Curtis Elizabeth M, Moon Rebecca J, D'Angelo Stefania, Crozier Sarah R, Bishop Nicholas J, Gopal-Kothandapani Jaya Sujatha, Kennedy Stephen H, Papageorghiou Aris T, Fraser Robert, Gandhi Saurabh V, Schoenmakers Inez, Prentice Ann, Inskip Hazel M, Godfrey Keith M, Javaid M Kassim, Eastell Richard, Cooper Cyrus, Harvey Nicholas C
Medical Research Council (MRC) Lifecourse Epidemiology Centre University of Southampton Southampton UK.
Paediatric Endocrinology University Hospital Southampton National Health Service (NHS) Foundation Trust Southampton UK.
JBMR Plus. 2022 Jun 11;6(7):e10651. doi: 10.1002/jbm4.10651. eCollection 2022 Jul.
In the Maternal Vitamin D Osteoporosis Study (MAVIDOS) randomized trial, vitamin D supplementation in pregnancy did not lead to greater neonatal bone mass across the trial as a whole, but, in a prespecified secondary analysis by season of birth, led to greater neonatal bone mass among winter-born babies. Demonstrating persistence of this effect into childhood would increase confidence in a long-term benefit of this intervention. We investigated whether antenatal vitamin D supplementation increases offspring bone mineralization in early childhood in a prespecified, single-center follow-up of a double-blinded, multicenter, randomized controlled clinical trial based in the UK (MAVIDOS). A total of 1123 women in early pregnancy with a baseline 25-hydroxyvitamin D level 25-100 nmol/L from three research centers (2008-2014) were randomized to 1000 IU/d cholecalciferol or matched placebo from 14 weeks of gestation to delivery. Offspring born at the Southampton, UK research center were assessed at age 4 years (2013-2018). Anthropometry and dual-energy X-ray absorptiometry (DXA) were performed (yielding whole body less head [WBLH] bone mineral content [BMC], areal bone mineral density [aBMD], bone area [BA], and body composition). Of 723 children, 564 (78.0%) children attended the 4-year visit, 452 of whom had a useable DXA. Maternal vitamin D supplementation led to greater WBLH aBMD in the children compared with placebo (mean [95% confidence interval {CI}]: supplemented group: 0.477 (95% CI, 0.472-0.481) g/cm; placebo group: 0.470 (95% CI, 0.466-0.475) g/cm, = 0.048). Associations were consistent for BMC and lean mass, and in age- and sex-adjusted models. Effects were observed across the whole cohort irrespective of season of birth. Maternal-child interactions were observed, with a greater effect size among children with low milk intake and low levels of physical activity. Child weight, height, and body mass index (BMI) were similar by maternal randomization group. These findings suggest a sustained beneficial effect of maternal vitamin D supplementation in pregnancy on offspring aBMD at age 4 years, but will require replication in other trials. © 2022 The Authors. published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
在母源性维生素D与骨质疏松症研究（MAVIDOS）随机试验中，从整个试验来看，孕期补充维生素D并未使新生儿骨量增加更多，但在一项按出生季节进行的预先指定的二次分析中，却使冬季出生婴儿的新生儿骨量增加更多。若能证明这种效应持续到儿童期，将增强人们对这一干预措施长期益处的信心。我们在一项预先指定的单中心随访研究中，调查了产前补充维生素D是否会增加幼儿期后代的骨矿化，该随访研究基于英国一项双盲、多中心、随机对照临床试验（MAVIDOS）。来自三个研究中心（2008 - 2014年）的总共1123名孕早期女性，其基线25 - 羟基维生素D水平为25 - 100 nmol/L，从妊娠14周开始至分娩被随机分为1000 IU/d胆钙化醇组或匹配的安慰剂组。在英国南安普敦研究中心出生的后代在4岁时（2013 - 2018年）接受评估。进行了人体测量和双能X线吸收法（DXA）检测（得出全身除头部[WBLH]的骨矿物质含量[BMC]、骨面积密度[aBMD]、骨面积[BA]和身体成分）。在723名儿童中，564名（78.0%）儿童参加了4岁时的随访，其中452名儿童有可用的DXA检测结果。与安慰剂相比，母亲补充维生素D使儿童的WBLH aBMD更高（均值[95%置信区间{CI}]：补充组：0.477（95% CI，0.472 - 0.481）g/cm；安慰剂组：0.470（95% CI，0.466 - 0.475）g/cm，P = 0.048）。对于BMC和瘦体重，以及在年龄和性别调整模型中，相关性是一致的。无论出生季节如何，在整个队列中都观察到了这种效应。观察到母婴之间存在相互作用，在牛奶摄入量低和身体活动水平低的儿童中效应大小更大。按母亲随机分组，儿童的体重、身高和体重指数（BMI）相似。这些发现表明，孕期母亲补充维生素D对4岁后代的aBMD有持续的有益影响，但这需要在其他试验中得到验证。© 2022作者。由Wiley Periodicals LLC代表美国骨与矿物质研究学会出版。
