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Effect of vitamin D supplementation during pregnancy on maternal and neonatal outcomes: a systematic review and meta-analysis of randomized controlled trials.
Fertil Steril. 2015 May; 103(5):1278-88.e4.FS

Abstract

OBJECTIVE

To assess the effects of vitamin D supplementation during pregnancy on obstetric outcomes and birth variables.

DESIGN

Systematic review and meta-analysis of randomized controlled trials (RCTs).

SETTING

Not applicable.

PATIENT(S)

Pregnant women and neonates.

INTERVENTION(S)

PubMed and 5 other research databases were searched through March 2014 for RCTs evaluating vitamin D supplementation ± calcium/vitamins/ferrous sulfate vs. a control (placebo or active) during pregnancy.

MAIN OUTCOME MEASURE(S)

Measures were: circulating 25-hydroxyvitamin D [25(OH)D] levels, preeclampsia, gestational diabetes mellitus (GDM), small for gestational age (SGA), low birth weight, preterm birth, birth weight, birth length, cesarean section. Mantel-Haenszel fixed-effects models were used, owing to expected scarcity of outcomes. Effects were reported as relative risks and their 95% confidence intervals (CIs).

RESULT(S)

Thirteen RCTs (n = 2,299) were selected. Circulating 25(OH)D levels were significantly higher at term, compared with the control group (mean difference: 66.5 nmol/L, 95% CI 66.2-66.7). Birth weight and birth length were significantly greater for neonates in the vitamin D group; mean difference: 107.6 g (95% CI 59.9-155.3 g) and 0.3 cm (95% CI 0.10-0.41 cm), respectively. Incidence of preeclampsia, GDM, SGA, low birth weight, preterm birth, and cesarean section were not influenced by vitamin D supplementation. Across RCTs, the doses and types of vitamin D supplements, gestational age at first administration, and outcomes were heterogeneous.

CONCLUSION(S)

Vitamin D supplementation during pregnancy was associated with increased circulating 25(OH)D levels, birth weight, and birth length, and was not associated with other maternal and neonatal outcomes. Larger, better-designed RCTs evaluating clinically relevant outcomes are necessary to reach a definitive conclusion.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, University of Zaragoza Faculty of Medicine and Lozano Blesa University Hospital, Zaragoza, Spain. Electronic address: faustino.perez@unizar.es.Department of Medicine, Case Western Reserve University, Cleveland, Ohio.Unit of Analysis and Generation of Evidence in Public Health (UNAGESP), Instituto Nacional de Salud, Lima, Peru; School of Medicine, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru.Unit of Analysis and Generation of Evidence in Public Health (UNAGESP), Instituto Nacional de Salud, Lima, Peru.Department of Medicine, Case Western Reserve University, Cleveland, Ohio.Medicine Institute Center for Value Based Care Research, Cleveland Clinic, Cleveland, Ohio.School of Medicine, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru; Health Outcomes and Clinical Epidemiology Section, Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

25813278

Citation

Pérez-López, Faustino R., et al. "Effect of Vitamin D Supplementation During Pregnancy On Maternal and Neonatal Outcomes: a Systematic Review and Meta-analysis of Randomized Controlled Trials." Fertility and Sterility, vol. 103, no. 5, 2015, pp. 1278-88.e4.
Pérez-López FR, Pasupuleti V, Mezones-Holguin E, et al. Effect of vitamin D supplementation during pregnancy on maternal and neonatal outcomes: a systematic review and meta-analysis of randomized controlled trials. Fertil Steril. 2015;103(5):1278-88.e4.
Pérez-López, F. R., Pasupuleti, V., Mezones-Holguin, E., Benites-Zapata, V. A., Thota, P., Deshpande, A., & Hernandez, A. V. (2015). Effect of vitamin D supplementation during pregnancy on maternal and neonatal outcomes: a systematic review and meta-analysis of randomized controlled trials. Fertility and Sterility, 103(5), 1278-e4. https://doi.org/10.1016/j.fertnstert.2015.02.019
Pérez-López FR, et al. Effect of Vitamin D Supplementation During Pregnancy On Maternal and Neonatal Outcomes: a Systematic Review and Meta-analysis of Randomized Controlled Trials. Fertil Steril. 2015;103(5):1278-88.e4. PubMed PMID: 25813278.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of vitamin D supplementation during pregnancy on maternal and neonatal outcomes: a systematic review and meta-analysis of randomized controlled trials. AU - Pérez-López,Faustino R, AU - Pasupuleti,Vinay, AU - Mezones-Holguin,Edward, AU - Benites-Zapata,Vicente A, AU - Thota,Priyaleela, AU - Deshpande,Abhishek, AU - Hernandez,Adrian V, Y1 - 2015/03/23/ PY - 2014/10/19/received PY - 2015/02/11/revised PY - 2015/02/12/accepted PY - 2015/3/28/entrez PY - 2015/3/31/pubmed PY - 2015/7/17/medline KW - Vitamin D KW - maternal outcomes KW - meta-analysis KW - neonatal outcomes KW - pregnancy SP - 1278 EP - 88.e4 JF - Fertility and sterility JO - Fertil. Steril. VL - 103 IS - 5 N2 - OBJECTIVE: To assess the effects of vitamin D supplementation during pregnancy on obstetric outcomes and birth variables. DESIGN: Systematic review and meta-analysis of randomized controlled trials (RCTs). SETTING: Not applicable. PATIENT(S): Pregnant women and neonates. INTERVENTION(S): PubMed and 5 other research databases were searched through March 2014 for RCTs evaluating vitamin D supplementation ± calcium/vitamins/ferrous sulfate vs. a control (placebo or active) during pregnancy. MAIN OUTCOME MEASURE(S): Measures were: circulating 25-hydroxyvitamin D [25(OH)D] levels, preeclampsia, gestational diabetes mellitus (GDM), small for gestational age (SGA), low birth weight, preterm birth, birth weight, birth length, cesarean section. Mantel-Haenszel fixed-effects models were used, owing to expected scarcity of outcomes. Effects were reported as relative risks and their 95% confidence intervals (CIs). RESULT(S): Thirteen RCTs (n = 2,299) were selected. Circulating 25(OH)D levels were significantly higher at term, compared with the control group (mean difference: 66.5 nmol/L, 95% CI 66.2-66.7). Birth weight and birth length were significantly greater for neonates in the vitamin D group; mean difference: 107.6 g (95% CI 59.9-155.3 g) and 0.3 cm (95% CI 0.10-0.41 cm), respectively. Incidence of preeclampsia, GDM, SGA, low birth weight, preterm birth, and cesarean section were not influenced by vitamin D supplementation. Across RCTs, the doses and types of vitamin D supplements, gestational age at first administration, and outcomes were heterogeneous. CONCLUSION(S): Vitamin D supplementation during pregnancy was associated with increased circulating 25(OH)D levels, birth weight, and birth length, and was not associated with other maternal and neonatal outcomes. Larger, better-designed RCTs evaluating clinically relevant outcomes are necessary to reach a definitive conclusion. SN - 1556-5653 UR - https://www.unboundmedicine.com/medline/citation/25813278/Effect_of_vitamin_D_supplementation_during_pregnancy_on_maternal_and_neonatal_outcomes:_a_systematic_review_and_meta_analysis_of_randomized_controlled_trials_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0015-0282(15)00149-1 DB - PRIME DP - Unbound Medicine ER -