Loading...
 
Translate Register Log In Login with facebookLogin and Register

Birth weight and length increased with high levels of vitamin D – meta-analysis March 2015

Erratum of the study - June 2016 - charts with the following text

The new pooled analysis showed the effect of vitamin D is larger with the same direction for

  • circulating 25-OHD (mean difference [MD], 70.69 vs. 66.46 nmol/L),
  • preeclampsia (relative risk [RR], 0.89 vs. 0.88),
  • gestational diabetes (RR, 1.08 vs. 1.05),
  • low birth weight (RR, 0.84 vs. 0.72),
  • preterm birth (RR, 1.30 vs. 1.26),
  • birth weight (MD,108.62 vs. 107.60 g), and
  • birth length (MD, 0.79 vs. 0.30 cm).

The new pooled analysis shows that the effect of vitamin D is smaller with the same direction for small for gestation age (RR, 0.69 vs. 0.78).
 Download the Erratum from VitaminDWiki
   Strangely this erratum is not mentioned at the web site for the original publication


Effect of vitamin D supplementation during pregnancy on maternal and neonatal outcomes: a systematic review and meta-analysis of randomized controlled trials

Fertility and Sterility, Received: October 19, 2014; Received in revised form: February 11, 2015; Accepted: February 12, 2015; Published Online: March 24, 2015, DOI: http://dx.doi.org/10.1016/j.fertnstert.2015.02.019
Faustino R. Pérez-López, M.D., Ph.D. faustino.perez at unizar.es, Vinay Pasupuleti, M.D., Ph.D., Edward Mezones-Holguin, M.D., Vicente A. Benites-Zapata, M.D., Priyaleela Thota, M.D., Abhishek Deshpande, M.D., Ph.D., Adrian V. Hernandez, M.D., Ph.D.

See also

Many of the RCT studied used very small doses of D3 or used D2 - so could not be expected to get high enough levels to make a difference. See BOLDED references for details
Virtually no Meta-analysis considers dose size

VitaminDWiki articles in Pregnancy AND Meta-analysis:

Web


Objective: To assess the effects of vitamin D supplementation during pregnancy on obstetric outcomes and birth variables.

Design: Systematic review and meta-analysis of randomized controlled trials (RCTs).

Setting; Not applicable.

Patient(s): Pregnant women and neonates.

Intervention(s): PubMed and 5 other research databases were searched through March 2014 for RCTs evaluating vitamin D supplementation ± calcium/vitamins/ferrous sulfate vs. a control (placebo or active) during pregnancy.

Main Outcome Measure(s): Measures were: circulating 25-hydroxyvitamin D [25(OH)D] levels, preeclampsia, gestational diabetes mellitus (GDM), small for gestational age (SGA), low birth weight, preterm birth, birth weight, birth length, cesarean section. Mantel-Haenszel fixed-effects models were used, owing to expected scarcity of outcomes. Effects were reported as relative risks and their 95% confidence intervals (CIs).

Result(s): Thirteen RCTs (n = 2,299) were selected. Circulating 25(OH)D levels were significantly higher at term, compared with the control group (mean difference: 66.5 nmol/L, 95% CI 66.2–66.7).
Birth weight and birth length were significantly greater for neonates in the vitamin D group; mean difference:

  • 107.6 g (95% CI 59.9–155.3 g) and
  • 0.3 cm (95% CI 0.10–0.41 cm), respectively.

Incidence of

  • preeclampsia,
  • GDM,
  • SGA,
  • low birth weight,
  • preterm birth, and
  • cesarean section

were not influenced by vitamin D supplementation.
Across RCTs, the doses and types of vitamin D supplements, gestational age at first administration, and outcomes were heterogeneous.

Conclusion(s): Vitamin D supplementation during pregnancy was associated with increased circulating 25(OH)D levels, birth weight, and birth length, and was not associated with other maternal and neonatal outcomes. Larger, better-designed RCTs evaluating clinically relevant outcomes are necessary to reach a definitive conclusion.

 Download the PDF from VitaminDWiki

References

Note: the Authors of the RCT used by the meta-analysis are bolded by VitaminDWiki, along with details

  1. Pérez-López, F.R., Chedraui, P., Fernández-Alonso, A.M. Vitamin D and aging: beyond calcium and bone metabolism. Maturitas. 2011;69:27–36. Abstract | Full Text | Full Text PDF | PubMed | Scopus (38)
  2. Wacker, M., Holick, M.F. Vitamin D—effects on skeletal and extraskeletal health and the need for supplementation. Nutrients. 2013;5:111–148. CrossRef | PubMed | Scopus (64)
  3. Ponsonby, A.L., Lucas, R.M., Lewis, S., Halliday, J. Vitamin D status during pregnancy and aspects of offspring health. Nutrients. 2010;2:389–407. CrossRef | PubMed | Scopus (5)
  4. Fernández-Alonso, A.M., Dionis-Sánchez, E.C., Chedraui, P., González-Salmerón, M.D., Pérez-López, F.R. Spanish Vitamin D and Women's Health Research Group. First-trimester maternal serum 25-hydroxyvitamin D status and pregnancy outcome. Int J Gynecol Obstet. 2012;116:6–9. Abstract | Full Text | Full Text PDF | PubMed | Scopus (22)
  5. Hossain, N., Khanani, R., Hussain-Kanani, F., Shah, T., Arif, S., Pal, L. High prevalence of vitamin D deficiency in Pakistani mothers and their newborns. Int J Gynecol Obstet. 2011;112:229–233. Abstract | Full Text | Full Text PDF | PubMed | Scopus (17)
  6. Pérez-López, F.R. Vitamin D: the secosteroid hormone and human reproduction. Gynecol Endocrinol. 2007;23:13–24. CrossRef | PubMed | Scopus (38)
  7. Thorne-Lyman, A., Fawzi, W.W. Vitamin D during pregnancy and maternal, neonatal and infant health outcomes: a systematic review and meta-analysis. Pediatr Perinat Epidemiol. 2012;26:75–90. CrossRef | PubMed | Scopus (41)
  8. Hollis, B.W., Johnson, D., Hulsey, T.C., Ebeling, M., Wagner, C.L. Vitamin D supplementation during pregnancy: double-blind, randomized clinical trial of safety and effectiveness J Bone Miner Res. 2011;26:2341–2357. CrossRef | PubMed | Scopus (192)
    VitaminDWiki 4000 IU Vitamin D Safe and Effective For Healthy Pregnant Women – RCT June 2011
  9. De Regil, L.M., Palacios, C., Ansary, A., Kulier, R., Peña-Rosas, J.P. Vitamin D supplementation for women during pregnancy. Cochrane Database Syst Rev. 2012;2:CD008873. PubMed
  10. Harvey, N.C., Holroyd, C., Ntani, G., Javaid, K., Cooper, P., Moon, R. et al, Vitamin D supplementation in pregnancy: a systematic review. Health Technol Assess. 2014;18:1–190. CrossRef | Scopus (5)
  11. Moher, D., Liberati, A., Tetzlaff, J., Altman, D.G. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg. 2010;8:336–341. Abstract | Full Text | Full Text PDF | PubMed | Scopus (410)
  12. Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0. Available at: http://www.cochrane-handbook.org. Accessed July 23, 2014.
  13. Mantel, N., Haenszel, W. Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst. 1959;22:719–748. PubMed
  14. Review Manager (RevMan) [Computer program]. Version 5.1. The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen; 2011.
  15. Asemi, Z., Samimi, M., Tabassi, Z., Shakeri, H., Esmaillzadeh, A. Vitamin D supplementation affects serum high-sensitivity C-reactive protein, insulin resistance, and biomarkers of oxidative stress in pregnant women. J Nutr. 2013;143:1432–1438. CrossRef | PubMed | Sco pus (11)
    VitaminDWiki During pregnancy even 400 IU helps metabolic status – RCT July 2013
  16. Brooke, O.G., Brown, I.R., Bone, C.D., Carter, N.D., Cleeve, H.J., Maxwell, J.D. et al, Vitamin D supplements in pregnant Asian women: effects on calcium status and fetal growth.Br Med J. 1980;280:751–754. CrossRef | PubMed 1000 IU vitamin D2
  17. Delvin, E.E., Salle, B.L., Glorieux, F.H., Adeleine, P., David, L.S. Vitamin D supplementation during pregnancy: effect on neonatal calcium homeostasis. J Pediatr. 1986;109:328–334. Abstract | Full Text PDF | PubMed | Scopus (107) 1000 IU Vitamin D3
  18. Goldring, S.T., Griffiths, C.J., Martineau, A.R., Robinson, S., Yu, C., Poulton, S. et al, Prenatal vitamin D supplementation and child respiratory health: a randomised controlled trial.. PLoS One. 2013;8:e66627. CrossRef | PubMed | Scopus (16) Single 200,000 IU D3 dose
  19. Hashemipour, S., Ziaee, A., Javadi, A., Movahed, F., Elmizadeh, K., Javadi, E.H. et al, Effect of treatment of vitamin D deficiency and insufficiency during pregnancy on fetal growth indices and maternal weight gain: a randomized clinical trial. Eur J Obstet Gynecol Reprod Biol. 2014;172:15–19. Abstract | Full Text | Full Text PDF | PubMed | Scopus (1)
    VitaminDWiki Vitamin D intervention for 8 weeks of pregnancy: infants taller, heavier and bigger heads – RCT Oct 2013 50,000 IU weekly
  20. Hossain, N., Kanani, F.H., Ramzan, S., Kausar, R., Ayaz, S., Khanani, R. et al, 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. CrossRef | PubMed | Scopus (2)
    VitaminDWiki Adding 4,000 IU of vitamin D daily at 20 weeks pregnancy not help much – RCT March 2014
  21. Mallet, E., Gügi, B., Brunelle, P., Hénocq, A., Basuyau, J.P., Lemeur, H. Vitamin D supplementation in pregnancy: a controlled trial of two methods. Obstet Gynecol. 1986;68:300–304. CrossRef | PubMed
    1000 IU vitamin D2
  22. Marya, R.K., Rathee, S., Manrow, M. Effect of calcium and vitamin D supplementation on toxaemia of pregnancy. Gynecol Obstet Invest. 1987;24:38–42. CrossRef | PubMed
  23. Marya, R.K., Rathee, S., Dua, V., Sangwan, K. Effect of vitamin D supplementation during pregnancy on foetal growth. Indian J Med Res. 1988;88:488–492. PubMed Vitamin D2, 1000 IU
  24. Roth, D.E., Al Mahmud, A., Raqib, R., Akhtar, E., Perumal, N., Pezzack, B. et al, Randomized placebo-controlled trial of high-dose prenatal third-trimester vitamin D3 supplementation in Bangladesh: the AViDD trial. Nutr J. 2013;12:47. CrossRef | PubMed | Scopus (7) 35,000 IU/week  PDF in VitaminDWiki
  25. Sabet, Z., Ghazi, A.A., Tohidi, M., Oladi, B. Vitamin D supplementation in pregnant Iranian women: effects on maternal and neonatal vitamin D and parathyroid hormone status. Acta Endo (Buc). 2012;8:59–66. CrossRef 100,000 IU monthly
  26. Yu, C.K., Sykes, L., Sethi, M., Teoh, T.G., Robinson, S. Vitamin D deficiency and supplementation during pregnancy. Clin Endocrinol (Oxf). 2009;70:685–690. CrossRef | PubMed | Scopus (56)
    Single dose of 200,000 IU followed by 800 IU daily, not enough to become sufficient
  27. Kovacs, C.S. Bone metabolism in the fetus and neonate. Pediatr Nephrol. 2014;29:793–803. CrossRef | PubMed | Scopus (1)
  28. Villar, J., Cheikh Ismail, L., Victora, C.G., Ohuma, E.O., Bertino, E., Altman, D.G. et al, International standards for newborn weight, length, and head circumference by gestational age and sex: the Newborn Cross-Sectional Study of the INTERGROWTH-21st Project. Lancet. 2014;384:857–868. Abstract | Full Text | Full Text PDF | PubMed
  29. Freemark, M. Placental hormones and the control of fetal growth. J Clin Endocrinol Metab. 2010;95:2054–2057. CrossRef | PubMed | Scopus (15)
  30. Shin, J.S., Choi, M.Y., Longtine, M.S., Nelson, D.M. Vitamin D effects on pregnancy and the placenta. Placenta. 2010;31:1027–1034. Abstract | Full Text | Full Text PDF | PubMed | Scopus (42)
  31. Figueras, F., Gratacós, E. Update on the diagnosis and classification of fetal growth restriction and proposal of a stage-based management protocol. Fetal Diagn Ther. 2014;36:86–98. CrossRef | PubMed | Scopus (6)
  32. Papageorghiou, A.T., Ohuma, E.O., Altman, D.G., Todros, T., Cheikh Ismail, L., Lambert, A. et al, International standards for fetal growth based on serial ultrasound measurements: the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project. Lancet. 2014;384:869–879. Abstract | Full Text | Full Text PDF | PubMed
  33. Song, S.J., Si, S., Liu, J., Chen, X., Zhou, L., Jia, G. et al, Vitamin D status in Chinese pregnant women and their newborns in Beijing and their relationships to birth size. Public Health Nutr. 2013;16:687–692. CrossRef | PubMed | Scopus (2)
  34. Bodnar, L.M., Rouse, D.J., Momirova, V., Peaceman, A.M., Sciscione, A., Spong, C.Y. et al, Maternal 25-hydroxyvitamin D and preterm birth in twin gestations. Obstet Gynecol. 2013;122:91–98. CrossRef | PubMed | Scopus (6)
  35. Thota, C., Menon, R., Fortunato, S.J., Brou, L., Lee, J.E., Al-Hendy, A. 1,25-Dihydroxyvitamin D deficiency is associated with preterm birth in African American and Caucasian women. Reprod Sci. 2014;21:244–250. CrossRef | PubMed
  36. Baker, A.M., Haeri, S., Camargo, C.A. Jr., Stuebe, A.M., Boggess, K.A. A nested case-control study of first-trimester maternal vitamin D status and risk for spontaneous preterm birth. Am J Perinatol. 2011;28:667–672. CrossRef | PubMed | Scopus (18)
  37. Thorp, J.M., Camargo, C.A., McGee, P.L., Harper, M., Klebanoff, M.A., Sorokin, Y. et al, Vitamin D status and recurrent preterm birth: a nested case-control study in high-risk women. BJOG. 2012;119:1617–1623. CrossRef | PubMed | Scopus (8)
  38. Liong, S., Di Quinzio, M.K., Fleming, G., Permezel, M., Georgiou, H.M. Is vitamin D binding protein a novel predictor of labour?. PLoS One. 2013;8:e76490.CrossRef | PubMed | Scopus (2)
  39. Bodnar, L.M., Simhan, H.N., Catov, J.M., Roberts, J.M., Platt, R.W., Diesel, J.C. et al, Maternal vitamin D status and the risk of mild and severe preeclampsia. Epidemiology. 2014;25:207–214. CrossRef | PubMed | Scopus (3)
  40. Bomba-Opon, D.A., Brawura-Biskupski-Samaha, R., Kozlowski, S., Kosinski, P., Bartoszewicz, Z., Bednarczuk, T. et al, First trimester maternal serum vitamin D and markers of preeclampsia. J Matern Fetal Neonatal Med. 2014;27:1078–1079. CrossRef | PubMed | Scopus (1)
  41. Ma, R., Gu, Y., Zhao, S., Sun, J., Groome, L.J., Wang, Y. Expressions of vitamin D metabolic components VDBP, CYP2R1, CYP27B1, CYP24A1, and VDR in placentas from normal and preeclamptic pregnancies. Am J Physiol Endocrinol Metab. 2012;303:E928–E935. CrossRef | PubMed | Scopus (13)
  42. Hofmeyr, G.J., Belizán, J.M., von Dadelszen, P., Calcium and Pre-eclampsia (CAP) Study Group. Low-dose calcium supplementation for preventing pre-eclampsia: a systematic review and commentary. BJOG. 2014;121:951–957. CrossRef | PubMed | Scopus (1)
  43. Hofmeyr, G.J., Lawrie, T.A., Atallah, A.N., Duley, L., Torloni, M.R. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database Syst Rev. 2014;6:CD001059. PubMed
  44. Burris, H.H., Rifas-Shiman, S.L., Kleinman, K., Litonjua, A.A., Huh, S.Y., Rich-Edwards, J.W. et al, Vitamin D deficiency in pregnancy and gestational diabetes mellitus. Am J Obstet Gynecol. 2012;207:182.e1–182.e8. Abstract | Full Text | Full Text PDF | Scopus (26)
  45. Poel, Y.H., Hummel, P., Lips, P., Stam, F., van der Ploeg, T., Simsek, S. Vitamin D and gestational diabetes: a systematic review and meta-analysis. Eur J Intern Med. 2012;23:465–469. Abstract | Full Text | Full Text PDF | PubMed | Scopus (32)
  46. Knabl, J., Hüttenbrenner, R., Hutter, S., Günthner-Biller, M., Riedel, C., Hiden, U. et al, Gestational diabetes mellitus upregulates vitamin D receptor in extravillous trophoblasts and fetoplacental endothelial cells. Reprod Sci. 2015;22:358–366. CrossRef | PubMed
  47. Wamberg, L., Christiansen, T., Paulsen, S.K., Fisker, S., Rask, P., Rejnmark, L. et al, Expression of vitamin D-metabolizing enzymes in human adipose tissue—the effect of obesity and diet-induced weight loss. Int J Obes (Lond). 2013;37:651–657. CrossRef | PubMed | Scopus (15)
  48. Karlsson, T., Osmancevic, A., Jansson, N., Hulthén, L., Holmäng, A., Larsson, I. Increased vitamin D-binding protein and decreased free 25-OHD in obese women of reproductive age. Eur J Nutr. 2014;53:259–267. CrossRef | PubMed | Scopus (3)
  49. Merewood, A., Mehta, S.D., Chen, T.C., Bauchner, H., Holick, M.F. Association between vitamin D deficiency and primary cesarean section. J Clin Endocrinol Metab. 2009;94:940–945. CrossRef | PubMed | Scopus (115)
  50. Scholl, T.O., Chen, X., Stein, P. Maternal vitamin D status and delivery by cesarean. Nutrients. 2012;4:319–330. CrossRef | PubMed | Scopus (11)
  51. Savvidou, M.D., Makgoba, M., Castro, P.T., Akolekar, R., Nicolaides, K.H. First-trimester maternal serum vitamin D and mode of delivery. Br J Nutr. 2012;108:1972–1975. CrossRef | PubMed | Scopus (4)
  52. Wootton, A.M. Improving the measurement of 25-hydroxyvitamin D. Clin Biochem Rev. 2005;26:33–36. PubMed
  53. Vassalle, C., Pérez-López, F.R. The importance of some analytical aspects and confounding factors in relation to clinical interpretation of results. in: C. Meer, H. Smits (Eds.) Vitamin D: Daily requirements, dietary sources and symptoms of deficiency. Nova Biomedicals, New York; 2013:91–114.
  54. Black, R.E., Allen, L.H., Bhutta, Z.A., Caulfield, L.E., de Onis, M., Ezzati, M. et al, Maternal and child undernutrition: global and regional exposures and health consequences. Lancet. 2008;371:243–260. Abstract | Full Text | Full Text PDF | PubMed | Scopus (1258)
  55. Josefson, J.L., Feinglass, J., Rademaker, A.W., Metzger, B.E., Zeiss, D.M., Price, H.E. et al, Maternal obesity and vitamin D sufficiency are associated with cord blood vitamin D insufficiency. J Clin Endocrinol Metab. 2013;98:114–119. CrossRef | PubMed | Scopus (12)
  56. Young, B.E., McNanley, T.J., Cooper, E.M., McIntyre, A.W., Witter, F., Harris, Z.L. et al, Maternal vitamin D status and calcium intake interact to affect fetal skeletal growth in utero in pregnant adolescents. Am J Clin Nutr. 2012;95:1103–1112. CrossRef | PubMed | Scopus (17)
  57. Lieben, L., Stockmans, I., Moermans, K., Carmeliet, G. Maternal hypervitaminosis D reduces fetal bone mass and mineral acquisition and leads to neonatal lethality. Bone. 2013;57:123–131. Abstract | Full Text | Full Text PDF | PubMed | Scopus (1)
  58. Burris, H.H., Rifas-Shiman, S.L., Huh, S.Y., Kleinman, K., Litonjua, A.A., Oken, E. et al, Vitamin D status and hypertensive disorders in pregnancy. Ann Epidemiol. 2014;24:399–403.e1. Abstract | Full Text | Full Text PDF | PubMed | Scopus (1)
  59. Ross, A.C., Manson, J.E., Abrams, S.A., Aloia, J.F., Brannon, P.M., Clinton, S.K. et al, The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab. 2011;96:53–58. CrossRef | PubMed | Scopus (892)
  60. in: A.C. Ross, C.L. Taylor, A.L. Yaktine, H.B. Del Valle (Eds.) Dietary reference intakes for calcium and vitamin D. National Academies Press, Washington, DC; 2011.
  61. Holick, M.F., Binkley, N.C., Bischoff-Ferrari, H.A., Gordon, C.M., Hanley, D.A., Heaney, R.P. et al, Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96:1911–1930. CrossRef | PubMed | Scopus (1303)
  62. ACOG Committee on Obstetric Practice. Committee Opinion Number 495: Vitamin D: screening and supplementation during pregnancy. Obstet Gynecol. 2011;118:197–198. CrossRef | PubMed | Scopus (23)
  63. Pérez-López, F.R. Low maternal vitamin D status during pregnancy requires appropriate therapeutic intervention. Int J Gynaecol Obstet. 2012;116:4–5. Abstract | Full Text | Full Text PDF | PubMed | Scopus (1)
  64. Blumfield, M.L., Hure, A.J., Macdonald-Wicks, L., Smith, R., Collins, C.E. A systematic review and meta-analysis of micronutrient intakes during pregnancy in developed countries. Nutr Rev. 2013;71:118–132. CrossRef | PubMed | Scopus (13)

Attached files

ID Name Comment Uploaded Size Downloads
7487 Erratum.pdf PDF admin 15 Dec, 2016 14:36 1.19 Mb 272
5721 Effect of vitamin supplementation during pregnancy - Meta-analysis of RCTs.pdf PDF 2015 admin 27 Jul, 2015 12:15 2.04 Mb 697
5360 ROTH.pdf PDF admin 21 Apr, 2015 02:39 4.02 Mb 591
See any problem with this page? Report it (FINALLY WORKS)