The importance of maternal pregnancy vitamin D for offspring bone health: learnings from the MAVIDOS trial.

Rebecca J Moon,Nicholas C Harvey,Stephen J Woolford,Cyrus Cooper,Shanze Ashai,Elizabeth M Curtis

doi:10.1177/1759720x211006979

Rebecca J Moon, Nicholas C Harvey + Show 4 more

Open Access

https://doi.org/10.1177/1759720x211006979

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Abstract

Optimisation of skeletal mineralisation in childhood is important to reduce childhood fracture and the long-term risk of osteoporosis and fracture in later life. One approach to achieving this is antenatal vitamin D supplementation. The Maternal Vitamin D Osteoporosis Study is a randomised placebo-controlled trial, the aim of which was to assess the effect of antenatal vitamin D supplementation (1000 IU/day cholecalciferol) on offspring bone mass at birth. The study has since extended the follow up into childhood and diversified to assess demographic, lifestyle and genetic factors that determine the biochemical response to antenatal vitamin D supplementation, and to understand the mechanisms underpinning the effects of vitamin D supplementation on offspring bone development, including epigenetics. The demonstration of positive effects of maternal pregnancy vitamin D supplementation on offspring bone development and the delineation of underlying biological mechanisms inform clinical care and future public-health policies.

Highlights

In the Southampton’s Women’s Survey (SWS), a UK-based prospective cohort, which included 1030 maternal–offspring pairs, offspring born to mothers with a serum 25(OH)D
The effect of antenatal cholecalciferol supplementation on offspring bone mineralisation The primary outcome of Maternal Vitamin D Osteoporosis Study (MAVIDOS) was to determine the effect of antenatal cholecalciferol supplementation on offspring bone mass at birth
We clearly demonstrated that antenatal supplementation with 1000 IU/day increased maternal 25(OH)D status in late pregnancy; 83% of women randomised to cholecalciferol achieved a 25(OH)D >50 nmol/L at 34 weeks’ gestation compared with only 36% in the placebo group (Figure 3)

Summary

Introduction

In the Southampton’s Women’s Survey (SWS), a UK-based prospective cohort, which included 1030 maternal–offspring pairs, offspring born to mothers with a serum 25(OH)D 95%)

Strengths and limitations

Key findings of the MAVIDOS trial

Findings

Conclusion