• Nazli Hossain, Fatima H Kanani, Shabana Ramzan, Robina Kausar, Shabana Ayaz, Rafiq Khanani, and Lubna Pal.
• Department of Obstetrics and Gynecology Unit II (N.H., S.R., R.K., S.A.), and Department of Pathology and Microbiology (R.K., F.H.K.), Dow Diagnostics and Reference Laboratory, Dow International Medical College, Dow University of Health Sciences, Dow University of Health Sciences, Karachi 74200, Pakistan; Program for Polycystic Ovarian Syndrome (L.P), Program for Reproductive Aging and Bone Health (L.P.), and Yale Reproductive Endocrinology, Department of Obstetrics, Gynecology, and Reproductive Sciences (L.P.), Yale University School of Medicine, New Haven, Connecticut 06520.
• J. Clin. Endocrinol. Metab. 2014 Jul 1;99(7):2448-55.

ObjectiveThe objective of the study was to determine whether vitamin D (vitD) supplementation during pregnancy affects obstetric and neonatal outcomes.SettingThe study was conducted at a university hospital in Karachi, Pakistan.MethodsThe study was a single-center, open-label, randomized, controlled trial of routine care (group A, 200 mg ferrous sulfate and 600 mg calcium daily) vs vitD supplementation (group B, 4000 IU vitamin D3 daily), started at 20 weeks and continued till delivery. Maternal serum samples of 25-hydroxyvitamin D (25OHD) were collected at baseline and delivery. Neonatal vitD status was assessed in cord blood or in neonatal serum samples within 48 hours of birth. Obstetric outcomes included gestational hypertension, gestational diabetes, and preterm labor, and neonatal well-being included small for gestational age, birth weight, length, head circumference, and 1- and 5-minute Apgar scores.ResultsOf 207 gravidae enrolled, 193 completed the trial. Maternal age, vitD status, and gestational age at enrollment were comparable between the two groups. At delivery, maternal 25OHD was increased in group B (18.3 ± 11 ng/dL vs 8.82 ± 11.84 ng/dL (P = .001) compared with group A (6.9 ± 7.0 ng/dL vs 6.32 ± 3.97 ng/dL, P = .06). The obstetric outcomes were comparable between the two groups (P > .05). Neonatal 25OHD levels were significantly higher in group B compared with group A (19.22 ± 12.19 ng/dL vs 6.27 ± 5.2 ng/dL). There was positive correlation between maternal and neonatal 25OHD levels (r = 0.83, P = .001). One- and 5-minute Apgar scores were significantly higher in group B (7.10 ± 0.66 vs 6.90 ± 0.50, P = .026, and 8.53 ± 0.68 vs 8.33 ± 0.81, P = .051, respectively). Neonatal anthropometric parameters were comparable between the two groups (P > .05).ConclusionMaternal vitD supplementation improved maternal and neonatal vitD status.

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