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The importance of maternal pregnancy vitamin D for offspring bone health: learnings from the MAVIDOS trial

Rebecca J Moon 1Elizabeth M Curtis 2Stephen J Woolford 2Shanze Ashai 2Cyrus Cooper 2Nicholas C Harvey 2

Ther Adv Musculoskelet Dis. 2021 Apr 8;13:1759720X211006979.

 doi: 10.1177/1759720X211006979. eCollection 2021.

Abstract

Optimisation of skeletal mineralisation in childhood is important to reduce childhood fracture and the long-term risk of osteoporosis and fracture in later life. One approach to achieving this is antenatal vitamin D supplementation. The Maternal Vitamin D Osteoporosis Study is a randomised placebo-controlled trial, the aim of which was to assess the effect of antenatal vitamin D supplementation (1000 IU/day cholecalciferol) on offspring bone mass at birth. The study has since extended the follow up into childhood and diversified to assess demographic, lifestyle and genetic factors that determine the biochemical response to antenatal vitamin D supplementation, and to understand the mechanisms underpinning the effects of vitamin D supplementation on offspring bone development, including epigenetics. The demonstration of positive effects of maternal pregnancy vitamin D supplementation on offspring bone development and the delineation of underlying biological mechanisms inform clinical care and future public-health policies.

Conclusion

The findings from the MAVIDOS trial of potential beneficial effects of maternal vitamin D supplementation during pregnancy on offspring bone mass, and the elucidation of possible underlying mechanisms, have increased our understanding of the role of vitamin D in pregnancy. Results from the MAVIDOS trial have informed policy from bodies such as the UK Scientific Advisory Committee on Nutrition87 and the National Institute for Health Research.88 These findings, and those from ongoing follow up, data analysis and substudies within the MAVIDOS trial, together with further independent trials such as SPRING, will be critical to future public-health advice on vitamin D supplementation in pregnancy.