Effectiveness of Prenatal Vitamin D Deficiency Screening and Treatment Program: A Stratified Randomized Field Trial
Rostami M, Tehrani FR, Simbar M, Bidhendi Yarandi R, Minooee S, Hollis BW, Hosseinpanah F
The Journal of clinical endocrinology and metabolism · 130 citas
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación independiente
- Universidad u hospital
- Shahid Beheshti University of Medical Sciences
- Universidad u hospital
- Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences
Según 2 financiadores declarados.
Publicación
- Publicado
- 2018-05-18 · J Clin Endocrinol Metab · vol. 103 · número 8 · págs. 2936–2948
- Editorial
- Oxford University Press
- Citado
- 161 citas · más que el 99% de estudios similares · 9.6× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 44 trabajos
- Acceso
- Lectura gratuita
- Áreas de investigación
- Vitamin D Research Studies · Vitamin K Research Studies · Pregnancy and Medication Impact
- Palabras clave
- vitamin D deficiency, prenatal screening, vitamin D supplementation, 25-hydroxyvitamin D, pregnancy complications, preeclampsia, gestational diabetes mellitus, preterm birth, maintenance therapy, adverse pregnancy outcomes
- MeSH
- humans, pregnancy complications, vitamin d deficiency, cholecalciferol, prenatal diagnosis, pregnancy outcome, treatment outcome, program evaluation, pregnancy, dietary supplements, adolescent, adult, infant, newborn, female, young adult
7 autores
- Maryam Rostami🇮🇷Research Institute for Endocrine Sciences; Islamic Azad University, Masjed Soleyman; Shahid Beheshti University; Shahid Beheshti University of Medical Sciences
- Fahimeh Ramezani Tehrani🇮🇷 · autor de correspondenciaResearch Institute for Endocrine Sciences; Shahid Beheshti University; Shahid Beheshti University of Medical Sciences
- Masoumeh Simbar🇮🇷Shahid Beheshti University; Shahid Beheshti University of Medical Sciences
- Razieh Bidhendi Yarandi🇮🇷Research Institute for Endocrine Sciences; Shahid Beheshti University; Shahid Beheshti University of Medical Sciences; Tehran University of Medical Sciences
- Sonia Minooee🇮🇷Research Institute for Endocrine Sciences; Shahid Beheshti University; Shahid Beheshti University of Medical Sciences
- Bruce W. Hollis🇺🇸Medical University of South Carolina
- Farhad Hosseinpanah🇮🇷Research Institute for Endocrine Sciences; Shahid Beheshti University; Shahid Beheshti University of Medical Sciences
Resumen
El texto original del estudio, en el idioma en que se publicó.
Context
Despite evidence on the association between hypovitaminosis D and adverse pregnancy outcomes and the positive impact of vitamin D supplementation, no evidence exists supporting a universal screening program in pregnancy as part of routine prenatal care.
Objective
We sought to determine the effectiveness of a prenatal screening program on optimizing 25-hydroxyvitamin D [25(OH)D] levels and preventing pregnancy complications. Also, to identify a safe regimen, we compared several regimens in a subgroup of vitamin D-deficient pregnant women.
Design
Two cities of Masjed-Soleyman and Shushtar from Khuzestan province, Iran, were selected as the screening and nonscreening arms, respectively. Within the screening arm, a randomized controlled trial was conducted on 800 pregnant women.
Setting
Health centers of Masjed-Soleyman and Shushtar cities.
Patients or participants
Pregnant women aged 18 to 40 years.
Intervention
Women with moderate [25(OH)D, 10 to 20 ng/mL] and severe [25(OH)D, <10 ng/mL] deficiency were randomly divided into four subgroups and received vitamin D3 (D3) until delivery.
Main outcome measure
Maternal concentration of 25(OH)D at delivery and rate of pregnancy complications.
Results
After supplementation, only 2% of the women in the nonscreening site met the sufficiency level (>20 ng/mL) vs 53% of the women in the screening site. Adverse pregnancy outcomes, including preeclampsia, gestational diabetes mellitus, and preterm delivery, were decreased by 60%, 50%, and 40%, respectively, in the screening site. A D3 injection in addition to monthly 50,000 IU maintenance therapy contributed the most to achievement of sufficient levels at delivery.
Conclusions
A prenatal vitamin D screening and treatment program is an effective approach in detecting deficient women, improving 25(OH)D levels, and decreasing pregnancy adverse outcomes.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.
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