Prenatal exposure to vitamin D from fortified margarine and risk of fractures in late childhood. Period and cohort results from 222 000 subjects in the D-tect observational study
Abstract
Prenatal low vitamin D may have consequences for bone health. By means of a nationwide mandatory vitamin D fortification program, we examined the risk of fractures among 10-18 year old children from proximate birth cohorts born around the date of the termination of the program. For all subjects born in Denmark during 1983-1988, civil registration numbers were linked to the Danish National Patient Registry for incident and recurrent fractures occurring at ages 10-18 years. Multiplicative Poisson models were used to examine the association between birth cohort and fracture rates. The variation in fracture rates across birth cohorts was analyzed by fitting an age-cohort model to the data. We addressed the potential modification of the effect of vitamin D availability by season of birth. The risk of fractures was increased among both girls and boys who were born before the vitamin D fortification terminated in 1985 (rate ratio (RR) exposed vs. non-exposed girls: 1.15 (95% confidence interval (CI): 1.11, 1.20; RR exposed vs. non-exposed boys: 1.11 (95% CI: 1.07, 1.14). However, these associations no longer persisted after including the period effects. There was no interaction between season of birth and vitamin D availability in relation to fracture risk.The study did not provide evidence that prenatal exposure to extra vitamin D from a mandatory fortification program of 1.25 µg vitamin D/100 g margarine was sufficient to influence the risk of fractures in late childhood,…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 18 participants or records.
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