Low Prenatal Vitamin D Linked to Later MS in Offspring
Children of mothers with too little vitamin D during their pregnancy may have a higher risk of developing multiple sclerosis when they reach adulthood, a new study suggests.
FAB RESEARCH COMMENT:
Multiple sclerosis in adults was almost twice as common if their mothers who had low Vitamin D levels during their early pregnancy, a new study reports.Of course, 'correlation is not causation'. Furthermore, as the authors of this new study point out themselves, two previous studies have not found a significant link between vitamin D levels in very early life and later development of MS - although adequate Vitamin D is known to be important for normal immune regulation; and indirect evidence such as rates of MS varying with season of birth is consistent with Vitamin D status in early development as a potential causal factor.
So the medical experts cited in news article cannot be faulted for their scientific accuracy and rigour when they say that these new findings:
For 'definitive' evidence of cause and effect, what would of course be needed are randomised, double-blind, placebo-controlled trials of Vitamin D supplementation during pregnancy.
Similarly, some obvious ethical and/or practical objections could be raised to question whether randomised controlled trials really are needed to find out if maternal Vitamin D deficiency increases risks for MS. To offer just two examples:
- allowing pregnant women to remain deficient in Vitamin D by using a genuinely inactive placebo treatment would seem unethical, given what is already known about the essentiality of adequate Vitamin D for the mother's health and wellbeing, and the risks of maternal deficiency to her unborn child*
- the prohibitive difficulty and expense of carrying out sufficiently large scale trials - especially as the children would need to be followed for decades into their adulthood, when MS usually first develops
* Leaving aside the ethics of conducting research involving pregnant women, a bigger question is whether it is ethical for public health authorities to take no effective action to reduce the very high rates of Vitamin D deficiency and insufficiency in the general population.
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07 March 2016 - U.S. News
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Children of mothers with too little vitamin D during their pregnancy may have a higher risk of developing multiple sclerosis when they reach adulthood, a new study suggests.
One expert in the United States said that the findings need to be interpreted with caution, however.
"We cannot say from this study that low vitamin D levels cause MS in women's offspring," said Dr. Daniel Skupski, chair of obstetrics and gynecology at NewYork-Presbyterian/Queens hospital in New York City. All the study points to is an association between the two, he stressed.
What the research does do, Skupski said, is "set the stage" for further research to see if getting more vitamin D in pregnancy might lower people's lifetime risk for multiple sclerosis.
Multiple sclerosis affects a person's brain and spinal cord by damaging the myelin sheath, the insulating layer that surrounds and protects nerve cells, according to the U.S. National Institutes of Health. This leads to symptoms such as muscle weakness, lack of coordination and balance, vision problems, and trouble with thinking and memory.
In the new study, researchers led by Kassandra Munger, of the Harvard School of Public Health in Boston, reviewed information from hundreds of adults in Finland.
The investigators found that people whose mothers hadn't had enough vitamin D in early pregnancy were 90 percent more likely to develop MS compared to people whose mothers had adequate vitamin D levels during pregnancy.
This suggests that vitamin D deficiency during pregnancy may increase a child's risk of MS later in life, the research team said. However, the study authors pointed out that two previous studies had not found a link between early vitamin D levels and later MS, so the jury may still be out on this issue.
Skupski agreed. The results of the latest study "do not tell us if providing vitamin D during pregnancy will improve the outcomes or lower the risk of offspring developing MS," he said.
Dr. Paul Wright is chair of neurology at North Shore University Hospital in Manhasset, N.Y. He also agreed that there have been conflicting results from various prior studies on the issue, and "additional studies" may be needed.
The new study was published online March 7 in the journal JAMA Neurology.
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