Pregnancy problems (LBW, PTB, SGA) associated with low vitamin D, 42nd meta-analysis
Effect of maternal vitamin D status on risk of adverse birth outcomes: a systematic review and dose-response meta-analysis of observational studies
Eur J Nutr. 2022 Mar 22. doi: 10.1007/s00394-022-02866-3 PDF is behind a $40 paywall
Rui Zhao 1, Leilei Zhou 1, Shanshan Wang 1, Heng Yin 2, Xuefeng Yang 1, Liping Hao 3
Purpose: Accumulating evidence suggests that vitamin D deficiency increases the risk of adverse perinatal outcomes. However, the dose-response relationship between maternal vitamin D status and adverse birth outcomes remains unclear. Focusing on prospective observational studies, we aimed to explore the dose-response relationship of vitamin D status with the risk of low birth weight (LBW), macrosomia (MA), preterm birth (PTB), small for gestational age (SGA), and intrauterine growth restriction (IUGR).
Methods: Databases including PubMed, Embase, Scopus, and Web of Science were used up to 19 January 2021 to search for observational studies that fulfilled criteria as follows: cohort studies, case-cohort studies, or nested case-control studies. Random-effects models were used to pool relative risks (RRs) and 95% confidence intervals (CIs) in the observational studies.
Results: A total of 72 publications were included in this systematic review and 71 in the meta-analysis. Maternal 25-hydroxyvitamin D (25(OH)D) concentrations were inversely associated with the risk of
LBW (RR: 0.65; 95% CI 0.48-0.86),
PTB (RR: 0.67; 95% CI 0.57-0.79), and
SGA (RR: 0.61; 95% CI 0.49-0.76)
in the highest versus lowest meta-analysis, but not associated with MA and IUGR. Linear dose-response analysis showed that each 25 nmol/L increase in 25(OH)D was associated with a 6% and 10% reduction in the risk of PTB (RR: 0.94; 95% CI 0.90-0.98) and SGA (RR: 0.90; 95% CI 0.84-0.97), respectively.
Conclusion: Our study suggests that a sufficient vitamin D status during pregnancy is protective against the risk of LBW, PTB, and SGA.
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