Vitamin D and risk of preterm birth: Up-to-date meta-analysis of randomized controlled trials and observational studies.
J Obstet Gynaecol Res. 2017 Feb;43(2):247-256. doi: 10.1111/jog.13239.
Zhou SS1, Tao YH2, Huang K2, Zhu BB2, Tao FB2.
1Department of Maternal, Child and Adolescent Health, Anhui Medical University, Hefei, China.
2Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China.
Pre-term birth - many of risk factors are associated with low vitamin D
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Reduces Evidence 0. Chance of not conceiving 3.4 times Observe 1. Miscarriage 2.5 times Observe 2. Pre-eclampsia 3.6 times RCT 3. Gestational Diabetes 3 times RCT 4. Good 2nd trimester sleep quality 3.5 times Observe 5. Premature birth 2 times RCT 6. C-section - unplanned 1.6 times Observe Stillbirth - OMEGA-3 4 times RCT - Omega-3 7. Depression AFTER pregnancy 1.4 times RCT 8. Small for Gestational Age 1.6 times meta-analysis 9. Infant height, weight, head size
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RCT = Randomized Controlled Trial
Vitamin D Receptor is a major factor in preterm births - see following
Preterm births are far more likely if poor Vitamin D Receptor
Health Problem 34 X Preterm birth seems too large 3.3 X Pre-term birth
We performed a meta-analysis of randomized controlled trials (RCT) and observational studies to answer the two following questions: (i) whether low maternal circulating 25 hydroxyvitamin D (25-OHD) is associated with an increased risk of preterm birth (PTB) or spontaneous PTB (sPTB); and (ii) whether vitamin D supplementation alone during pregnancy can reduce the risk of PTB.
Literature search was carried out using Pubmed, Web of Science and Embase databases up to June 2016. Pooled OR or relative risk (RR) with 95%CI were computed using fixed or random effects models depending on the size of heterogeneity. Subgroup analysis was used to explore potential sources of between-study heterogeneity. Publication bias was evaluated using Egger's test and Begg's test.
Twenty-four articles (six RCT and 18 observational studies) were identified.
Maternal circulating 25-OHD deficiency (pooled OR, 1.25; 95%CI: 1.13-1.38)
rather than insufficiency (pooled OR, 1.09; 95%CI: 0.89-1.35)
was associated with an increased risk of PTB,
and vitamin D supplementation alone during pregnancy could reduce the risk of PTB (pooled RR, 0.57; 95%CI: 0.36-0.91).
This was also the case for the sPTB subgroup (circulating 25-OHD <50 vs >50 nmol/L; pooled OR, 1.45; 95%CI: 1.20-1.75).
Maternal circulating 25-OHD deficiency could increase PTB risk and vitamin D supplementation alone during pregnancy could reduce PTB risk. Extrapolation of the results, however, must be done with caution, and there is urgent need for larger, better-designed RCT to confirm this effect.
PMID: 28150405 DOI: 10.1111/jog.13239
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Patients and/or caregivers may access this content for use in relation to their own personal healthcare or that of a family member only.Preterm birth rate reduced by 43 percent with adequate Vitamin D supplementation – meta-analysis Feb 2017
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