Impact of a Prenatal Vitamin D Supplementation Program on Vitamin D Deficiency, Rickets and Early Childhood Caries in an Alaska Native Population

• Published in: Nutrients 2022-09, Vol.14 (19), p.3935
• Main Authors: Singleton, Rosalyn J, Day, Gretchen M, Thomas, Timothy K, Klejka, Joseph A, Desnoyers, Christine A, McIntyre, Melanie N P, Compton, David M, Thummel, Kenneth E, Schroth, Robert J, Ward, Leanne M, Lenaker, Dane C, Lescher, Rachel K, McLaughlin, Joseph B
• Format: Article
• Language: English
• Subjects: Aged; Alaska Natives; Alfacalcidol; Babies; Calcifediol; Calciferol; Child; Child, Preschool; Childhood; Children; Cholecalciferol; Cohort analysis; Dental caries; Dental Caries - epidemiology; Dental Caries - prevention & control; Dental Caries Susceptibility; Diet; Dietary Supplements; Electronic health records; Electronic medical records; Evaluation; Female; Humans; Native peoples; Nutrient deficiency; Offspring; Pharmacy; Pregnancy; Pregnant women; Prenatal experience; Rickets; Rickets - epidemiology; Rickets - prevention & control; Teeth; Vitamin D; Vitamin D deficiency; Vitamin D Deficiency - drug therapy; Vitamin D Deficiency - epidemiology; Vitamin D3; Vitamin deficiency; Vitamins - therapeutic use; Womens health
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu14193935

Background: Early childhood rickets increased in Alaska Native children after decreases in vitamin D-rich subsistence diet in childbearing-aged women. We evaluated the impact of routine prenatal vitamin D supplementation initiated in Alaska’s Yukon Kuskokwim Delta in Fall 2016. Methods: We queried electronic health records of prenatal women with 25(OH) vitamin D testing during the period 2015−2019. We evaluated 25(OH)D concentrations, vitamin D3 supplement refills, and decayed, missing, and filled teeth (dmft) scores and rickets in offspring. Results: Mean 25(OH)D concentrations increased 36.5% from pre- to post-supplementation; the percentage with deficient 25(OH)D decreased by 66.4%. Women with ≥ 60 vitamin D3 refill days had higher late pregnancy 25(OH)D concentrations than those with no refill days (p < 0.0001). Women with late pregnancy insufficient 25(OH)D concentrations had offspring with higher dmft scores than those with sufficient 25(OH)D (RR 1.3, p < 0.0001). Three children were diagnosed with nutritional rickets during the period 2001−2021, and none after 2017. Conclusions: These findings suggest that prenatal vitamin D supplementation can improve childhood outcomes in high-risk populations with high rates of rickets.