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Randomized Controlled Trial
. 2025 Sep;36(9):1583-1591.
doi: 10.1007/s00198-025-07568-0. Epub 2025 Jun 23.

Pregnancy vitamin D supplementation and bone mineral density of the mother: a post hoc analysis of the MAVIDOS randomised placebo-controlled trial

Rebecca J Moon  1   2   3 , Stefania D'Angelo  4   5 , Elizabeth M Curtis  4   6 , Kate A Ward  4   6 , Keith M Godfrey  4   6 , Cyrus Cooper  4   6   5   7 , Nicholas C Harvey  4   6
Affiliations
Randomized Controlled Trial

Pregnancy vitamin D supplementation and bone mineral density of the mother: a post hoc analysis of the MAVIDOS randomised placebo-controlled trial

Rebecca J Moon et al. Osteoporos Int. 2025 Sep.

Abstract

The effect of pregnancy vitamin D supplementation on bone mineral density (BMD) in the mother immediately after delivery and at 4 years after delivery was assessed in a randomised placebo-controlled trial. The mothers' BMD did not differ between the two intervention groups.

Purpose: Vitamin D supplementation during pregnancy has positive effects on the offspring's bone development and bone mineral density (BMD) in childhood, but there are limited data on the effects on the mother's skeleton. We assessed this in a post hoc follow-up of a randomised trial.

Methods: MAVIDOS was a randomised placebo-controlled trial of 1000 IU/day cholecalciferol from 14 to 17 weeks gestation until delivery. Participants were invited to have a dual-energy X-ray absorptiometry (DXA) scan of the whole body, lumbar spine (LS) and left hip within 2 weeks after delivery and again 4 years after delivery. BMD was compared between the cholecalciferol and placebo groups; in women with DXA at both time points, the effect of cholecalciferol was assessed using mixed effects modelling to account for repeated measures.

Results: Four hundred one and 443 participants had a DXA within 2 weeks after delivery and at a mean of 4.1 years after delivery, respectively. Cholecalciferol supplementation increased serum 25-hydroxyvitamin D status in late pregnancy compared to placebo. BMD at all sites was similar between the two randomisation groups at both time points (p > 0.05 for all). Two hundred sixty-three participants had a DXA at both birth and 4 years. BMD increased between 1 and 6% depending on the site from within 2 weeks to 4 years after delivery. This was similar between randomisation groups. The pregnancy cholecalciferol had no effect on BMD at 4 years in repeated measures modelling.

Conclusions: Despite previously demonstrated benefits for the offspring skeleton in this trial, maternal BMD did not differ in the short or medium term in women randomised to 1000 IU/day vitamin D or placebo.

Keywords: Bone mineral density; Cholecalciferol; Epidemiology; Osteoporosis; Pregnancy; Vitamin D.

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Conflict of interest statement

Declarations. Conflicts of interest: RJM has received travel bursaries from Kyowa Kirin unrelated to this work. EMC has received travel bursaries, consultancy or lecture fees from Celltrion, Eli Lilly, Pfizer, Theramex, Thornton and Ross and UCB, unrelated to this work. KMG has received reimbursement for speaking at conferences sponsored by companies selling nutritional products and is part of an academic consortium that has received research funding from Bayer, Nestec, BenevolentAI Bio Ltd., Boehringer-Ingelheim and Danone, outside the submitted work. KAW received Honoraria from Abbott Nutrition and Nestle Nutrition unrelated to this work. CC reports personal fees from ABBH, Amgen, Eli Lilly, GSK, Medtronic, Merck, Novartis, Pfizer, Roche, Servier and Takeda, outside the submitted work. NCH reports personal fees, consultancy, lecture fees and honoraria from Alliance for Better Bone Health, AMGEN, MSD, Eli Lilly, Servier, Theramex, Shire, Consilient Healthcare, Kyowa Kirin and Internis Pharma, outside the submitted work.

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