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CompletedNCT02548520Updated Sep 14, 2015

Maternal and Infant Vitamin Status During the First Nine Months of Infant Life

An observational study in Rickets, Osteomalacia and Osteoporosis, sponsored by University of Aarhus. Completed at 1 site in Denmark. Open to female participants aged 24 Years to 41 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2015-09-14.

Sponsored by University of Aarhus · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
107
Ages
24 Years to 41 Years
Sex
Female
01

Study summary

In this study the investigators wanted to assess vitamin D status and possible consequences of low plasma 25-hydroxyvitamin D levels in a population of healthy mothers and their infants, in the community of Aarhus, Denmark.

Read the detailed description

Danish people living at northern latitudes (56°N), often with overcast and foggy weather and few sunshine hours are at increased risk of vitamin D insufficiency. Although vitamin D is obtainable from fortified food and oily fish, the major source is the dermal synthesis of the vitamin D through exposure to solar ultraviolet light.

In the 19th century rickets was endemic in northern Europe, and many children developed rickets, a severe bone-deforming disease. Encouragement of sensible sun exposure, supplementation with cod liver oil and fortification of milk with vitamin D, resulted in an almost complete eradication of rickets by the end of the 19th century. At present vitamin D deficiency seems again to be more widespread. The classical outcomes of severe vitamin D deficiency are rickets in growing individuals and osteomalacia in adults. Low vitamin D status also relates to low bone density and increased risk of osteoporotic fractures. Although the incidence of rickets has declined over the last decades, cases attributable to inadequate vitamin D intake and low exposure to sunlight continue to be reported, and maternal vitamin D status may have permanent effects on newborns' health. Pregnant women, newborns, breastfed children, and lactating women are at a high risk of vitamin D deficiency, especially during winter and early spring.

Since fetal plasma 25-hydroxyvitamin D (25OHD) depends on maternal 25OHD, fetal vitamin D status may show seasonal changes parallel to those observed in the mothers. To prevent rickets and vitamin D deficiency in infants, most Western countries, including Denmark, recommend a daily maternal intake during pregnancy and lactation of 10 μg and that breastfed children are given a supplement of 10 μg of vitamin D/day. Despite these recommendations, approximately one third of Danish pregnant and lactating women have vitamin D insufficiency. However, childhood rickets is nowadays rare in Denmark, although it still exists especially among immigrants and mothers with prolonged lactation. Accordingly, in 2010, the Danish National Board of Health extended the recommendations for vitamin D supplementation to the first two years of life.

02

Conditions studied

  • Rickets
  • Osteomalacia
  • Osteoporosis
03

Who can participate

Ages eligible
24 Years to 41 Years
Sexes eligible
Female
Accepts healthy volunteers
Yes
Sampling method
Non-probability sample

Study population

Healthy pregnant Caucasian women with a normal pregnancy

Inclusion criteria

  • Healthy pregnant Caucasian women aged 24-41 years,
  • A normal pregnancy giving birth between 38-42 gestational weeks.

Exclusion criteria

Exclusion Criteria:

  • Chronic diseases,
  • Other ethnic origin than Caucasian, and
  • Alcohol or drug abuse.
04

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
107 participants (actual)
Patient registry
No

Interventions

  • OtherBlood and breastmilk samples

    The investigators collected maternal and infants blood samples from birth, and 4 and 9 months forward, including breastmilk from the mothers at all visits

05

What researchers measure

Primary outcomes

  1. Prevalence in plasma 25OHD and parathyroid hormone at birth

    For determination of plasma 25OHD and plasma parathyroid hormone concentrations, the investigators sampled cord blood at baseline. Furthermore the investigators collected maternal blood at 2 weeks after birth (baseline).

    Time frame: at birth (baseline)

Secondary outcomes

  1. Prevalence in plasma 25OHD and parathyroid hormone at 4 months

    For determination of plasma 25OHD and plasma parathyroid hormone concentrations, the investigators sampled maternal and infants blood samples at 4 months (1. follow-up).

    Time frame: at 4 months

  2. Prevalence in plasma 25OHD and parathyroid hormone at 9 months

    For determination of plasma 25OHD and plasma parathyroid hormone concentrations, the investigators sampled maternal and infants blood samples at 9 months (2. follow-up).

    Time frame: at 9 months

Other outcomes

  1. Questionnaire about lifestyle factors at birth

    At birth the investigators collected, via self reported focused questionnaires, data regarding breastfeeding status, use of vitamin D supplements among children and their mothers, use of calcium supplements and dietary calcium intake (milk and cheese consumption) and other lifestyle factors, including physical activity (baseline).

    Time frame: at birth

  2. Questionnaire about lifestyle factors at 4 months

    At 4 months the investigators collected, via self reported focused questionnaires, data regarding breastfeeding status, use of vitamin D supplements among children and their mothers, use of calcium supplements and dietary calcium intake (milk and cheese consumption) and other lifestyle factors, including physical activity (1. follow up).

    Time frame: at 4 months

  3. Questionnaire about lifestyle factors at 9 months

    At 9 months visit the investigators collected, via self reported focused questionnaires, data regarding breastfeeding status, use of vitamin D supplements among children and their mothers, use of calcium supplements and dietary calcium intake (milk and cheese consumption) and other lifestyle factors, including physical activity (2. follow up).

    Time frame: at 9 months

  4. peripheral Quantitative Computed Tomography i nine months old infants

    At 9 months the investigators investigated 1) whether there was a correlation between maternal vitamin D status or calcium intake (i.e. diet and supplements) and bone mass and structure as measured by peripheral quantitative computed tomography in the infants 9 months after birth, and 2) gender differences in measured peripheral quantitative computed tomography variables. Furthermore the investigators evaluated 3) the feasibility of performing peripheral quantitative computed tomography scans on newborn infants in terms of assessing the precision of peripheral quantitative computed tomography scan.

    Time frame: at 9 months

06

Study locations

1 site
  • Department of Internal Medicine and Endocrinology, Aarhus University Hospital
    Aarhus, Central Denmark Region DK-8000, Denmark
07

References and documents

Publications

  • Vieth Streym S, Kristine Moller U, Rejnmark L, Heickendorff L, Mosekilde L, Vestergaard P. Maternal and infant vitamin D status during the first 9 months of infant life-a cohort study. Eur J Clin Nutr. 2013 Oct;67(10):1022-8. doi: 10.1038/ejcn.2013.152. Epub 2013 Sep 4. PubMed 24002039 ↗
  • vieth Streym S, Hojskov CS, Moller UK, Heickendorff L, Vestergaard P, Mosekilde L, Rejnmark L. Vitamin D content in human breast milk: a 9-mo follow-up study. Am J Clin Nutr. 2016 Jan;103(1):107-14. doi: 10.3945/ajcn.115.115105. Epub 2015 Dec 16. PubMed 26675779 ↗
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Registry details

Key details

Study ID
NCT02548520
Lead sponsor
University of Aarhus
Responsible party
Sponsor
First posted
Sep 14, 2015
Start date
Oct 2008
Primary completion
Jul 2011
Completion
Mar 2012
Last update
Sep 14, 2015

Study contacts

Susanna við Streym, PhD
principal investigator · Department of Internal Medicine and Endocrinology, Aarhus University Hospital
Lars Rejnmark, Professor
study director · Department of Internal Medicine and Endocrinology, Aarhus University Hospital
Peter Vestergaard, Professor
study chair · The Department of Endocrinology, Aalborg University Hospital

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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