Vitamin D Status of Infants of Mothers with Gestational Diabetes: Status at Birth and a Randomized Controlled Trial of Vitamin D Supplementation across Infancy

• Published in: The Journal of nutrition Vol. 152; no. 11; pp. 2441 - 2450
• Main Authors: Weiler, Hope A, Attar, Atheer, Farahnak, Zahra, Sotunde, Olusola F, Razaghi, Maryam, Gharibeh, Nathalie, Khamessan, Ali, Vanstone, Catherine A
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2022; American Institute of Nutrition
• Subjects: Calciferol; Diabetes; Diabetes mellitus; Diet; Dietary supplements; Gestational diabetes; Immunoassay; infant; Infants; Maternal & child health; Medical records; Neonates; Pregnancy; randomized controlled trial; Vitamin D; vitamin D status; vitamin D supplementation; Vitamin D3; Vitamin deficiency; UVB; RCT; CAD; LGA; AI; infant; SGA; vitamin D status; randomized controlled trial; SRM; GDM; gestational diabetes; ITA; UL; NIST; 25(OH)D; BMC; GA; AGA; DEQAS; vitamin D supplementation; CLIA
• ISSN: 0022-3166; 1541-6100
• DOI: 10.1093/jn/nxac194

Vitamin D status and requirements of infants of women with gestational diabetes mellitus (GDM) are unclear. The objectives were to assess vitamin D status in infants of mothers with GDM and compare vitamin D status in response to 400 vs. 1000 IU/d vitamin D supplementation in infants born with serum 25-hydroxyvitamin D [25(OH)D] <50 nmol/L. Women with GDM delivering full-term infants (n = 98; March 2017–2019, Montreal, Canada) were surveyed for demographic and lifestyle factors. Pregnancy history was obtained from medical records. Newborn serum 25(OH)D was measured (immunoassay) and categorized as <30 (deficient) or ≥40 nmol/L (adequate). Breastfed neonates (n = 16) with serum 25(OH)D <50 nmol/L at birth were randomly assigned to 400 or 1000 IU/d of supplemental cholecalciferol (vitamin D3), and serum 25(OH)D was measured at baseline (≤1 mo) and 3, 6, and 12 mo of age. Groups were compared using a linear mixed-effects model and Tukey-Kramer post hoc tests. Mean newborn serum 25(OH)D was 46.4 (95% CI: 43.9, 49.9) nmol/L, with 15.3% (95% CI: 8.2%, 22.4%) <30 nmol/L and 61.2% (95% CI: 51.6%, 70.9%) ≥40 nmol/L. During the trial, most infants were breastfed to 3 mo (400 IU/d: 87.5%; 1000 IU/d: 75.0%). Mean (± SEM) infant serum 25(OH)D was higher in the 1000-IU/d group at 3 mo (79.9 ± 5.9 vs. 111.5 ± 15.2 nmol/L; P = 0.0263), and although not different at 6–12 mo, was maintained at >50 nmol/L. Most infants of women with GDM had adequate vitamin D status in this study. In those born with serum 25(OH)D <50 nmol/L, vitamin D status was corrected by 3 mo of age in response to 400 or 1000 IU/d of supplemental vitamin D. Dietary guidance should continue to recommend that all women who could become pregnant take a multivitamin supplement and that breastfed infants receive 400 IU/d of supplemental vitamin D. This study and ancillary trial were registered at clinicaltrials.gov (https://www.clinicaltrials.gov/ct2/show/NCT02563015) as NCT02563015.