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Fertil Steril. 2015 May;103(5):1278-88.e4. doi: 10.1016/j.fertnstert.2015.02.019. Epub 2015 Mar 23.

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

Author information

1
Department of Obstetrics and Gynecology, University of Zaragoza Faculty of Medicine and Lozano Blesa University Hospital, Zaragoza, Spain. Electronic address: faustino.perez@unizar.es.
2
Department of Medicine, Case Western Reserve University, Cleveland, Ohio.
3
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.
4
Unit of Analysis and Generation of Evidence in Public Health (UNAGESP), Instituto Nacional de Salud, Lima, Peru.
5
Medicine Institute Center for Value Based Care Research, Cleveland Clinic, Cleveland, Ohio.
6
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.

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.

KEYWORDS:

Vitamin D; maternal outcomes; meta-analysis; neonatal outcomes; pregnancy

[Indexed for MEDLINE]

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