"The Impact Of Continuous Prenatal And Early Postpartum Maternal Vitami" by Doria K. Thiele

Date of Award

January 2013

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Nursing

First Advisor

Cindy M. Anderson

Abstract

In the United States, at least 50% of breastfeeding mothers are vitamin D deficient, increasing risk for vitamin D deficiency in exclusively breastfed infants. A gap in knowledge exists regarding best practices in maternal vitamin D supplementation during pregnancy and lactation that will yield adequate infant vitamin D levels. The objective of this study was to identify the combined effect of maternal prenatal and postnatal vitamin D supplementation on vitamin D transfer to exclusively breastfed infants. Additionally, due to the immune modulating effects of vitamin D, maternal pro- and anti-inflammatory cytokines were measured across pregnancy and the postpartum. A double-blind, randomized controlled trial design was used. A total of 16 pregnant women were enrolled in the study at 24-28 weeks gestation. The control group (N= 6) received a prenatal vitamin containing vitamin D 400 IU daily plus a placebo void of vitamin D. The experimental group (N=7) received the same prenatal vitamin plus a capsule containing 3400 IU vitamin D, for a total of 3800 IU daily. Participants continued their assigned supplements through 4-6 weeks of lactation. Pertinent pregnancy, delivery, and postnatal health data were collected on maternal and infant participants. Serum levels of 25-hydroxyvitamin D were measured in maternal participants at enrollment and in both maternal and infant participants at delivery and after 4-6 weeks of lactation. Maternal plasma TNF-alpha, IL-6, and IL-10 were measured at enrollment, delivery and 4-6 weeks of lactation. There was a significant effect of maternal vitamin D supplementation on maternal 25-hydroxyvitamin D at delivery (p=0.044) and at 4-6 weeks of lactation (p=0.002). A significant difference in the infant participant groups at delivery was also found (p=0.017), however this was not significant at 4-6 weeks of lactation (p=0.256). Controlling for maternal baseline using repeated measures techniques, the overall effect of maternal vitamin D supplementation on infant 25-hydroxyvitamin D approached significance (p=0.065). There was no impact of vitamin D supplementation on maternal cytokine production. This study adds novel information regarding the impact of continuous prenatal to postpartum maternal vitamin D supplementation on the vitamin D status of exclusively breastfed infants.

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