Maternal prenatal, with or without postpartum, vitamin D3 supplementation does not improve maternal iron status at delivery or infant iron status at 6 months of age: secondary analysis of a randomised controlled trial.

Autor:	O'Callaghan KM; Department of Nutritional Sciences, King's College London, London, UK.; Centre for Global Child Health and SickKids Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada., Qamar H; Centre for Global Child Health and SickKids Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada., Gernand AD; Department of Nutritional Sciences, The Pennsylvania State University, University Park, Pennsylvania, USA., Onoyovwi AK; Centre for Global Child Health and SickKids Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada., Zlotkin S; Centre for Global Child Health and SickKids Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada.; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.; Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada., Mahmud AA; Nutrition Research Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh., Ahmed T; Nutrition Research Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh., Keya FK; Nutrition Research Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh., Roth DE; Centre for Global Child Health and SickKids Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada.; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.; Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.
Jazyk:	angličtina
Zdroj:	BMJ nutrition, prevention & health [BMJ Nutr Prev Health] 2023 Dec; Vol. 6 (2), pp. 282-292. Date of Electronic Publication: 2023 Nov 14.
DOI:	10.1136/bmjnph-2023-000758
Abstrakt:	Background: Vitamin D may modify iron status through regulation of hepcidin and inflammatory pathways. This study aimed to investigate effects of maternal vitamin D supplementation on iron status in pregnancy and early infancy. Methods: In a trial in Dhaka, Bangladesh, women (n=1300) were randomised to one of five vitamin D 3 regimens from 17 to 24 weeks' gestation until 26 weeks postpartum (prenatal; postpartum doses): 0;0, 4200;0, 16 800;0, 28 000;0 or 28 000;28 000 IU/week. All participants received standard iron-folic acid supplementation. In this secondary analysis (n=998), we examined effects of prenatal;postpartum vitamin D on serum ferritin and other biomarkers of maternal iron status (transferrin saturation, total iron binding capacity, soluble transferrin receptor and hepcidin) at delivery, and infant ferritin and haemoglobin at 6 months of age. Using linear regression, we estimated per cent mean differences between each intervention group and placebo with 95% CIs, with and without adjustment for baseline ferritin or inflammatory biomarkers (C reactive protein and α-1-acid glycoprotein (AGP)). Results: At delivery, ferritin concentrations were similar between each intervention group and placebo in unadjusted (n=998) and baseline ferritin-adjusted analyses (n=992; p>0.05). Compared with placebo, AGP was lower in each intervention group (per cent difference (95% CI) = -11% (-21 to -1.0), -14% (-23 to -3.5) and -11% (-19 to -2.0) in the 4200 IU/week, 16 800 IU/week and 28 000 IU/week groups, respectively; n=779). In the subgroup of women with baseline 25-hydroxyvitamin D < 30 nmol/L, ferritin was lower in each intervention group versus placebo (-23% (-37 to -5.0), -20% (-35 to -1.9) and -20% (-33 to -4.1) in the 4200 IU/week, 16 800 IU/week and 28 000 IU/week groups, respectively; n=645); effects were slightly attenuated after adjustment for inflammation (n=510). There were no effects of vitamin D on other iron biomarkers among women at delivery or infants aged 6 months. Conclusion: These findings do not support improvement of iron status by vitamin D. The effect of prenatal vitamin D supplementation on ferritin may reflect an anti-inflammatory mechanism. Competing Interests: Competing interests: None declared (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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