Project Details

The Effect of Early Life Vitamin D on Child Bone Health – A Personalized Approach

Nicklas Brustad, MD, PhD

Summary

BACKGROUND: The prevalence of vitamin D insufficiency among pregnant women is high and low levels of 25(OH)D in pregnancy is related to childhood bone disorders such as rickets and craniotabes. GAP: Vitamin D deficiency has increased in the last few decades possibly due to changing lifestyles and dietary habits and Vitamin D supplementation in pregnancy has been suggested to have effects on early life bone mineralization and fracture risk, but the effect seem to depend on several factors including the genetic profile$ HYPOTHESIS: Vitamin D sufficiency in pregnancy and childhood improves bone mineralization and reduces the risk of fractures during childhood and adolescence. The effect of prenatal vitamin D supplementation on child bone outcomes are influenced by the genetic profile of the mothers and children. METHODS: The COPSAC2010 randomized controlled trial of high-dose (2800IU/day) vs. standard-dose (400IU/day) vitamin D supplementation from week 24 in pregnancy until 1 week after birth. The COPSAC2010 cohort is a Danish population-based mother-child cohort with longitudinally clinical follow-up of the children with 15 scheduled visits including dual-energy x-ray absorptiometry (DXA) scans at age 3- and 6-years until age 12 years and genotyping of the mothers and the children. RESULTS: High-dose vitamin D supplementation in pregnancy improved offspring bone mineralization through age 6 years compared with the standard dose. (Brustad et al, 2020 JAMA Pediatr. 2020;174(5):419-427). IMPACT: This is the leading large mother-child RCT within this field and the project has the potential to change current guidelines of vitamin D intake during pregnancy in order to improve bone health and prevent fractures in childhood and later life as well as add knowledge to the development of a personalized vitamin D supplementation strategy based on our genetic analyses. Website Link: copsac.com.