Efficacy of vitamin D supplementation in gestational diabetes mellitus: Systematic review and meta-analysis of randomized trials.
Study Goal
The researchers aimed to evaluate whether oral vitamin D supplementation (with or without calcium) improved maternal and neonatal outcomes in pregnant women with gestational diabetes mellitus (GDM).
Results Summary
The study found no significant differences in cesarean delivery rates between groups, but vitamin D supplementation may reduce newborn complications like hyperbilirubinemia and polyhydramnios, though evidence quality was low or very low.
Population
Pregnant women with gestational diabetes mellitus (GDM).
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
oral vitamin D supplements | increase | maternal and neonatal outcomes | pregnant women with gestational diabetes mellitus (GDM) | - | would improve | #1 |
vitamin D supplementation | no change | frequency of cesarean deliveries | pregnant women with GDM | - | did not show significant differences | #2 |
vitamin D supplementation | decrease | newborn complications such as hyperbilirubinemia | pregnant women with GDM | RR: 0.40, 95% CI: 0.23 to 0.68 | may reduce | #3 |
vitamin D supplementation | decrease | polyhydramnios | pregnant women with GDM | RR: 0.17, 95% CI: 0.03 to 0.89 | may reduce | #4 |
vitamin D supplementation | decrease | need for maternal hospitalization | pregnant women with GDM | RR: 0.13; 95% CI: 0.02 to 0.98 | may reduce | #5 |
vitamin D supplementation | decrease | need for infant hospitalization | pregnant women with GDM | RR: 0.40, 95% CI: 0.23 to 0.69 | may reduce | #6 |
vitamin D supplementation | no change | glucose metabolism, adverse maternal and neonatal outcomes related to GDM | pregnant women | - | did not find evidence indicating that ... improves | #7 |
BACKGROUND: Trials have examined on the benefits of vitamin D supplementation in pregnant women. OBJECTIVE: This review aimed to evaluate whether oral vitamin D supplements, when given to pregnant women with gestational diabetes mellitus (GDM), would improve maternal and neonatal outcomes, compared with no treatment or placebo. METHOD: We performed a systematic review following Cochrane methodology, and randomized trials were included where pregnant women with GDM received vitamin D supplementation versus placebo/no treatment or vitamin D and calcium versus placebo/no treatment. Primary outcomes were preeclampsia, preterm birth, cesarean delivery, gestational hypertension, and adverse events related to vitamin D supplementation. The search strategies were applied to the following databases: MEDLINE, Embase, LILACS, and CENTRAL. Similar outcomes in at least two trials were plotted using Review Manager 5.3 software. The quality of evidence was generated according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). RESULTS: The total of 1224 references were identified, eleven trials were potentially eligible, and six were included in this review (totaling 456 women). The meta-analysis of frequency of cesarean deliveries did not show significant differences between groups, none of the trials evaluated the remaining primary outcomes. For secondary outcomes, our results suggest that vitamin D supplementation in pregnant women with GDM may reduce newborn complications such as hyperbilirubinemia, polyhydramnios (RR: 0.40, 95% CI: 0.23 to 0.68; RR: 0.17, 95% CI: 0.03 to 0.89; respectively), and the need for maternal or infant hospitalization (RR: 0.13; 95% CI: 0.02 to 0.98; RR: 0.40, 95% CI: 0.23 to 0.69). However, the evidence was of low or very low quality. CONCLUSION: We did not find moderate or high quality evidence indicating that vitamin D supplementation, when compared with placebo, improves glucose metabolism, adverse maternal and neonatal outcomes related to GDM in pregnant women.