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
• Main Authors: Rosalyn J. Singleton, Gretchen M. Day, Timothy K. Thomas, Joseph A. Klejka, Christine A. Desnoyers, Melanie N. P. McIntyre, David M. Compton, Kenneth E. Thummel, Robert J. Schroth, Leanne M. Ward, Dane C. Lenaker, Rachel K. Lescher, Joseph B. McLaughlin
• Format: Text
• Language: English
• Published: Multidisciplinary Digital Publishing Institute 2022
• Subjects: Vitamin D; rickets; pregnancy; caries; early childhood caries; vitamin D supplementation; vitamin D deficiency; Yukon; Kuskokwim; Alaska
• Online Access: https://doi.org/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.