Maternal vitamin D insufficiency and risk of adverse pregnancy and birth outcomes: A systematic review and meta-analysis of longitudinal studies
Three previous reviews on the association of vitamin D insufficiency in pregnancy with preterm birth (PTB) and stillbirth were limited in scope and deemed inconclusive. With important new evidence accumulating, there is the need to update the previous estimates and assess evidence on other clinicall...
Gespeichert in:
| Veröffentlicht in: | PloS one 2017-03, Vol.12 (3), p.e0173605-e0173605 |
|---|---|
| Hauptverfasser: | , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | e0173605 |
|---|---|
| container_issue | 3 |
| container_start_page | e0173605 |
| container_title | PloS one |
| container_volume | 12 |
| creator | Amegah, A Kofi Klevor, Moses K Wagner, Carol L |
| description | Three previous reviews on the association of vitamin D insufficiency in pregnancy with preterm birth (PTB) and stillbirth were limited in scope and deemed inconclusive. With important new evidence accumulating, there is the need to update the previous estimates and assess evidence on other clinically important outcomes such as spontaneous abortion and Apgar score. We conducted a systematic review and meta-analysis to evaluate the quality and strength of the available evidence on the relations between vitamin D nutritional status, and pregnancy and birth outcomes.
PubMed and Scopus databases were searched from their inception to June, 2015 with no language restrictions imposed. Eighteen longitudinal studies satisfied the inclusion criteria. Random effects model was applied in computing the summary effect estimates and their corresponding 95% confidence intervals.
Serum 25(OH)D levels |
| doi_str_mv | 10.1371/journal.pone.0173605 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_1878396807</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A485894104</galeid><doaj_id>oai_doaj_org_article_7d33a9249a7a4f709bc94c85cb587ec9</doaj_id><sourcerecordid>A485894104</sourcerecordid><originalsourceid>FETCH-LOGICAL-c725t-fe384f3036a029582466293bae5fecfe2de7ce3e8db4ae51f8014f6af01f3683</originalsourceid><addsrcrecordid>eNqNk1trFDEUxwdRbK1-A9EBQfRh12QyuYwPQqm3hUpBi68hmznZTZ1Jtklmdb-FH9lMu1u60oeSh4ST3_mfS3KK4jlGU0w4fnfhh-BUN115B1OEOWGIPigOcUOqCasQeXjrfFA8ifECIUoEY4-Lg0oQxHhFD4u_31SCUadc26R668qPpXVxMMZqC05vSuXaMtj4q_SmVO0aQoRyFWDh1O52bkNaln5I2vcQ35fHZdzEBL1KVpcB1hZ-X3E9JDVROdYm2jjKdd4tbBpaO8aP4wHi0-KRUV2EZ9v9qDj__On85Ovk9OzL7OT4dKJz3mligIjaEESYQlVDRVUzVjVkroAa0AaqFrgGAqKd19mGjUC4NkwZhA1hghwVL69lV52PctvLKLHggjRMIJ6J2TXRenUhV8H2KmykV1ZeGXxYSBVyhR1I3hKimqpuFFe14aiZ66bWguo5FRx0k7U-bKMN8x5aDS4F1e2J7t84u5QLv5aUUI4wzQJvtgLBXw4Qk-xt1NB1yoEfxrwF5pRhXN8D5UJUrKFjWq_-Q-9uxJZaqFyrdcbnFPUoKo9rQUVTYzSGnd5B5dVCb3X-o8Zm-57D2z2HzCT4kxZqiFHOfny_P3v2c599fYtdgurSMvpuSNa7uA_W16AOPsYA5uY9MJLjiO26IccRk9sRy24vbr_ljdNupsg_3BQjhw</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1878396807</pqid></control><display><type>article</type><title>Maternal vitamin D insufficiency and risk of adverse pregnancy and birth outcomes: A systematic review and meta-analysis of longitudinal studies</title><source>MEDLINE</source><source>Public Library of Science (PLoS) Journals Open Access</source><source>TestCollectionTL3OpenAccess</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><creator>Amegah, A Kofi ; Klevor, Moses K ; Wagner, Carol L</creator><contributor>Nguyen, Tuan Van</contributor><creatorcontrib>Amegah, A Kofi ; Klevor, Moses K ; Wagner, Carol L ; Nguyen, Tuan Van</creatorcontrib><description>Three previous reviews on the association of vitamin D insufficiency in pregnancy with preterm birth (PTB) and stillbirth were limited in scope and deemed inconclusive. With important new evidence accumulating, there is the need to update the previous estimates and assess evidence on other clinically important outcomes such as spontaneous abortion and Apgar score. We conducted a systematic review and meta-analysis to evaluate the quality and strength of the available evidence on the relations between vitamin D nutritional status, and pregnancy and birth outcomes.
PubMed and Scopus databases were searched from their inception to June, 2015 with no language restrictions imposed. Eighteen longitudinal studies satisfied the inclusion criteria. Random effects model was applied in computing the summary effect estimates and their corresponding 95% confidence intervals.
Serum 25(OH)D levels <75 nmol/l was associated with 83% (95% CI: 1.23, 2.74) and 13% (95% CI: 0.94, 1.36) increased risk of PTB measured at <32-34 weeks and <35-37 weeks, respectively. An inverse dose-response relation was observed for both PTB outcome. Serum 25(OH)D levels <75 nmol/l was also associated with 11% increased risk of spontaneous PTB (<35-37 weeks; RR = 1.11; 95% CI: 0.75, 1.65) with a dose-response relation also noted. Vitamin D insufficiency was not associated with risk of spontaneous abortion and stillbirth (RR of 1.04 [95% CI: 0.95, 1.13] and 1.02 [95% CI: 0.96, 1.09], respectively), as well as short gestational length (ES = -0.24, 95% CI: -0.69, 0.22), and low Apgar score.
We found vitamin D insufficiency to be associated with risk of PTB. Regarding spontaneous abortion and stillbirth, the available evidence suggest no association with low vitamin D levels. The evidence on vitamin D nutrition and Apgar score is conflicting and controversial. Overall, the experimental evidence uncovered was small and weak. Hence, the benefits of vitamin D supplementation during pregnancy should be further evaluated through rigorous intervention studies.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0173605</identifier><identifier>PMID: 28306725</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Abortion ; Apgar score ; Biology and Life Sciences ; Birth ; Births ; Childbirth & labor ; Confidence intervals ; Correlation analysis ; Diabetes ; Dietary supplements ; Female ; Health aspects ; Humans ; Labor complications ; Longitudinal Studies ; Maternal-fetal exchange ; Medicine and Health Sciences ; Meta-analysis ; Miscarriage ; Nutrition ; Nutritional status ; Physical sciences ; Preeclampsia ; Pregnancy ; Pregnancy Complications ; Pregnancy Outcome ; Premature birth ; Public health ; Research and Analysis Methods ; Reviews ; Risk ; Risk factors ; Stillbirth ; Studies ; Systematic review ; Vitamin D ; Vitamin D Deficiency - complications ; Vitamin deficiency</subject><ispartof>PloS one, 2017-03, Vol.12 (3), p.e0173605-e0173605</ispartof><rights>COPYRIGHT 2017 Public Library of Science</rights><rights>2017 Amegah et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2017 Amegah et al 2017 Amegah et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c725t-fe384f3036a029582466293bae5fecfe2de7ce3e8db4ae51f8014f6af01f3683</citedby><cites>FETCH-LOGICAL-c725t-fe384f3036a029582466293bae5fecfe2de7ce3e8db4ae51f8014f6af01f3683</cites><orcidid>0000-0001-5868-6402</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5357015/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5357015/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,729,782,786,866,887,2104,2930,23873,27931,27932,53798,53800</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28306725$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Nguyen, Tuan Van</contributor><creatorcontrib>Amegah, A Kofi</creatorcontrib><creatorcontrib>Klevor, Moses K</creatorcontrib><creatorcontrib>Wagner, Carol L</creatorcontrib><title>Maternal vitamin D insufficiency and risk of adverse pregnancy and birth outcomes: A systematic review and meta-analysis of longitudinal studies</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Three previous reviews on the association of vitamin D insufficiency in pregnancy with preterm birth (PTB) and stillbirth were limited in scope and deemed inconclusive. With important new evidence accumulating, there is the need to update the previous estimates and assess evidence on other clinically important outcomes such as spontaneous abortion and Apgar score. We conducted a systematic review and meta-analysis to evaluate the quality and strength of the available evidence on the relations between vitamin D nutritional status, and pregnancy and birth outcomes.
PubMed and Scopus databases were searched from their inception to June, 2015 with no language restrictions imposed. Eighteen longitudinal studies satisfied the inclusion criteria. Random effects model was applied in computing the summary effect estimates and their corresponding 95% confidence intervals.
Serum 25(OH)D levels <75 nmol/l was associated with 83% (95% CI: 1.23, 2.74) and 13% (95% CI: 0.94, 1.36) increased risk of PTB measured at <32-34 weeks and <35-37 weeks, respectively. An inverse dose-response relation was observed for both PTB outcome. Serum 25(OH)D levels <75 nmol/l was also associated with 11% increased risk of spontaneous PTB (<35-37 weeks; RR = 1.11; 95% CI: 0.75, 1.65) with a dose-response relation also noted. Vitamin D insufficiency was not associated with risk of spontaneous abortion and stillbirth (RR of 1.04 [95% CI: 0.95, 1.13] and 1.02 [95% CI: 0.96, 1.09], respectively), as well as short gestational length (ES = -0.24, 95% CI: -0.69, 0.22), and low Apgar score.
We found vitamin D insufficiency to be associated with risk of PTB. Regarding spontaneous abortion and stillbirth, the available evidence suggest no association with low vitamin D levels. The evidence on vitamin D nutrition and Apgar score is conflicting and controversial. Overall, the experimental evidence uncovered was small and weak. Hence, the benefits of vitamin D supplementation during pregnancy should be further evaluated through rigorous intervention studies.</description><subject>Abortion</subject><subject>Apgar score</subject><subject>Biology and Life Sciences</subject><subject>Birth</subject><subject>Births</subject><subject>Childbirth & labor</subject><subject>Confidence intervals</subject><subject>Correlation analysis</subject><subject>Diabetes</subject><subject>Dietary supplements</subject><subject>Female</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Labor complications</subject><subject>Longitudinal Studies</subject><subject>Maternal-fetal exchange</subject><subject>Medicine and Health Sciences</subject><subject>Meta-analysis</subject><subject>Miscarriage</subject><subject>Nutrition</subject><subject>Nutritional status</subject><subject>Physical sciences</subject><subject>Preeclampsia</subject><subject>Pregnancy</subject><subject>Pregnancy Complications</subject><subject>Pregnancy Outcome</subject><subject>Premature birth</subject><subject>Public health</subject><subject>Research and Analysis Methods</subject><subject>Reviews</subject><subject>Risk</subject><subject>Risk factors</subject><subject>Stillbirth</subject><subject>Studies</subject><subject>Systematic review</subject><subject>Vitamin D</subject><subject>Vitamin D Deficiency - complications</subject><subject>Vitamin deficiency</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk1trFDEUxwdRbK1-A9EBQfRh12QyuYwPQqm3hUpBi68hmznZTZ1Jtklmdb-FH9lMu1u60oeSh4ST3_mfS3KK4jlGU0w4fnfhh-BUN115B1OEOWGIPigOcUOqCasQeXjrfFA8ifECIUoEY4-Lg0oQxHhFD4u_31SCUadc26R668qPpXVxMMZqC05vSuXaMtj4q_SmVO0aQoRyFWDh1O52bkNaln5I2vcQ35fHZdzEBL1KVpcB1hZ-X3E9JDVROdYm2jjKdd4tbBpaO8aP4wHi0-KRUV2EZ9v9qDj__On85Ovk9OzL7OT4dKJz3mligIjaEESYQlVDRVUzVjVkroAa0AaqFrgGAqKd19mGjUC4NkwZhA1hghwVL69lV52PctvLKLHggjRMIJ6J2TXRenUhV8H2KmykV1ZeGXxYSBVyhR1I3hKimqpuFFe14aiZ66bWguo5FRx0k7U-bKMN8x5aDS4F1e2J7t84u5QLv5aUUI4wzQJvtgLBXw4Qk-xt1NB1yoEfxrwF5pRhXN8D5UJUrKFjWq_-Q-9uxJZaqFyrdcbnFPUoKo9rQUVTYzSGnd5B5dVCb3X-o8Zm-57D2z2HzCT4kxZqiFHOfny_P3v2c599fYtdgurSMvpuSNa7uA_W16AOPsYA5uY9MJLjiO26IccRk9sRy24vbr_ljdNupsg_3BQjhw</recordid><startdate>20170317</startdate><enddate>20170317</enddate><creator>Amegah, A Kofi</creator><creator>Klevor, Moses K</creator><creator>Wagner, Carol L</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-5868-6402</orcidid></search><sort><creationdate>20170317</creationdate><title>Maternal vitamin D insufficiency and risk of adverse pregnancy and birth outcomes: A systematic review and meta-analysis of longitudinal studies</title><author>Amegah, A Kofi ; Klevor, Moses K ; Wagner, Carol L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c725t-fe384f3036a029582466293bae5fecfe2de7ce3e8db4ae51f8014f6af01f3683</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Abortion</topic><topic>Apgar score</topic><topic>Biology and Life Sciences</topic><topic>Birth</topic><topic>Births</topic><topic>Childbirth & labor</topic><topic>Confidence intervals</topic><topic>Correlation analysis</topic><topic>Diabetes</topic><topic>Dietary supplements</topic><topic>Female</topic><topic>Health aspects</topic><topic>Humans</topic><topic>Labor complications</topic><topic>Longitudinal Studies</topic><topic>Maternal-fetal exchange</topic><topic>Medicine and Health Sciences</topic><topic>Meta-analysis</topic><topic>Miscarriage</topic><topic>Nutrition</topic><topic>Nutritional status</topic><topic>Physical sciences</topic><topic>Preeclampsia</topic><topic>Pregnancy</topic><topic>Pregnancy Complications</topic><topic>Pregnancy Outcome</topic><topic>Premature birth</topic><topic>Public health</topic><topic>Research and Analysis Methods</topic><topic>Reviews</topic><topic>Risk</topic><topic>Risk factors</topic><topic>Stillbirth</topic><topic>Studies</topic><topic>Systematic review</topic><topic>Vitamin D</topic><topic>Vitamin D Deficiency - complications</topic><topic>Vitamin deficiency</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Amegah, A Kofi</creatorcontrib><creatorcontrib>Klevor, Moses K</creatorcontrib><creatorcontrib>Wagner, Carol L</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>TestCollectionTL3OpenAccess</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Amegah, A Kofi</au><au>Klevor, Moses K</au><au>Wagner, Carol L</au><au>Nguyen, Tuan Van</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Maternal vitamin D insufficiency and risk of adverse pregnancy and birth outcomes: A systematic review and meta-analysis of longitudinal studies</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2017-03-17</date><risdate>2017</risdate><volume>12</volume><issue>3</issue><spage>e0173605</spage><epage>e0173605</epage><pages>e0173605-e0173605</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Three previous reviews on the association of vitamin D insufficiency in pregnancy with preterm birth (PTB) and stillbirth were limited in scope and deemed inconclusive. With important new evidence accumulating, there is the need to update the previous estimates and assess evidence on other clinically important outcomes such as spontaneous abortion and Apgar score. We conducted a systematic review and meta-analysis to evaluate the quality and strength of the available evidence on the relations between vitamin D nutritional status, and pregnancy and birth outcomes.
PubMed and Scopus databases were searched from their inception to June, 2015 with no language restrictions imposed. Eighteen longitudinal studies satisfied the inclusion criteria. Random effects model was applied in computing the summary effect estimates and their corresponding 95% confidence intervals.
Serum 25(OH)D levels <75 nmol/l was associated with 83% (95% CI: 1.23, 2.74) and 13% (95% CI: 0.94, 1.36) increased risk of PTB measured at <32-34 weeks and <35-37 weeks, respectively. An inverse dose-response relation was observed for both PTB outcome. Serum 25(OH)D levels <75 nmol/l was also associated with 11% increased risk of spontaneous PTB (<35-37 weeks; RR = 1.11; 95% CI: 0.75, 1.65) with a dose-response relation also noted. Vitamin D insufficiency was not associated with risk of spontaneous abortion and stillbirth (RR of 1.04 [95% CI: 0.95, 1.13] and 1.02 [95% CI: 0.96, 1.09], respectively), as well as short gestational length (ES = -0.24, 95% CI: -0.69, 0.22), and low Apgar score.
We found vitamin D insufficiency to be associated with risk of PTB. Regarding spontaneous abortion and stillbirth, the available evidence suggest no association with low vitamin D levels. The evidence on vitamin D nutrition and Apgar score is conflicting and controversial. Overall, the experimental evidence uncovered was small and weak. Hence, the benefits of vitamin D supplementation during pregnancy should be further evaluated through rigorous intervention studies.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>28306725</pmid><doi>10.1371/journal.pone.0173605</doi><tpages>e0173605</tpages><orcidid>https://orcid.org/0000-0001-5868-6402</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2017-03, Vol.12 (3), p.e0173605-e0173605 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1878396807 |
| source | MEDLINE; Public Library of Science (PLoS) Journals Open Access; TestCollectionTL3OpenAccess; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Abortion Apgar score Biology and Life Sciences Birth Births Childbirth & labor Confidence intervals Correlation analysis Diabetes Dietary supplements Female Health aspects Humans Labor complications Longitudinal Studies Maternal-fetal exchange Medicine and Health Sciences Meta-analysis Miscarriage Nutrition Nutritional status Physical sciences Preeclampsia Pregnancy Pregnancy Complications Pregnancy Outcome Premature birth Public health Research and Analysis Methods Reviews Risk Risk factors Stillbirth Studies Systematic review Vitamin D Vitamin D Deficiency - complications Vitamin deficiency |
| title | Maternal vitamin D insufficiency and risk of adverse pregnancy and birth outcomes: A systematic review and meta-analysis of longitudinal studies |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-06T09%3A58%3A14IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Maternal%20vitamin%20D%20insufficiency%20and%20risk%20of%20adverse%20pregnancy%20and%20birth%20outcomes:%20A%20systematic%20review%20and%20meta-analysis%20of%20longitudinal%20studies&rft.jtitle=PloS%20one&rft.au=Amegah,%20A%20Kofi&rft.date=2017-03-17&rft.volume=12&rft.issue=3&rft.spage=e0173605&rft.epage=e0173605&rft.pages=e0173605-e0173605&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0173605&rft_dat=%3Cgale_plos_%3EA485894104%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1878396807&rft_id=info:pmid/28306725&rft_galeid=A485894104&rft_doaj_id=oai_doaj_org_article_7d33a9249a7a4f709bc94c85cb587ec9&rfr_iscdi=true |