Effect of vitamin D supplementation during pregnancy on maternal and neonatal outcomes: a systematic review and meta analysis of randomized controlled trials

Vitamin D supplementation during pregnancy was associated with increased circulating 25-hydroxyvitamin D levels, birth weight, and birth length; it was not associated with other maternal and neonatal outcomes.

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Authors

Faustino R. Pérez-López, M.D., Ph.D., Vinay Pasupuleti, M.D., Ph.D., Edward Mezones-Holguin, M.D., Vicente A. Benites-Zapata, M.D., Priyaleela Thota, M.D., Abhishek Deshpande, M.D., Ph.D., Adrian V. Hernandez, M.D., Ph.D.

Volume 103, Issue 5, Pages 1278-1288

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.

Read the full text at: http://www.fertstert.org/article/S0015-0282(15)00149-1/fulltext


Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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