Abstract
To synthesize and critically review the current evidence available on maternal vitamin
D deficiency and its effects on maternal–fetal outcomes, this study reviewed the maternal–fetal
outcomes, including prolonged labour or cesarean delivery, preeclampsia, gestational
diabetes, low birth weight and small for gestational age, and preterm birth. An extensive
systematic searched was performed in Medline and EMBASE, where a medical subject heading
(MeSH) was used with terms “Vitamin D/25(OH)D” and “pregnancy/fetal outcomes”; these
terms were combined with “and.” In Web of Science and Google Scholar, a key word search
was used. Nineteen articles were included for full review. This review found that
the current state of the evidence is equivocal for maternal–fetal outcomes such as
the risk of prolonged labour and cesarean delivery, gestational diabetes, low birth
weight and small for gestational age, and preterm birth. Although some previous studies
have found improvement in pregnancy outcomes with sufficient vitamin D levels, others
have not shown any association with the aforementioned outcomes. This systematic review
also highlights an association between the risk of preeclampsia and maternal vitamin
D levels that is found to be consistent among studies.
Résumé
Dans le but de synthétiser les données probantes actuellement disponibles sur la carence
maternelle en vitamine D et ses effets sur les issues fœto-maternelles et d'effectuer
une analyse critique de ces données, cette étude a examiné ces issues, notamment le
travail prolongé et la césarienne, la pré-éclampsie, le diabète gestationnel, le fœtus
petit pour l'âge gestationnel et le faible poids à la naissance ainsi que la naissance
avant terme. Une recherche systématique approfondie a été réalisée dans les bases
de données Medline et EMBASE, pour laquelle une liste Medical Subject Heading (MeSH)
a été utilisée avec les termes Vitamin D/25(OH)D et pregnancy/fetal outcomes et l'opérateur booléen AND. Une recherche par mot-clé a été effectuée dans les bases
de données Web of Science et Google Scholar. L'examen approfondi a porté sur 19 articles.
Cette étude a révélé que l'état actuel des données probantes est équivoque en ce qui
a trait aux issues fœto-maternelles telles que les risques de travail prolongé et
de césarienne, de diabète gestationnel, de fœtus petit pour l'âge gestationnel et
de faible poids à la naissance, et de naissance avant terme. Bien que certaines études
antérieures aient constaté une amélioration des issues de grossesse en présence d'un
taux suffisant de vitamine D, d'autres n'ont révélé aucune corrélation avec les issues
susmentionnées. Cette revue systématique met aussi en lumière une corrélation entre
le risque de pré-éclampsie et le taux maternel de vitamine D, laquelle se révèle cohérente
avec les autres études.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Obstetrics and Gynaecology CanadaAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
REFERENCES
- Vitamin D insufficiency is common in Indian mothers but is not associated with gestational diabetes or variation in newborn size.Eur J Clin Nutr. 2009; 63: 646
- Does vitamin D during pregnancy impact offspring growth and bone?.Proc Nutr Soc. 2012; 71: 38-45
- Vitamin A and carotenoids during pregnancy and maternal, neonatal and infant health outcomes: a systematic review and meta‐analysis.Paediatr Perinat Epidemiol. 2012; 26: 36-54
- Maternal serum 25-hydroxyvitamin D and measures of newborn and placental weight in a US multicenter cohort study.J Clin Endocrinol Metab. 2013; : 398-404
- Prevalence and risk factors for vitamin D insufficiency and deficiency at birth and associated outcome.BMC Pediatrics. 2016; 16: 208
- Maternal BMI associations with maternal and cord blood vitamin D levels in a North American subset of hyperglycemia and adverse pregnancy outcome (HAPO) study participants.PloS One. 2016; 11e0150221
- Associations between 25-hydroxyvitamin D levels and pregnancy outcomes: a prospective observational study in southern china.Eur J Clin Nutr. 2014; 68: 925
- Low vitamin D status despite abundant sun exposure.J Clin Endocrinol Metab. 2007; 92: 2130-2135
- Vitamin D: A growing perspective.Crit Rev Clin Lab Sci. 2008; 45: 339-414
- Vitamin D insufficiency: no recommended dietary allowance exists for this nutrient.CMAJ. 2002; 166: 1541-1542
- Dietary calcium and pregnancy-induced hypertension: is there a relation?.Amm J Clin Nutr. 2000; 71: 1371S-1374S
- Vitamin D regulates contractile profile in human uterine myometrial cells via NF-kappaB pathway.Am J Obstet Gynecol. 2014; 210: 347
- Maternal vitamin D status, prolonged labor, cesarean delivery and instrumental delivery in an era with a low cesarean rate.J Perinatol. 2015; 35: 23-28
- Vitamin D and pre-eclampsia: original data, systematic review and meta-analysis.Ann Nutr Metab. 2013; 63: 331-340
- Serum 25-hydroxyvitamin D and glycated haemoglobin levels in women with gestational diabetes mellitus.Med J Aust. 2011; 194: 334
- Vitamin D supplements in pregnant Asian women: effects on calcium status and fetal growth.Br Med J. 1980; 280: 751-754
- Vitamin D and Calcium: Updated Dietary Reference Intakes.Health Canada, Ottawa2010 (Available at)
- Effect of vitamin D supplementation during pregnancy on maternal and neonatal outcomes: a systematic review and meta-analysis of randomized controlled trials.Fertil Steril. 2015; 103: 1278-1288
- Maternal vitamin D status and adverse pregnancy outcomes: a systematic review and meta-analysis.J Matern Fetal Neonatal Med. 2013; 26: 889-899
- The Cochrane Collaboration's tool for assessing risk of bias in randomised trials.BMJ. 2011; 343: d5928
- Association of maternal vitamin D status with glucose tolerance and caesarean section in a multi-ethnic Asian cohort: the Growing Up in Singapore Towards Healthy Outcomes study.PloS One. 2015; 10e0142239
- Associations of maternal circulating 25-hydroxyvitamin D3 concentration with pregnancy and birth outcomes.BJOG. 2015; 122: 1695-1704
- A case control study to evaluate the association between primary cesarean section for dystocia and vitamin D deficiency.J Clin Diagn Res. 2015; 9: QC05-QC08
- Early pregnancy vitamin D status and risk of preeclampsia.J Clin Invest. 2016; 126: 4702-4715
- The effects of vitamin D plus calcium supplementation on metabolic profiles, biomarkers of inflammation, oxidative stress and pregnancy outcomes in pregnant women at risk for pre‐eclampsia.J Hum Nutr Diet. 2016; 29: 505-515
- Supplementation of vitamin D in pregnancy and its correlation with feto‐maternal outcome.Clin Endocrinol. 2015; 83: 536-541
- Maternal vitamin D sufficiency and reduced placental gene expression in angiogenic biomarkers related to comorbidities of pregnancy.J Steroid Chem Mol Biol. 2017; 173: 273-279
- Vitamin D supplementation for women during pregnancy.Sao Paulo Med J. 2016; 134: 274-275
- Effect of various doses of vitamin D supplementation on pregnant women with gestational diabetes mellitus: a randomized controlled trial.Exp Ther Med. 2016; 12: 1889-1895
- Effects of vitamin D supplementation on glucose metabolism, lipid concentrations, inflammation, and oxidative stress in gestational diabetes: a double-blind randomized controlled clinical trial.Am J Clin Nutr. 2013; 98: 1425-1432
- The effects of vitamin D supplementation on maternal and neonatal outcome: a randomized clinical trial.Iran J Reprod Med. 2015; 13: 687-696
- Vitamin D supplementation and the effects on glucose metabolism during pregnancy: a randomized controlled trial.Diabetes Care. 2014; 37: 1837-1844
- Association between vitamin D status and the risk of gestational diabetes mellitus: a meta-analysis.Arch Gynecol Obstet. 2016; 293: 959-966
- Obstetric and neonatal outcomes of maternal vitamin D supplementation: results of an open-label, randomized controlled trial of antenatal vitamin D supplementation in Pakistani women.J Clin Endocrinol Metab. 2014; 99: 2448-2455
- Vitamin D levels during pregnancy and associations with birth weight and body composition of the newborn: a longitudinal multiethnic population-based study.Br J Nutr. 2017; 117: 985-993
- Maternal vitamin D concentrations during pregnancy, fetal growth patterns, and risks of adverse birth outcomes, 2.Am J Clin Nutr. 2016; 103: 1514-1522
- Vitamin D, pre‐eclampsia, and preterm birth among pregnancies at high risk for pre‐eclampsia: an analysis of data from a low‐dose aspirin trial.BJOG. 2017; 124: 1874-1882
Article info
Publication history
Published online: December 21, 2019
Footnotes
Disclosures: The authors declare they have nothing to disclose.
Each author has indicated that they meet the journal's requirements for authorship.
Identification
Copyright
© 2019 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.
