Vitamin D status during pregnancy and offspring outcomes: a systematic review and meta-analysis of observational studies

• Published in: European journal of clinical nutrition Vol. 74; no. 1; pp. 36 - 53
• Main Authors: Tous, Monica, Villalobos, Marcela, Iglesias-Vázquez, Lucía, Fernández-Barrés, Sílvia, Arija, Victoria
• Format: Journal Article
• Language: English
• Published: England Nature Publishing Group 01.01.2020
• Subjects: 25-Hydroxyvitamin D; Alfacalcidol; Analysis; Anthropometry; Birth weight; Calcifediol; Calciferol; Female; Gestational age; Humans; Infant; Infant, Newborn; Infant, Small for Gestational Age; Infants; Infants (Premature); Literature reviews; Meta-analysis; Observational studies; Observational Studies as Topic; Offspring; Pregnancy; Pregnancy Outcome; Pregnant women; Premature birth; Premature Birth - etiology; Risk; Small for gestational age; Systematic review; Vitamin D; Vitamin D Deficiency - complications; Vitamin deficiency; China; Spain
• ISSN: 0954-3007; 1476-5640; 1476-5640
• DOI: 10.1038/s41430-018-0373-x

Vitamin D deficiency during pregnancy may influence adverse outcomes in offspring. The aim of this systematic review and meta-analysis of observational studies was to assess the association between low prenatal concentrations of 25(OH)D (by using three different cut-off levels), preterm birth (PTB) and anthropometric and neurodevelopmental outcomes in offspring. Studies reporting data on the association between maternal vitamin D concentrations and offspring outcomes identified through a systematic review of scientific literature published in PubMed/MEDLINE, Scopus and the Cochrane Library databases up to April 2017. We included 54 eligible studies. Vitamin D-deficient mothers (<30 nmol/L) had offspring with lower birthweight (MD -87.82 g; 95% CI -119.73, -55.91 g), head circumference (MD -0.19 cm; 95% CI -0.32, -0.06 cm) and a higher risk of small for gestational age (SGA) infants and PTB (OR 1.59; 95% CI 1.24, 2.03) compared to mothers with concentrations ≥30 nmol/L. Vitamin D insufficiency (<50 nmol/L) was associated with a higher risk of SGA and PTB (OR 1.43; 95% CI 1.08, 1.91 and OR 1.28; 95% CI 1.08, 1.52, respectively). Concentrations of 25(OH)D ≥75 nmol/L were not found to be associated with birthweight, SGA or PTB. Offspring of vitamin D-insufficient mothers had lower scores in mental (MD -1.12 points; 95% CI -1.82, -0.42 cm) and language developmental tests (MD -0.35 points; 95% CI -1.00, 0.31 cm). Maternal vitamin D deficiency is associated with offspring adverse anthropometric outcomes and PTB; insufficiency with a higher risk of SGA, PTB and adverse neurodevelopmental outcomes.