Supplementation of vitamin D in pregnancy and its correlation with feto‐maternal outcome

Sablok, Aanchal; Batra, Aruna; Thariani, Karishma; Batra, Achla; Bharti, Rekha; Aggarwal, Abha; Kabi, B C; Chellani, Harish

doi:10.1111/cen.12751

Cited by 167 publications

(206 citation statements)

References 38 publications

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“…40 Furthermore, studies with sample size >100, low risk of bias, and single-dose vitamin D supplementation all showed that vitamin D supplement could reduce the risk of PTB, but we could not draw a conclusion because the subgroups had only one or two RCTs, and the results may be misleading. Sensitivity analysis of RCT indicated that the Sablok et al 34 and Grant et al studies 37 could both significantly affect the results. A possible reason is that the small sample size generated less stable results, therefore it is difficult to exclude the possibility that the positive association is due to chance.…”

Section: Discussionmentioning

confidence: 99%

“…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. Most studies defined PTB as delivery before 37 weeks' gestation, but two studies used a threshold of <35 weeks.…”

Section: Literature Searchmentioning

confidence: 99%

“…OR) for PTB among women receiving supplement ranged from 0.06 to 1.20, and positive and significant results were reported in one out of the six RCT. 34 All of the interventions consisted of supplement of oral vitamin D alone, and the comparison was placebo or routine care (ferrous sulfate 200 mg and calcium 600 mg daily, but no vitamin D). Of the six RCT, three had a low risk of bias, one had a moderate risk of bias, and two had a high risk of bias.…”

Section: Literature Searchmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Literature Searchmentioning

confidence: 99%

Section: Literature Searchmentioning

confidence: 99%

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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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“…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].…”

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

106

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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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“…Epidemiological data have shown that deficiency during pregnancy causes higher risk of maternal preeclampsia [55][56][57][58], gingivitis, and periodontal disease in the mother [59,60] and impaired fetal growth [61,62], impaired dentition [63,64], and increased risk of respiratory syncytial virus infection [65] in the infant. A recent RCT in India showed that women who were given vitamin D supplementation during pregnancy had a 61% lower risk of preterm labor and a 47% lower risk of hypertensive complications compared to participants who were not given supplementation [66]. In another RCT, vitamin D supplementation of 4000 IU/day was shown to be safe and effective in achieving sufficiency (32 ng/mL) for pregnant women and their infants, whereas 400 IU/day was ineffective [67][68][69].…”

Section: Pregnancymentioning

confidence: 99%

Sunlight and Vitamin D: Necessary for Public Health

Baggerly

Cuomo

French

et al. 2015

Journal of the American College of Nutrition

122

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Supplementation of vitamin D in pregnancy and its correlation with feto‐maternal outcome

Abstract: Vitamin D supplementation reduces risk of maternal comorbidities and helps improve neonatal outcomes.

Cited by 167 publications

References 38 publications

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

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

Sunlight and Vitamin D: Necessary for Public Health

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