Vitamin D deficit and high-risk pregnancies: narrative literature - March 2024
Ginecología y obstetricia de México Ginecol. obstet. Méx. online. 2023, vol.91, n.10, pp.736-752. https://doi.org/10.24245/gom.v91i10.8109.
FREE PDF is in Spanish
MOLINA GIRALDO, Saulo; TIJERINA, Andrea y TORRES VALENCIA, Natalia.
BACKGROUND:
There is increasing interest in the effects of vitamin D in pregnancy and on placental function, glucose homeostasis, infection and inflammatory response, and the association of vitamin D deficiency with high-risk obstetric conditions.
OBJECTIVE:
To identify the relevant known and controversial aspects of vitamin D deficiency and its supplementation in patients at high obstetric risk, in order to provide the reader with decision-making tools for clinical practice.
METHODOLOGY:
A review of the literature registered in the MEDLINE databases via PubMed, EBSCO and OVID from 2016 to 2022 was performed. Articles published in English and Spanish were included using the MeSH terms “vitamin D”, “pre-eclampsia”, “preterm birth”, “gestational diabetes” and “fetal growth retardation”.
RESULTS:
The initial search yielded 685 articles, of which 364 were discarded for lack of relevance, 248 for lack of complete source and 44 for duplication. In accordance with the stated objective, 29 articles remained at the end, which were supplemented by 55 classic texts found in a manual search to contextualise the review.
CONCLUSIONS:
The evidence for an association between vitamin D deficiency and poor obstetric outcomes in terms of rates of pre-eclampsia, preterm birth, gestational diabetes and fetal growth restriction is inconclusive. However, analysis of the above studies shows an association between vitamin D deficiency and increased risk, with striking results consistent with the risk of gestational diabetes.
Reduce risk of Congenital Anomalies by 24% if supplement with vitamin D - meta-analysis - April 2023
Vitamin D Supplementation and Vitamin D Status during Pregnancy and the Risk of Congenital Anomalies—A Systematic Review and Meta-Analysis
Nutrients 2023, 15(9), 2125; https://doi.org/10.3390/nu15092125
by Karen Christina Walker 1,*,Fanney Thorsteinsdottir 1ORCID,Henrik Thybo Christesen 2,3,Vibeke Elisabeth Hjortdal 4,Berit Lilienthal Heitmann 1,5,6ORCID,Ina Olmer Specht 1,6ORCID andMina Nicole Händel 1,7,*ORCID
Maternal dietary factors have been suggested as possible contributing influences for congenital anomalies (CAs). We aimed to assess the association between vitamin D supplementation or vitamin D status (s-25OHD) during pregnancy and CAs in the offspring. A comprehensive literature search was conducted in the three electronic databases: PubMed, Embase, and Cochrane Library. Included studies were critically appraised using appropriate tools (risk of bias 2, ROBINS-I). A protocol was registered in the International Prospective Register of Systematic Reviews (CRD42019127131). A meta-analysis of four randomised controlled trials (RCTs) including 3931 participants showed no effect of vitamin D supplementation on CAs, a relative risk of 0.76 (95% CI 0.45; 1.30), with moderate certainty in the effect estimates by GRADE assessment. Of the nine identified observational studies, six were excluded due to a critical risk of bias in accordance with ROBINS-I. Among the included observational studies, two studies found no association, whereas one case-control study identified an association between s-25OHD < 20 nmol/L and neural tube defects, with an adjusted odds ratio of 2.34 (95% CI: 1.07; 5.07). Interpretation of the results should be cautious given the low prevalence of CAs, RCTs with onset of supplementation after organogenesis, and low-quality observational studies.
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