Vitamin D Optimization Can Stop Tragic Increase in Preterm Births

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  • Despite having the highest health care expenditures in the world, U.S. rates of premature births have risen two years in a row, hitting 9.8 percent in 2016 — a 2 percent increase from 2015
  • Underweight births in the U.S. have also increased since 2014, and increases a child’s risk of infections and brain bleeds during infancy, and chronic health problems such as obesity, diabetes and heart disease later in life
  • Racial disparities are pronounced. African-Americans have a 13 percent low birth weight rate compared to 8 percent for Asian and Native Americans and 7 percent for Hispanics and Caucasians
  • Research shows vitamin D optimization could prevent 60 percent of premature births. Among African-Americans, up to 75 percent of all preterm births could be prevented by raising vitamin D levels to 40 ng/mL by the third trimester
  • The Organic & Natural Health Association will be submitting a health claim petition for vitamin D’s ability to lower premature birth to the FDA

By Dr. Mercola

Despite having the highest health care expenditures in the world, U.S. rates of premature births are on the rise, especially among African-Americans. Preterm birth (which is responsible for 28 percent of newborn deaths during the first month of life) is defined as a baby being born before 37 weeks of gestation,1 and preterm birth rates have risen two years in a row, hitting 9.8 percent in 2016 — a 2 percent increase from the year prior.2

That means nearly 1 in 10 babies is now born prematurely in the U.S. Prevalence of low birth weight is also rising. Any newborn weighing less than 5 pounds, 8 ounces is considered underweight. While the most common reason for low birth weight is premature birth, poor maternal nutrition also plays a role.

African-American Women Are Disproportionately Affected

According to the "2018 County Health Rankings Key Findings Report"3 produced by the University of Wisconsin Population Health Institute in collaboration with the Robert Wood Johnson Foundation, underweight births in the U.S. have increased since 2014, and as noted in Mother Jones,4 "Low birth weight is associated with a range of health problems, from infections and brain bleeds in infancy to a higher risk of obesity, diabetes and heart disease later in life."

Because of its health implications for both mother and child, birth weight is a good indicator of public health in general. Interestingly, Southeast and Southwest states are disproportionately affected by low birth weight rates. Racial disparities are also pronounced, with African-Americans having a 13 percent low birth weight rate compared to 8 percent for Asian and Native Americans and 7 percent for Hispanics and Caucasians. African-American women are also four times more likely to die during childbirth.

Vitamin D Optimization Can Prevent 60 Percent of Premature Births

Research shows vitamin D optimization could prevent 60 percent of premature births. Among African-American and Hispanic populations, as much as 70 to 75 percent of all preterm births might be prevented. Many other benefits could also be achieved by making vitamin D testing and optimization part of standard prenatal care. For example:

  • Women with a vitamin D level of above 40 nanograms per milliliter (ng/mL) have a 25 percent lower risk of infections, including respiratory and vaginal infections,5 which in turn lowers their risk of pregnancy complications
  • Comorbidities of pregnancy are 30 percent lower in women who achieve a vitamin D level of at least 40 ng/mL, including diabetes, high blood pressure and pre-eclampsia — a potentially deadly increase in blood pressure and fluid accompanied by low platelets
  • A mother's vitamin D status during pregnancy can have lifelong ramifications for her child. Vitamin D deficiency in pregnancy has been linked to higher rates of childhood allergies, asthma,6,7 colds and flu, dental cavities, diabetes, and even strokes and cardiovascular disease later in life8,9

According to Julie A. Willems Van Dijk, a public health scientist at the University of Wisconsin and a lead researcher on the featured report, "the right kind of action" will be necessary to close the racial gap, and this includes not just medical care but also societal issues such as reducing segregation and improving access to healthy food and employment.10 What she failed to mention was vitamin D optimization — one of the least expensive and quickest acting remedial actions available!

Organic Trade Association to Submit Petition for Vitamin D Health Claim

It's quite remarkable that at a time when there's so much research data supporting the use of vitamin D to dramatically improve pregnancy outcomes, lower preterm birth rates and improve the long-term health of both mother and child, health authorities still make no mention of it whatsoever.

In an effort to break the silence, the Organic & Natural Health Association, which is committed to "empowering conscious consumer choice,"11 will be submitting a health claim petition for vitamin D to the U.S. Food and Drug Administration.

In a press release, executive director and CEO Karen Howard noted "The petition will assert there is a well-established body of research, including that of GrassrootsHealth and its results12 at the Medical University of South Carolina, documenting vitamin D levels of 40 ng/ml or higher reduces the rate of preterm birth by 60 percent."

The petition is being prepared for submission during a planned April 12 meeting at Capitol Hill, where the association will be sharing the message with key legislators and staff. The key message is that vitamin D supplementation "directly impacts health outcomes and is changing the standards of care, in this case, for pregnant women and a generation of children."

40 ng/mL Is the 'Magic' Minimum Number for Reducing Preterm Birth Rates

According to findings by Grassrootshealth, there's a clear and definitive correlation between vitamin D levels and time of gestation — up to 40 ng/mL, where the impact plateaus.13 Overall, evidence shows pregnant women with a vitamin D level between 40 and 60 ng/mL have 46 percent lower preterm birth rate than the general population, while those with a vitamin D level at or above 40 ng/mL by their third trimester have a 59 percent lower risk for premature birth compared to those with levels below 20 ng/mL.14

Among non-Caucasian women (among whom vitamin D deficiency is far more common) the reduction in risk is even more significant. In this group, those who achieved a vitamin D level of 40 ng/mL by their second vitamin D test had a 78 percent lower preterm birth rate — reducing the preterm birth rate from 18 percent to 4 percent! To ignore this astounding improvement in preterm birth rate among African-American women would be foolhardy in the extreme.

preterm birth rate for women
preterm birth rate non-white women

As noted in a 2015 press release announcing the findings:15 "The March of Dimes estimates that the annual cost of preterm births in the United States as $12 billion (for 455,918 children). If approximately 50 percent of preterm births could be prevented in the general population, as this analysis suggests is possible, there could be $6 billion available for other services, and more than 225,000 children and families spared this trauma."

gestation time chart

Researchers Call for Vitamin D Testing as Part of Standard of Prenatal Care

As a result of these findings, the Medical University of South Carolina (MUSC) updated its standard of care for prenatal patients to include vitamin D testing and, if necessary, vitamin D3 supplementation. Pregnant women are typically given 4,000 IU of vitamin D3 per day to start. Regular testing then helps determine whether this dose is sufficient, or how much more might be needed to reach a serum level of at least 40 ng/mL by the third trimester.

MUSC is clearly a frontrunner in this regard, and it's a great start, but it's quite clear vitamin D testing and optimization needs to be expanded across the nation, and there's absolutely no reason not to. It's simple, inexpensive and profoundly effective.

To speed up this change, physicians across the U.S. are encouraged to enroll their pregnant patients in the Protect Our Children NOW! project, which seeks to resolve vitamin D deficiency among pregnant women and children, and raise global awareness about the health risks associated with vitamin D deficiency.

The project was initiated by Carole Baggerly of GrassrootsHealth16 in 2015, and has a panel of 42 vitamin D researchers that provide scientific advice. If you are 12 to 17 weeks pregnant, at least 18 years of age and currently reside in the U.S., this fully sponsored study is available at no cost to you. Participation in the program includes:

  • Free vitamin D blood tests, which you can do from the comfort of your own home
  • Your and your newborn's new questionnaire entries
  • Reporting of results directly to you
  • Free vitamin D supplements

>>>>> Click Here <<<<<

If you are planning a pregnancy, or are more than 17 weeks pregnant, you can still take control of your and your child's health by using the D*Action test kit. It's one of the most cost-effective ways to monitor your vitamin D status. Again, the minimum vitamin D level you're aiming for is 40 ng/mL, while additional research suggests a level between 60 and 80 ng/mL provides the greatest health benefits and widest protection against chronic disease.

Vitamin D Status Is Strongly Correlated With Cancer Risk 

For example, mounting evidence suggests that optimizing your vitamin D level may significantly reduce your risk of cancer, including breast cancer. Most recently, a Japanese study17 published in The BMJ concluded higher vitamin D levels do in fact provide cancer protection, as indicated by many other studies. As reported by Technology Networks:18

"As vitamin D concentrations and metabolism can vary by ethnicity, it is important to find out whether similar effects would be seen in non-Caucasian populations. So an international research team, based in Japan, set out to assess whether vitamin D was associated with the risk of total and site specific cancer. They analyzed data from the Japan Public Health Center-based Prospective Study, involving 33,736 male and female participants aged between 40 to 69 years …

After accounting for … seasonal variation, samples were split into four groups, ranging from the lowest to highest levels of vitamin D. Participants were then monitored for an average of 16 years …

After adjusting for several known cancer risk factors … the researchers found that a higher level of vitamin D was associated with a lower (around 20 percent) relative risk of overall cancer in both men and women … [N]one of the cancers examined showed an increased risk associated with higher vitamin D levels."

As mentioned, the link between vitamin D status and cancer risk has been assessed in many studies, including the following, which found that:  

  • Having a serum vitamin D level of at least 40 ng/mL reduces your risk for cancer by 67 percent, compared to having a level of 20 ng/ml or less.19,20 Most cancers occur in people with a vitamin D blood level between 10 and 40 ng/mL, and the optimal level for cancer protection was identified as being between 40 and 60 ng/mL
  • Women with vitamin D concentrations of at least 30 ng/mL have a 55 percent lower risk of colorectal cancer than those who had a blood level below 18 ng/mL21
  • Women with vitamin D levels above 60 ng/mL have an 83 percent lower risk of breast cancer than those with levels below 20 ng/mL22
  • Women over 55 who raised their average serum level to 38 ng/mL lowered their risk of all invasive cancers, including breast cancer, by 77 percent23
  • Vitamin D also increases your chances of surviving cancer if you do get it,24,25 and this includes melanoma26,27 and breast cancer. In the case of the latter, breast cancer patients with high vitamin D levels are twice as likely to survive than those with low levels.28 Higher vitamin D levels are also associated with a lower risk of severe peripheral neuropathy in cancer patients29

Additional studies can be found on GrassrootHealth's vitamin D*Action breast cancer page,30 where you can also enroll in the D*Action Breast Cancer Prevention project, which now includes both vitamin D and omega-3 testing. Besides cancer protection, vitamin D sufficiency also lowers your mortality risk from all causes.31,32

It even lowers your risk of Type 2 diabetes by about 60 percent, as evidenced by a GrassrootsHealth analysis.33 Here, those with a median vitamin D level of 41 ng/mL had a diabetes rate of 3.7 per 1,000, compared to a rate of 9.3 per 1,000 among those with a median serum level of 22 ng/mL.

Be Mindful of the Interplay of Vitamins D and K2, Calcium and Magnesium

The best way to optimize your vitamin D level is through sensible sun exposure, but for many, oral supplementation will be necessary to achieve an optimal level, especially if you're pregnant during the winter. Remember, the only way to accurately assess your need for supplementation is to measure your vitamin D level. It's a simple, relatively inexpensive blood test. Considering the extreme cost of pregnancy complications and preterm birth, the cost of vitamin D testing and supplementation is negligible.

Just keep in mind that if you take high-dose vitamin D, you may also need to increase your intake of calcium, magnesium and vitamin K2 as well, as these four nutrients work in tandem and rely on sufficient amounts of each to work properly. Importantly, excessive vitamin D in combination with lack of vitamin K2 may cause overabsorption of calcium, which in turn may result in calcium deposits in your heart and kidneys.

Maintaining an appropriate calcium-to-magnesium ratio34 is also important, as magnesium helps keep calcium in your cells so they can function better. A ratio of 1-to-1 appears to be ideal. Magnesium is also required for the activation of vitamin D. Without sufficient magnesium, taking a vitamin D supplement may be ineffective, essentially making it appear you need unnecessarily high amounts. Magnesium and vitamin K2 also complement each other.

Preterm Birth Rate Can Be Significantly and Immediately Slashed

At this point, there's simply no doubt that maintaining a vitamin D level of 40 to 60 ng/mL during pregnancy is one of the most important strategies you can implement, both for your own health and for the health of your child. The science is done and the results are in. It just needs to be put into practice. I cannot think of any other measure that can reduce pregnancy complications, deaths and future health problems for less money, and be as safe and risk free.35

If you're planning a pregnancy or are already pregnant, please, get your vitamin D tested, and if you're below 40 ng/mL, take a vitamin D3 supplement (and make sure you're getting sufficient amounts of vitamin K2, magnesium and calcium as well). One in 10 children is born prematurely in the U.S., and there's simply no reason for this tragedy to continue. This rate can be cut by at least 60 percent simply by making vitamin D optimization a standard part of prenatal care.

Again, if you're between 12 and 17 weeks pregnant, you can enroll for free in the Protect Our Children NOW! study. If you're planning a pregnancy, or have passed the 17-week mark, enrolling in the D*Action study is a cost-effective way to get regular testing done. The D*Action study is also open to non-pregnant women, as well as men and children.

+ Sources and References