Vitamin D, preeclampsia and prematurity: A systematic review and meta-analysis of observational and interventional studies
| Autor: | Tania Rivero-Blanco, María José Aguilar-Cordero, Íñigo María Pérez-Castillo, Ximena Alejandra Leon-Rios, N. Mur-Villar, Agustín Lasserrot-Cuadrado |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Pediatrics medicine.medical_specialty vitamin D deficiency Preeclampsia 03 medical and health sciences 0302 clinical medicine Pre-Eclampsia Pregnancy Risk Factors Maternity and Midwifery medicine Vitamin D and neurology Odds Ratio Humans Vitamin D 030219 obstetrics & reproductive medicine 030504 nursing business.industry Infant Newborn Obstetrics and Gynecology Odds ratio medicine.disease Vitamin D Deficiency Clinical trial Meta-analysis Premature Birth Observational study Female 0305 other medical science business |
| Zdroj: | Midwifery. 87 |
| ISSN: | 1532-3099 |
| Popis: | Vitamin D has important functions outside of bone metabolism. Deficiency has been associated with several adverse outcomes during pregnancy such as preeclampsia and prematurity. There is an increasing body of literature on this topic with studies performed to date having produced contradictory results.To synthesize the literature about vitamin D deficiency and its association with preeclampsia and prematurity in order to determine if maternal vitamin D insufficiency and/or deficiency during pregnancy is associated with the prevalence of preeclampsia and prematurity.A systematic review and meta-analysis of observational and interventional studies.Two independent researchers reviewed the included studies according to PRISMA reporting guidelines. A protocol for this review was registered in PROSPERO with the registration number: "CRD42019136318". Three electronic databases (PubMed, ScienceDirect and Web of Science); were searched in order to identify eligible studies. Observational and interventional studies were selected which had been published in the last 6 years, and analysed the association between maternal vitamin D concentrations during pregnancy and the development of preeclampsia and/or preterm birth. Data were extracted and presented in tables and figures. Fixed and random-effects meta-analyses were performed on the studies which provided enough sample data to calculate odds ratios. Results from both statistical methods were compared. Meta-analysis cut-off points for vitamin D insufficiency and deficiency were defined as75nmol/L and50nmol/L, respectively.Fifty-five studies met the inclusion criteria. Fixed-effects meta-analysis of the interventional studies indicated that vitamin D supplementation acts as a prevention factor for preeclampsia and prematurity. Fixed-effects meta-analysis of observational studies concluded that vitamin D insufficiency and deficiency are associated with a higher risk of developing preeclampsia. However, prematurity and vitamin D were only associated when maternal vitamin D concentrations was75 nmol/L. Random-effects meta-analysis found no significant association between vitamin D, preeclampsia and prematurity in either observational or interventional studies.Higher vitamin D concentrations during pregnancy could be associated with a decreased risk of preeclampsia and prematurity but statistical significance of associations depends on the study design used. Well-designed clinical trials with vitamin D supplementation are needed in order to better define associations. |
| Databáze: | OpenAIRE |
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