Maternal and neonatal outcomes of vitamin D supplementation in hypovitaminosis D pregnancy: preg-D randomized trial
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ID: 321185
2026
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Abstract
Abstract Context Hypovitaminosis D during pregnancy is common and may have adverse maternal and neonatal effects. While randomized trials show that supplementation improves biochemical vitamin D status, the optimal dose and its effects on neonatal bone outcomes remain uncertain. Objective To compare the effects of 2 vitamin D supplementation doses during pregnancy on maternal and neonatal serum 25-hydroxyvitamin D (25(OH)D) at delivery, and on neonatal bone mineral content. Methods In this double-blind trial, pregnant women ≤17.5 weeks' gestation with baseline 25(OH)D 10 to 30 ng/mL were randomized to receive either 20 000 IU/week or 10 000 IU every 2 weeks (equivalent to 714 IU/day) vitamin D3. Primary outcomes were the proportion of women achieving a 25(OH)D level ≥20 ng/mL at delivery and neonatal bone mineral content (BMC) at ∼1 month of age. We used liquid chromatography tandem mass spectrometry (standard LC–MS/MS) at a CDC-certified laboratory. Results One hundred and ninety-two maternal neonatal pairs had complete biochemical data and 67 neonates had evaluable DXA scans. A significantly higher proportion (100%) of women and neonates (77%) in the higher dose group achieved 25(OH)D levels ≥20 ng/mL at delivery, compared with the lower dose group (85% and 40%, respectively, P = .001). Mean 25(OH)D in mothers and neonates at delivery followed a similar pattern (P = .001). However, neonatal subtotal whole-body BMC did not differ between groups (45.9 ± 8.5 vs 42.2 ± 7.1 g, respectively; P = .059), nor did neonatal bone mineral density or bone area. We did not identify any safety concerns related to supplementation. Conclusion Higher dose vitamin D supplementation safely achieved biochemical sufficiency in mothers and neonates without measurable effect on neonatal bone outcomes.
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| Authors | Marlene Chakhtoura, Anwar H. Nassar, Sara Ajjour, Maya Rahme, Mariam Assaad, Mona Nabulsi, Lama Charafeddine, Ziyad Mahfoud, Nawal Tfaily, Taghrid Diab, Rihab Al-Tayeh, Ali Zeitoun, John Shepherd, Etienne Cavalier, Cyrus Cooper, Nicholas C. Harvey, Joe Eid, Myriam Chlela, Ghada El‐Hajj Fuleihan |
| Journal | the journal of clinical endocrinology & metabolism |
| Year | 2026 |
| DOI |
10.1210/clinem/dgag245
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| URL | |
| Keywords | Keywords not found |
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