health in an intergenerational dimension is needed to reduce its prevalence.

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“…Achieved cord blood levels of 25-hydroxyvitamin D were 103 versus 30 nM, respectively. There was no effect on length, weight, head circumference, and femur length at birth (568). Cord blood calcium levels were done but have not been reported.…”

Section: Interventional Studiesmentioning

confidence: 95%

Bone Development and Mineral Homeostasis in the Fetus and Neonate: Roles of the Calciotropic and Phosphotropic Hormones

Kovacs

2014

Physiological Reviews

211

188

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Mineral and bone metabolism are regulated differently in utero compared with the adult. The fetal kidneys, intestines, and skeleton are not dominant sources of mineral supply for the fetus. Instead, the placenta meets the fetal need for mineral by actively transporting calcium, phosphorus, and magnesium from the maternal circulation. These minerals are maintained in the fetal circulation at higher concentrations than in the mother and normal adult, and such high levels appear necessary for the developing skeleton to accrete a normal amount of mineral by term. Parathyroid hormone (PTH) and calcitriol circulate at low concentrations in the fetal circulation. Fetal bone development and the regulation of serum minerals are critically dependent on PTH and PTH-related protein, but not vitamin D/calcitriol, fibroblast growth factor-23, calcitonin, or the sex steroids. After birth, the serum calcium falls and phosphorus rises before gradually reaching adult values over the subsequent 24 -48 h. The intestines are the main source of mineral for the neonate, while the kidneys reabsorb mineral, and bone turnover contributes mineral to the circulation. This switch in the regulation of mineral homeostasis is triggered by loss of the placenta and a postnatal fall in serum calcium, and is followed in sequence by a rise in PTH and then an increase in calcitriol. Intestinal calcium absorption is initially a passive process facilitated by lactose, but later becomes active and calcitriol-dependent. However, calcitriol's role can be bypassed by increasing the calcium content of the diet, or by parenteral administration of calcium.

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Maternal Vitamin D3 Supplementation during the Third Trimester of Pregnancy: Effects on Infant Growth in a Longitudinal Follow-Up Study in Bangladesh

Cited by 69 publications

References 27 publications

Maternal Mineral and Bone Metabolism During Pregnancy, Lactation, and Post-Weaning Recovery

Maternal Mineral and Bone Metabolism During Pregnancy, Lactation, and Post-Weaning Recovery

Stunting at birth: recognition of early-life linear growth failure in the western highlands of Guatemala

Bone Development and Mineral Homeostasis in the Fetus and Neonate: Roles of the Calciotropic and Phosphotropic Hormones

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