Effects of vitamin D in pregnancy on maternal and offspring health-related outcomes: An umbrella review of systematic review and meta-analyses

Chien, Mei-Chun; Huang, Chueh-Yi; Wang, Jie-Huei; Shih, Chia-Lung; Wu, Pensee

Abstract

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.

Citation

Chien, M.-C., Huang, C.-Y., Wang, J.-H., Shih, C.-L., & Wu, P. (in press). Effects of vitamin D in pregnancy on maternal and offspring health-related outcomes: An umbrella review of systematic review and meta-analyses. Nutrition and Diabetes, 14(1), Article 35. https://doi.org/10.1038/s41387-024-00296-0

• Journal Article Type: Article
• Acceptance Date: May 16, 2024
• Online Publication Date: May 30, 2024
• Deposit Date: Jun 3, 2024
• Publicly Available Date: Jun 3, 2024
• Journal: Nutrition & Diabetes
• Publisher: Nature Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 14
• Issue: 1
• Article Number: 35
• DOI: https://doi.org/10.1038/s41387-024-00296-0
• Public URL: https://keele-repository.worktribe.com/output/844732
• Publisher URL: https://www.nature.com/articles/s41387-024-00296-0