Associations between 25-hydroxyvitamin D levels and pregnancy outcomes: a prospective observational study in southern China

Zhou, Jing; Su, Lei; Liu, M; Liu, Y; Cao, Xiaopei; Wang, Z; Xiao, Hang

doi:10.1038/ejcn.2014.99

Cited by 131 publications

(178 citation statements)

References 31 publications

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“…[3536] Zhou et al . [37] examined the effect of vitamin D on pregnancy outcomes, and their results showed that at the end of pregnancy, macrosome neonate, rate of C/S, birth weight, and congenital abnormalities were observed, consistent with our study's results; however, no decrease was observed in the Apgar score, while the prevalence of gestational diabetes and preterm delivery was higher in the group who had received higher levels of vitamin D than in women who had received low or moderate levels of vitamin D.[3738]…”

Section: Discussionsupporting

confidence: 89%

The effect of vitamin D supplementation on gestational diabetes in high-risk women: Results from a randomized placebo-controlled trial

2016

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Background:Vitamin D deficiency is common in pregnancy, leading to increase in the frequency of preeclampsia, cesarean delivery, neonatal bacterial vaginosis, and gestational diabetes. The current study was designed and implemented to investigate the effect of vitamin D during the first and second trimesters of pregnancy in reducing the risk of gestational diabetes mellitus (GDM) in women who are at high risk [history of GDM, birth macrosomia, family history, and high body mass index (BMI)].Materials and Methods:In a randomized, double-blind, and placebo-controlled trial, 90 pregnant women who had at least one risk factor for GDM were randomized into intervention (46 participants) and control (44 participants) groups. Participants in the intervention group took 5000 units of vitamin D daily and the control group took placebo until the 26th week of pregnancy. Then the glucose challenge test (GCT) and the glucose tolerance test (GTT) were performed to evaluate GDM.Results:Mean ± standard deviation (SD) age was 31.28 ± 6.38 years and 29 ± 6.24 years for the intervention group and the placebo group, respectively, (P > 0.05). In addition, there were no significant differences between two groups in terms of vitamin D levels and GCT (P > 0.05), and the difference was not significant. The incidence of diabetes in the intervention groups was statistically lower than in control group (11.4% vs 34.8; P < 0.01). The results showed that abnormal GCT in the placebo group was statistically higher than in intervention group (35.9% vs 10.9 P < 0.005).Conclusion:The results of the current study showed that the prescription of vitamin D supplementation in the first and second trimesters of pregnancy was effective in reducing GDM and controlling GTT and GTC.

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Section: Discussionsupporting

confidence: 89%

The effect of vitamin D supplementation on gestational diabetes in high-risk women: Results from a randomized placebo-controlled trial

2016

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“…The score for one article, however, was unable to be evaluated because the full text was not available, and three RCT had low risk of bias. Table 1 lists the characteristics of the 18 observational studies 9,[12][13][14][15][16][17][18][19][20][21][22][23][24][30][31][32] and six RCT. [33][34][35][36][37][38] There was some disparity in the definition of PTB between studies.…”

Section: Literature Searchmentioning

confidence: 99%

Vitamin D and risk of preterm birth: Up‐to‐date meta‐analysis of randomized controlled trials and observational studies

Zhou

Tao

Huang

et al. 2017

J of Obstet and Gynaecol

110

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Aim: We performed a meta-analysis of randomized controlled trials (RCT) and observational studies to answer the two following questions: (i) whether low maternal circulating 25 hydroxyvitamin D (25-OHD) is associated with an increased risk of preterm birth (PTB) or spontaneous PTB (sPTB); and (ii) whether vitamin D supplementation alone during pregnancy can reduce the risk of PTB. Methods: Literature search was carried out using Pubmed, Web of Science and Embase databases up to June 2016. Pooled OR or relative risk (RR) with 95%CI were computed using fixed or random effects models depending on the size of heterogeneity. Subgroup analysis was used to explore potential sources of between-study heterogeneity. Publication bias was evaluated using Egger's test and Begg's test. Results: Twenty-four articles (six RCT and 18 observational studies) were identified. Maternal circulating 25-OHD deficiency (pooled OR, 1.25; 95%CI: 1.13-1.38) rather than insufficiency (pooled OR, 1.09; 95%CI: 0.89-1.35) was associated with an increased risk of PTB, and vitamin D supplementation alone during pregnancy could reduce the risk of PTB (pooled RR, 0.57; 95%CI: 0.36-0.91). This was also the case for the sPTB subgroup (circulating 25-OHD <50 vs >50 nmol/L; pooled OR, 1.45; 95%CI: 1.20-1.75). Conclusions: Maternal circulating 25-OHD deficiency could increase PTB risk and vitamin D supplementation alone during pregnancy could reduce PTB risk. Extrapolation of the results, however, must be done with caution, and there is urgent need for larger, better-designed RCT to confirm this effect.

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“…Four studies [19, 20, 21, 22] were randomized controlled trials (RCTs).Two studies [23, 24] were post hoc analyses of RCT. Prospective cohort design was applied by six studies [25, 26, 27–29, 30]. One study [31] was a restrospective cohort.…”

Section: Resultsmentioning

confidence: 99%

Maternal vitamin D insufficiency and risk of adverse pregnancy and birth outcomes: A systematic review and meta-analysis of longitudinal studies

Amegah¹,

Klevor²,

Wagner³

2017

PLoS ONE

105

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BackgroundThree previous reviews on the association of vitamin D insufficiency in pregnancy with preterm birth (PTB) and stillbirth were limited in scope and deemed inconclusive. With important new evidence accumulating, there is the need to update the previous estimates and assess evidence on other clinically important outcomes such as spontaneous abortion and Apgar score. We conducted a systematic review and meta-analysis to evaluate the quality and strength of the available evidence on the relations between vitamin D nutritional status, and pregnancy and birth outcomes.MethodsPubMed and Scopus databases were searched from their inception to June, 2015 with no language restrictions imposed. Eighteen longitudinal studies satisfied the inclusion criteria. Random effects model was applied in computing the summary effect estimates and their corresponding 95% confidence intervals.ResultsSerum 25(OH)D levels <75 nmol/l was associated with 83% (95% CI: 1.23, 2.74) and 13% (95% CI: 0.94, 1.36) increased risk of PTB measured at <32–34 weeks and <35–37 weeks, respectively. An inverse dose-response relation was observed for both PTB outcome. Serum 25(OH)D levels <75 nmol/l was also associated with 11% increased risk of spontaneous PTB (<35–37 weeks; RR = 1.11; 95% CI: 0.75, 1.65) with a dose-response relation also noted. Vitamin D insufficiency was not associated with risk of spontaneous abortion and stillbirth (RR of 1.04 [95% CI: 0.95, 1.13] and 1.02 [95% CI: 0.96, 1.09], respectively), as well as short gestational length (ES = -0.24, 95% CI: -0.69, 0.22), and low Apgar score.ConclusionsWe found vitamin D insufficiency to be associated with risk of PTB. Regarding spontaneous abortion and stillbirth, the available evidence suggest no association with low vitamin D levels. The evidence on vitamin D nutrition and Apgar score is conflicting and controversial. Overall, the experimental evidence uncovered was small and weak. Hence, the benefits of vitamin D supplementation during pregnancy should be further evaluated through rigorous intervention studies.

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Associations between 25-hydroxyvitamin D levels and pregnancy outcomes: a prospective observational study in southern China

Cited by 131 publications

References 31 publications

The effect of vitamin D supplementation on gestational diabetes in high-risk women: Results from a randomized placebo-controlled trial

The effect of vitamin D supplementation on gestational diabetes in high-risk women: Results from a randomized placebo-controlled trial

Vitamin D and risk of preterm birth: Up‐to‐date meta‐analysis of randomized controlled trials and observational studies

Maternal vitamin D insufficiency and risk of adverse pregnancy and birth outcomes: A systematic review and meta-analysis of longitudinal studies

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