Maternal Vitamin D Insufficiency Early in Pregnancy Is Associated with Increased Risk of Preterm Birth in Ethnic Minority Women in Canada

Tabatabaei, Negar; Auger, Nathalie; Herba, Catherine M.; Wei, Shuqin; Allard, Catherine; Fink, Guy D.; Fraser, William D.

doi:10.3945/jn.116.241216

Cited by 29 publications

(28 citation statements)

References 34 publications

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“…A total of 1639 were excluded after reading titles and/or abstracts, and 75 articles were subjected to a full-text review. After reading the full text, a total of 24 cohorts were invited to participate, which included 13 cohort studies [27][28][29][30][31][32][33][34][35][36][37][38][39], seven case-control studies [40][41][42][43][44][45][46] and four cross-sectional studies [47][48][49][50].…”

Section: Search Resultsmentioning

confidence: 99%

“…Because three studies [29][30][31] of 24 measured serum 25(OH)D concentrations at two or three periods of pregnancies, our meta-analysis included nine studies [28][29][30][31]36,39,41,44,46] in the first trimester, 11 studies [27,[30][31][32][33][34][35]37,38,40,43] in the second trimester, and nine studies [29][30][31]42,45,[47][48][49][50] in the third trimester.…”

Section: Search Resultsmentioning

confidence: 99%

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Does Vitamin D Deficiency in Different Periods of Gestation Have the Same Effect on Preterm Birth? A Systematic Review and Meta-Analysis

Lian

et al. 2020

Preprint

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Background: Current studies suggest that vitamin D deficiency during pregnancy can produce a certain effect for preterm birth, but there is no research showing whether vitamin D deficiency has a consistent effect in different pregnancies; thus, we conducted a systematic review and meta-analysis of 24 observational studies, grouping them according to the gestational age at the time of serum sampling, to investigate whether vitamin D deficiency in different periods of gestation has different effects on preterm birth and to provide an evidence-based basis for pregnant women to measure and supplement vitamin D. Methods: The databases PubMed-Medline, EMBASE, the Cochrane Library, Web of Science, EBSCO, CBM, and CNKI were searched until July 2019. Two researchers independently assessed the eligibility and quality of studies, and STATA 12.0 software was used for meta-analysis. Result: Seven cohort studies, 13 case-control studies, and four cross-sectional studies were included from 2500 articles by inclusion and exclusion criteria. After adjusting for age, race, and other confounding factors, meta-analysis results showed that vitamin D deficiency in the first trimester, the second trimester and the third trimester did not increase the risk of preterm birth (odds ratio (OR) = 1.01, 95% confidence interval (CI) (0.88, 1.16), P = 0.867; OR = 1.12, 95%CI (0.92, 1.37), P = 0.249; OR = 1.05, 95%CI (0.87, 1.27), P = 0.602). However, there was moderate heterogeneity in the study of vitamin D deficiency in the second trimester, and subgroup analysis suggested that vitamin D deficiency in the second trimester may increase the risk of preterm birth (OR = 1.33, 95%CI (1.15, 1.54), P = 0.000). A sensitivity analysis of the second trimester showed that excluding any one study did not significantly change the results. Conclusions: Vitamin D deficiency in early and late pregnancy may not be associated with preterm birth, while vitamin D deficiency in middle pregnancy is likely to have an important effect on preterm birth. Vitamin D levels should be measured in the second trimester of pregnancy, and vitamin D supplements should be provided if necessary.

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Section: Search Resultsmentioning

confidence: 99%

Section: Search Resultsmentioning

confidence: 99%

Does Vitamin D Deficiency in Different Periods of Gestation Have the Same Effect on Preterm Birth? A Systematic Review and Meta-Analysis

Lian

et al. 2020

Preprint

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“…In a cohort study by Wagner et al, Hispanic women with serum 25(OH)D > 40 ng/ml had 79% reduced risk of preterm birth in comparison with those with serum 25(OH)D ≤ 20 ng/ml, while the reduced risk was 45% among black women [83]. Also, an increased risk of preterm birth associated with Vitamin D insufficiency in ethnic minority women in Canada [84] suggests the stratification of women based on their ethnicity in further studies. Another important thing should be considered in study design is the association of vitamin D status in different gestational age with pregnancy outcome.…”

Section: Preterm Deliverymentioning

confidence: 99%

Maternal Vitamin D Status among Different Ethnic Groups and Its Potential Contribution to Adverse Pregnancy and Child Outcomes

Keshavarz¹,

Jandaghi²,

Shafiee³

et al. 2020

Vitamin D Deficiency

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Maternal vitamin D deficiency in pregnancy is a widespread public health concern. Race and ethnicity as biological and cultural factors, respectively, can affect vitamin D status through differences in skin color, sunlight exposure, and dietary intake. Low maternal vitamin D status in pregnancy may affect both mother and fetus adversely. Vitamin D deficiency and insufficiency are linked to a wide variety of adverse pregnancy outcomes such as gestational diabetes, preeclampsia, and preterm delivery. Furthermore, maternal vitamin D deficiency has been linked to several adverse health outcomes in infants and children. The examples include, but not limited to, impaired growth, skeletal problems, and autoimmune diseases such as type 1 diabetes and asthma. This chapter reviews the vitamin D status during pregnancy across different ethnic groups, looking into the adverse pregnancy and child outcomes, followed by a discussion on the association between maternal and child vitamin D status and successful interventions. Strong evidence exists about the association between vitamin D and some health outcomes during pregnancy, while more studies are needed to confirm the other claim. The existing body of evidence justifies the need for well-designed policies and systematic interventions to ensure optimal vitamin D status of pregnant women and their offsprings across different ethnic and racial groups.

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“…Research has shown that serum 25(OH)D concentration increases by 1 ng/mL for every 100 units of vitamin D intake per day . Therefore, vitamin D supplementation of 1000 units daily in a severely vitamin D‐deficient pregnant woman with a 25(OH)D concentration of 8 ng/mL would only increase serum 25(OH)D concentration to 18 ng/mL, which is still considered deficient and well below the point at which conversion of 25(OH)D to 1,25(OH) 2 D is optimized .…”

Section: Vitamin D Preterm Birth and Preeclampsiamentioning

confidence: 99%

“…The 4 studies that have been published and not included in the most recent meta‐analysis found a significant association between maternal vitamin D deficiency and preterm birth risk. For example, in the study by Rostami et al, pregnant Iranian women enrolled at less than 14 weeks’ gestation received vitamin D supplementation based on their baseline 25(OH)D .…”

Section: Vitamin D Preterm Birth and Preeclampsiamentioning

confidence: 99%

Evidence of an Association Between Vitamin D Deficiency and Preterm Birth and Preeclampsia: A Critical Review

Woo

Giurgescu

Wagner

2019

J Midwife Womens Health

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Vitamin D deficiency has been associated with adverse pregnancy and birth outcomes such as increased risk for preterm birth and preeclampsia. This state of the science review analyzed recently published meta-analyses and relevant studies that have evaluated the association between vitamin D deficiency and preeclampsia or preterm birth. The results suggest that a positive association between vitamin D deficiency and preterm birth exists. However, the findings of the relationship between vitamin D deficiency and preeclampsia were inconclusive, possibly because of the need for supplementation to occur prior to placentation. This may be because of a lack of studies with ethnic minority populations, who are more likely to experience vitamin D deficiency, and inadequate supplementation doses used for treatment of vitamin D deficiency. Health care providers should screen pregnant women at risk for vitamin D deficiency and supplement women accordingly based on their vitamin D status. Lastly, well-designed and standardized clinical trials need to include large cohorts of minority pregnant women to establish the impact of vitamin D supplementation on improving preterm birth and preeclampsia risk in pregnancy.

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Maternal Vitamin D Insufficiency Early in Pregnancy Is Associated with Increased Risk of Preterm Birth in Ethnic Minority Women in Canada

Cited by 29 publications

References 34 publications

Does Vitamin D Deficiency in Different Periods of Gestation Have the Same Effect on Preterm Birth? A Systematic Review and Meta-Analysis

Does Vitamin D Deficiency in Different Periods of Gestation Have the Same Effect on Preterm Birth? A Systematic Review and Meta-Analysis

Maternal Vitamin D Status among Different Ethnic Groups and Its Potential Contribution to Adverse Pregnancy and Child Outcomes

Evidence of an Association Between Vitamin D Deficiency and Preterm Birth and Preeclampsia: A Critical Review

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