Is 400 IU per day of Vitamin-D given to healthy well-nourished mothers antenatally enough to prevent neonatal Vitamin-D deficiency?

BACKGROUND

The incidence of Vitamin D deficiency (VDD) among newborns is very high in India, this is usually secondary to maternal deficiency. Currently Vitamin D at the dose of 400-600 IU/day is being prescribed during pregnancy for prevention. There is paucity of data regarding efficacy of current recommendations in preventing neonatal hypovitaminosis D.Our aim was to determine if good nutritional status of the mother and regular calcium and Vitamin D supplementation during pregnancy in the currently recommended doses help prevent or reduce VDD in neonates.

METHODS

Cord blood Serum 25(OH)D levels were studied in 342 neonates born to 323 healthy mothers at a tertiary care center in Mumbai. All the mothers were on regular antenatal follow up and received Vitamin D and calcium supplements as per current recommendations.

RESULTS

Mean umbilical cord blood 25(OH)D level was 12.088 ng/ml (SD 3.349, range 31.1-5.1). Out of 342 neonates, 335 (97.95%) had Vitamin D deficiency [cord blood 25(OH)D level <20 mg/ml] 1.75% had cord blood 25(OH)D level between 21 and 29 ng/ml in the insufficiency range and only 0.29% of the subjects had 'normal' cord blood 25(OH)D levels of >30 ng/ml. However, none of the neonates in the study were found to have severe VDD (<5 ng/ml).

CONCLUSION

Antenatal supplementation of well nourished, socioeconomically better off mothers in our population with 400 IU/day of Vitamin D3 is ineffective in preventing VDD in neonates.