Effects of vitamin D in pregnancy on maternal and offspring health-related outcomes: An umbrella review of systematic review and meta-analyses.
Study Goal
The researchers aimed to summarize systematic reviews and meta-analyses on the effects of vitamin D deficiency and supplementation during pregnancy on maternal and offspring health outcomes.
Results Summary
Vitamin D deficiency in pregnancy was associated with increased risks of preterm birth, small-for-gestational-age infants, recurrent miscarriage, bacterial vaginosis, and gestational diabetes. Supplementation improved birth weight and reduced risks of pre-eclampsia, miscarriage, neonatal mortality, ADHD, and autism spectrum disorder.
Population
Pregnant women, particularly those at high risk of vitamin D deficiency.
Effective Dosage
>400 IU/day
Duration
Duration of pregnancy (not specified further)
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
vitamin D deficiency in pregnancy | increase | preterm birth | women | - | is associated with increased risk of | #1 |
vitamin D deficiency in pregnancy | increase | small-for gestational age/low birth weight infants | women | - | is associated with increased risk of | #2 |
vitamin D deficiency in pregnancy | increase | recurrent miscarriage | women | - | is associated with increased risk of | #3 |
vitamin D deficiency in pregnancy | increase | bacterial vaginosis | women | - | is associated with increased risk of | #4 |
vitamin D deficiency in pregnancy | increase | gestational diabetes mellitus | women | - | is associated with increased risk of | #5 |
vitamin D supplementation in pregnancy | increase | birth weight | pregnant women | - | increases | #6 |
vitamin D supplementation in pregnancy | decrease | maternal pre-eclampsia | pregnant women | - | reduces the risk of | #7 |
vitamin D supplementation in pregnancy | decrease | miscarriage | pregnant women | - | reduces the risk of | #8 |
vitamin D supplementation in pregnancy | decrease | vitamin D deficiency | pregnant women | - | reduces the risk of | #9 |
vitamin D supplementation in pregnancy | decrease | fetal or neonatal mortality | pregnant women | - | reduces the risk of | #10 |
vitamin D supplementation in pregnancy | decrease | attention-deficit hyperactivity disorder | offspring in childhood | - | reduces the risk of | #11 |
vitamin D supplementation in pregnancy | decrease | autism spectrum disorder | offspring in childhood | - | reduces the risk of | #12 |
vitamin D supplementation in pregnancy | decrease | maternal hyperbilirubinemia | women with gestational diabetes mellitus | - | can reduce the risk of | #13 |
vitamin D supplementation in pregnancy | decrease | polyhydramnios | women with gestational diabetes mellitus | - | can reduce the risk of | #14 |
vitamin D supplementation in pregnancy | decrease | macrosomia | women with gestational diabetes mellitus | - | can reduce the risk of | #15 |
vitamin D supplementation in pregnancy | decrease | fetal distress | women with gestational diabetes mellitus | - | can reduce the risk of | #16 |
vitamin D supplementation in pregnancy | decrease | neonatal hospitalization | women with gestational diabetes mellitus | - | can reduce the risk of | #17 |
vitamin D supplementation during pregnancy | decrease | adverse outcomes | pregnant women | >400 IU/day | to prevent certain adverse outcomes | #18 |
BACKGROUND: Vitamin D deficiency has been linked with several adverse maternal and fetal outcomes. OBJECTIVE: To summarize systematic reviews and meta-analyses evaluating the effects of vitamin D deficiency and of vitamin D supplementation in pregnancy on maternal and offspring health-related outcomes. METHODS: Prior to conducting this umbrella review, we registered the protocol in PROSPERO (CRD42022368003). We conducted searches in PubMed, Embase, and Cochrane Library for systematic reviews and meta-analyses on vitamin D in pregnancy, from database inception to October 2, 2023. All outcomes related to vitamin D in pregnancy obtained from the systematic reviews and meta-analyses were extracted. DATA EXTRACTION: Two reviewers independently chose studies and collected information on health outcomes. The quality of the included articles' methodology was assessed using AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews-2). RESULTS: We identified 16 eligible systematic reviews and meta-analyses, which included 250,569 women. Our results demonstrated that vitamin D deficiency in pregnancy is associated with increased risk of preterm birth, small-for gestational age/low birth weight infants, recurrent miscarriage, bacterial vaginosis and gestational diabetes mellitus. Vitamin D supplementation in pregnancy increases birth weight, and reduces the risk of maternal pre-eclampsia, miscarriage, and vitamin D deficiency, fetal or neonatal mortality, as well as attention-deficit hyperactivity disorder, and autism spectrum disorder in childhood. In women with gestational diabetes mellitus, vitamin D supplementation in pregnancy can reduce the risk of maternal hyperbilirubinemia, polyhydramnios, macrosomia, fetal distress, and neonatal hospitalization. CONCLUSION: Due to the association with adverse maternal and offspring health outcomes, we recommend the vitamin D status in pregnancy should be monitored, particularly in women at high risk of vitamin D deficiency. It is suggested that pregnant women take a dose of >400 IU/day of vitamin D supplementation during pregnancy to prevent certain adverse outcomes.