This is a preliminary study of oral vitamin D3 supplementation in pregnant and non-pregnant women of reproductive age in Bangladesh. The primary objective of the study is to identify a dose of vitamin D3 that can safely be administered during pregnancy to improve the vitamin D status of the mother and infant.
Vitamin D deficiency is common among pregnant and non-pregnant Bangladeshi women. The consequences of vitamin D deficiency during pregnancy are unknown, but increasing evidence suggests it may compromise fetal growth and development of the immune system. We hypothesize that vitamin D deficiency in pregnant women has an adverse effect on the newborn's defenses against infectious diseases in early infancy, and thus contributes to the high rates of neonatal mortality in South Asia. Randomized controlled trials of antenatal vitamin D supplementation are needed to test this hypothesis. However, preliminary studies are first necessary to establish a safe and efficacious dose of vitamin D to be used in such trials. In the proposed study, we will measure the response of the 25-hydroxyvitamin D serum concentration (a biomarker of vitamin D status) to oral vitamin D3 supplementation in pregnant women and non-pregnant women of reproductive age. The goal is to establish a safe, efficacious and feasible weekly vitamin D supplementation regimen for use in future trials. Five groups of approximately 15 women (3 groups of pregnant and 2 groups of non-pregnant women; total up to 75 women) will be supplemented and followed closely for 10 weeks (non-pregnant women) or until delivery (pregnant participants). The primary outcomes will be the change in 25-hydroxyvitamin D concentrations following vitamin D supplementation, and safety parameters that reflect calcium regulation (serum albumin-adjusted calcium concentrations and urine calcium excretion) and fetal development.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
75
Vitamin D3 oral liquid 70,000 IU once
Vitamin D3 oral liquid 70,000 IU as loading dose, then 35,000 IU weekly thereafter for 10 weeks (non-pregnant) or until delivery (pregnant)
Vitamin D3 14,000 IU per week by mouth, starting at 27-30 weeks gestation and continued until delivery.
SHIMANTIK Maternity Centre
Dhaka, Dhaka Division, Bangladesh
25-hydroxyvitamin D concentration
Time frame: 6 scheduled timepoints during supplementation period
Serum calcium concentration (albumin-corrected)
Time frame: 6 scheduled timepoints during supplementation period
Urine calcium: creatinine ratio
Time frame: 7-8 scheduled timepoints during supplementation period
Blood pressure
Time frame: Weekly during supplementation period
Urinary protein excretion
Time frame: Weekly during supplementation period
Maternal weight
Time frame: Weekly during supplementation period
Birth anthropometry
Time frame: At birth
Neonatal echocardiography
Time frame: Neonatal period
Fetal LL-37 expression/secretion in saliva, vernix, and cord tissue
Time frame: Birth
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