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J Obstet Gynaecol Res. 2017 Feb;43(2):247-256. doi: 10.1111/jog.13239.

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

Author information

1
Department of Maternal, Child and Adolescent Health, Anhui Medical University, Hefei, China.
2
Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China.

Erratum in

Abstract

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.

KEYWORDS:

meta-analysis; pregnancy; premature birth; randomized controlled trial; vitamin D

PMID:
28150405
DOI:
10.1111/jog.13239
[Indexed for MEDLINE]

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