{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T19:56:51Z","timestamp":1773518211106,"version":"3.50.1"},"reference-count":37,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2022,9,22]],"date-time":"2022-09-22T00:00:00Z","timestamp":1663804800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institutes of Health (NIH) NIGMS","award":["#1S06GM127911.01"],"award-info":[{"award-number":["#1S06GM127911.01"]}]},{"name":"Native American Research Centers for Health (NARCH)","award":["#1S06GM127911.01"],"award-info":[{"award-number":["#1S06GM127911.01"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>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\u2019s 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\u20132019. 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 \u2265 60 vitamin D3 refill days had higher late pregnancy 25(OH)D concentrations than those with no refill days (p &lt; 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 &lt; 0.0001). Three children were diagnosed with nutritional rickets during the period 2001\u20132021, 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.<\/jats:p>","DOI":"10.3390\/nu14193935","type":"journal-article","created":{"date-parts":[[2022,9,22]],"date-time":"2022-09-22T23:07:55Z","timestamp":1663888075000},"page":"3935","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Impact of a Prenatal Vitamin D Supplementation Program on Vitamin D Deficiency, Rickets and Early Childhood Caries in an Alaska Native Population"],"prefix":"10.3390","volume":"14","author":[{"given":"Rosalyn J.","family":"Singleton","sequence":"first","affiliation":[{"name":"Department of Research Services, Alaska Native Tribal Health Consortium, Anchorage, AK 99508, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gretchen M.","family":"Day","sequence":"additional","affiliation":[{"name":"Department of Research Services, Alaska Native Tribal Health Consortium, Anchorage, AK 99508, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy K.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Research Services, Alaska Native Tribal Health Consortium, Anchorage, AK 99508, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph A.","family":"Klejka","sequence":"additional","affiliation":[{"name":"Department of Quality, Yukon Kuskokwim Health Corporation, Bethel, AK 99559, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine A.","family":"Desnoyers","sequence":"additional","affiliation":[{"name":"Department of Quality, Yukon Kuskokwim Health Corporation, Bethel, AK 99559, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melanie N. P.","family":"McIntyre","sequence":"additional","affiliation":[{"name":"Laboratory, Yukon Kuskokwim Health Corporation, Bethel, AK 99559, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David M.","family":"Compton","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Yukon Kuskokwim Health Corporation, Bethel, AK 99559, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth E.","family":"Thummel","sequence":"additional","affiliation":[{"name":"School of Pharmacy, University of Washington, Seattle, WA 99559, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6262-5378","authenticated-orcid":false,"given":"Robert J.","family":"Schroth","sequence":"additional","affiliation":[{"name":"Department of Preventive Dental Science, University of Manitoba, Winnipeg, MB R3E 3P4, Canada"},{"name":"Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB R3E 3P4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leanne M.","family":"Ward","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Ottawa, Ottawa, ON K1 H8 L1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dane C.","family":"Lenaker","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Southeast Alaska Regional Health Consortium, Juneau, AK 99801, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel K.","family":"Lescher","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Alaska Native Tribal Health Consortium, Anchorage, AK 99508, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph B.","family":"McLaughlin","sequence":"additional","affiliation":[{"name":"Division of Public Health, State of Alaska, Anchorage, AK 99508, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1503\/cmaj.061377","article-title":"Vitamin D-deficiency rickets among children in Canada","volume":"177","author":"Ward","year":"2007","journal-title":"Can. Med. Assoc. J."},{"key":"ref_2","first-page":"72","article-title":"Nutritional rickets among breast-fed black and Alaska Native children","volume":"39","author":"Gessner","year":"1997","journal-title":"Alsk. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1515\/jpem-2014-0446","article-title":"Rickets and vitamin D deficiency in Alaska native children","volume":"28","author":"Singleton","year":"2015","journal-title":"J. Pediatr. Endocrinol. Metab."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"20244","DOI":"10.3402\/ijch.v72i0.20244","article-title":"Severe vitamin D deficiency in 6 Canadian First Nation formula-fed infants","volume":"72","author":"Gross","year":"2013","journal-title":"Int. J. Circumpolar Health"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"318","DOI":"10.3945\/jn.115.223388","article-title":"Genetics, Diet, and Season Are Associated with Serum 25-Hydroxycholecalciferol Concentration in a Yup\u2019ik Study Population from Southwestern Alaska","volume":"146","author":"Fohner","year":"2016","journal-title":"J. Nutr."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"62","DOI":"10.3402\/ijch.v66i1.18228","article-title":"Nutrient intakes are associated with adherence to a traditional diet among Yup\u2019ik Eskimos living in remote Alaska Native communities: The CANHR Study","volume":"66","author":"Bersamin","year":"2007","journal-title":"Int. J. Circumpolar Health"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.1093\/jn\/134.6.1447","article-title":"Arctic Indigenous Peoples Experience the Nutrition Transition with Changing Dietary Patterns and Obesity","volume":"134","author":"Kuhnlein","year":"2004","journal-title":"J. Nutr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1111\/j.1753-4887.2011.00406.x","article-title":"Vitamin D deficiency and disease risk among aboriginal Arctic populations","volume":"69","author":"Sharma","year":"2011","journal-title":"Nutr. Rev."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1746","DOI":"10.3945\/jn.111.139006","article-title":"Food Insecurity and Nutrition Transition Combine to Affect Nutrient Intakes in Canadian Arctic Communities","volume":"141","author":"Egeland","year":"2011","journal-title":"J. Nutr."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1016\/j.jada.2006.04.026","article-title":"Diet Quality among Yup\u2019ik Eskimos Living in Rural Communities Is Low: The Center for Alaska Native Health Research Pilot Study","volume":"106","author":"Bersamin","year":"2006","journal-title":"J. Am. Diet. Assoc."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1210\/jc.2010-2704","article-title":"The 2011 Report on Dietary Reference Intakes for Calcium and Vitamin D from the Institute of Medicine: What Clinicians Need to Know","volume":"96","author":"Ross","year":"2011","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e1229","DOI":"10.1542\/peds.2014-2173","article-title":"Optimizing Bone Health in Children and Adolescents","volume":"134","author":"Golden","year":"2014","journal-title":"Pediatrics"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"454","DOI":"10.3945\/ajcn.115.127985","article-title":"The vitamin D status of the US population from 1988 to 2010 using standardized serum concentrations of 25-hydroxyvitamin D shows recent modest increases","volume":"104","author":"Schleicher","year":"2016","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1542\/peds.2007-1894","article-title":"Vitamin D Deficiency in Children and Its Management: Review of Current Knowledge and Recommendations","volume":"122","author":"Misra","year":"2008","journal-title":"Pediatrics"},{"key":"ref_15","first-page":"1738","article-title":"Declines in traditional marine food intake and vitamin D levels from the 1960s to present in young Alaska Native women","volume":"20","author":"Bulkow","year":"2016","journal-title":"Public Health Nutr."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1016\/S0003-9969(87)80010-9","article-title":"Histology and microradiography of earlypost-natal molar tooth development in vitamin-D deficient rats","volume":"32","author":"Berdal","year":"1987","journal-title":"Arch. Oral Biol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1177\/0022034512444929","article-title":"Hypoplasia-associated Severe Early Childhood Caries\u2014A Proposed Definition","volume":"91","author":"Caufield","year":"2012","journal-title":"J. Dent. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1016\/S0022-3476(81)80580-X","article-title":"The etiology of enamel hypoplasia: A unifying concept","volume":"98","author":"Nikiforuk","year":"1981","journal-title":"J. Pediatr."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e1277","DOI":"10.1542\/peds.2013-2215","article-title":"Prenatal Vitamin D and Dental Caries in Infants","volume":"133","author":"Schroth","year":"2014","journal-title":"Pediatrics"},{"key":"ref_20","unstructured":"Centers for Disease Control and Prevention (2011). Dental caries in rural Alaska Native children\u2014Alaska, 2008. MMWR. Morb. Mortal. Wkly. Rep., 60, 1275\u20131278."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1726256","DOI":"10.1080\/22423982.2020.1726256","article-title":"A comparison of individual-level vs. hypothetically pooled mercury biomonitoring data from the Maternal Organics Monitoring Study (MOMS), Alaska, 1999\u20132012","volume":"79","author":"Mosites","year":"2020","journal-title":"Int. J. Circumpolar Health"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1177\/0022034519834518","article-title":"Association of Maternal Vitamin D Deficiency with Early Childhood Caries","volume":"98","author":"Singleton","year":"2019","journal-title":"J. Dent. Res."},{"key":"ref_23","unstructured":"(2016). Vitamin D Deficiency in Prenatal Alaska Native Women, State of Alaska Epidemiology Bulletin, No 27."},{"key":"ref_24","unstructured":"State of Alaska (2018). Vitamin D Supplementation and Screening for the Prevention of Rickets and Osteomalacia in Alaska. Epi-Demiology Bull. Recomm. Rep., 20."},{"key":"ref_25","unstructured":"Institute of Medicine (2011). Dietary Reference Intakes for Calcium and Vitamin D, National Academies Press."},{"key":"ref_26","unstructured":"Alaska Department of Labor and Workforce Development, R.a.A.S (2021, August 24). Alaska Population by Age, Sex, Bridged Race and Hispanic Origin, 2000 to 2010, Available online: https:\/\/live.laborstats.alaska.gov\/pop\/index.cfm."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1590\/1516-3180.20161343T2","article-title":"Vitamin D supplementation for women during pregnancy","volume":"134","author":"Palacios","year":"2016","journal-title":"Sao Paulo Med. J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.jsbmb.2016.02.008","article-title":"Vitamin D supplementation during pregnancy: Updated meta-analysis on maternal outcomes","volume":"164","author":"Palacios","year":"2016","journal-title":"J. Steroid Biochem. Mol. Biol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e143","DOI":"10.1542\/peds.2013-2602","article-title":"Vitamin D During Pregnancy and Infancy and Infant Serum 25-Hydroxyvitamin D Concentration","volume":"133","author":"Grant","year":"2014","journal-title":"Pediatrics"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1111\/cen.12989","article-title":"The persistence of maternal vitamin D deficiency and insufficiency during pregnancy and lactation irrespective of season and supplementation","volume":"84","author":"Kramer","year":"2016","journal-title":"Clin. Endocrinol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1093\/pch\/pxac003","article-title":"Canadian Paediatric Society; First Nations, Inuit, and Metis Health Committee. Preventing symptomatic vitamin D deficiency and rickets among Indigenous infants and children in Canada","volume":"27","author":"Irvine","year":"2022","journal-title":"Paediatr. Child Health"},{"key":"ref_32","unstructured":"American College of Obstetricians and Gynecologists (ACOG) (2011). Vitamin D: Screening and Sup-plementation During Pregnancy. Obstet. Gynecol., 118, 197\u2013198."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Nutrition Working Group, O\u2019Connor, D.L., Blake, J., Bell, R., Bowen, A., Callum, J., Fenton, S., Gray-Donald, K., Rossiter, M., and Adamo, K. (2016). Canadian consensus on female nutrition: Adolescence, reproduction, menopause, and beyond. J. Obstet. Gynaecol. Can., 38, 508\u2013554.","DOI":"10.1016\/j.jogc.2016.01.001"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1186\/1471-2431-13-174","article-title":"Vitamin D status of children with severe early childhood caries: A case\u2013control study","volume":"13","author":"Schroth","year":"2013","journal-title":"BMC Pediatr."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"g2035","DOI":"10.1136\/bmj.g2035","article-title":"Vitamin D and multiple health outcomes: Umbrella review of systematic reviews and meta-analyses of observational studies and randomised trials","volume":"348","author":"Theodoratou","year":"2014","journal-title":"BMJ"},{"key":"ref_36","first-page":"5","article-title":"Prenatal and early childhood determinants of enamel hypoplasia in infants","volume":"5","author":"Schroth","year":"2021","journal-title":"J. Pediatrics Perinatol. Child Health"},{"key":"ref_37","first-page":"k13","article-title":"The Influence of Prenatal Vitamin D Supplementation on Dental Caries in Infants","volume":"86","author":"Schroth","year":"2020","journal-title":"J. Can. Dent. Assoc."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/14\/19\/3935\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:37:28Z","timestamp":1760143048000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/14\/19\/3935"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,22]]},"references-count":37,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2022,10]]}},"alternative-id":["nu14193935"],"URL":"https:\/\/doi.org\/10.3390\/nu14193935","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,22]]}}}