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Pregnancy and vitamin D meta-analysis – July 2012

Vitamin D During Pregnancy and Maternal, Neonatal and Infant Health Outcomes:

A Systematic Review and Meta-analysis

Andrew Thorne-Lyman1,*, Wafaie W. Fawzi1,2,3
Paediatric and Perinatal Epidemiology
Special Issue: Improving maternal, newborn, and child health outcomes through better designed policies and programs that enhance the nutrition of women
Volume 26, Issue Supplement s1, pages 75–90, July 2012

Vitamin D has well-defined classical functions related to calcium metabolism and bone health but also has non-classical effects that may influence other aspects of health. There has been considerable recent interest in the role of vitamin D on outcomes related to pregnancy and young child health but few efforts have been made to systematically consolidate this evidence to inform the research and policy agenda for low-income countries. A systematic review was undertaken to identify intervention and observational studies of vitamin D supplementation, intake or status (25-hydroxy-vitamin D) during pregnancy on perinatal and infant health outcomes. Data from trials and observational studies isolating the effect of vitamin D supplementation and intake were extracted and study quality was evaluated. Meta-analysis was used to pool effect estimates. We identified five randomised trials with outcomes of relevance to our review. All had small sample size and dosage amount, duration and frequency varied as did the ability to correct deficiency.

Pooled analysis of trials using fixed-effects models suggested protective effects of supplementation on

  • low birthweight (three trials, risk ratio (RR) = 0.40 [95% confidence interval (CI) 0.23, 0.71]) and
  • non-significant but suggestive effects of daily supplementation on
    small-for-gestational age (two trials, RR = 0.67 [0.40, 1.11]).
  • No effect on preterm delivery (<37 weeks) was evident (two trials, RR = 0.77 [0.35, 1.66]).
  • Little evidence from trials exists to evaluate the effect of vitamin D supplementation during pregnancy on maternal, perinatal or infant health outcomes.

Based on both trials and observational studies, we recommend that future research explore small-for-gestational age, preterm delivery, pre-eclampsia, and maternal and childhood infections, as outcomes of interest. Trials should focus on populations with a high prevalence of vitamin D deficiency, explore the relevance of timing of supplementation, and the dosage used in such trials should be sufficient to correct deficiency.

PDF is attached at the bottom of this page
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Comment by VitaminDWiki

Yet another meta-analysis which ignores the type and amount of vitamin D in each trial
A trial using 800 IU of vitamin D2 is given the same weight as another trial which used 200,000 IU (hopefully of D3 - it does not say)

See also VitaminDWiki

IU Cumulative Benefit Blood level CofactorsCalcium $*/year
400 Less Rickets (but not zero with 400 IU)
3X less adolescent Schizophrenia
Fewer child seizures
20-30 ng/ml Not needed No effect $3
2000 2X More likely to get pregnant naturally/IVF
2X Fewer dental problems with pregnancy
8X less diabetes
4X fewer C-sections (>37 ng)
4X less preeclampsia (40 ng vs 10 ng)
5X less child asthma
2X fewer language problems age 5
42 ng/ml Desirable < 750 mg $15
4000 2X fewer pregnancy complications
2X fewer pre-term births
49 ng/ml Must have
cofactors
< 750 mg $75
6000 Probable: larger benefits for above items
Perhaps prevent 2nd autistic child
   clinical trials underway
Just enough D for breastfed infant
Must have
cofactors
< 750 mg $85

See also in VitaminDWiki: High risk of being vitamin D deficient during pregnancy

Attached files

ID Name Comment Uploaded Size Downloads
1561 Pregnancy meta-analysis.pdf PDF admin 18 Aug, 2012 15:37 695.04 Kb 656
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