Association Between Vitamin D Supplementation During Pregnancy and Offspring Growth, Morbidity, and Mortality: A Systematic Review and Meta-analysis
Bi WG, Nuyt AM, Weiler H, Leduc L, Santamaria C, Wei SQ
JAMA pediatrics · 134 citas
Etiquetas de revisión
Financiación no declaradaDatos neutrales que nuestra revisión registró sobre cómo se hizo este estudio. Describen el método, nunca si nos gusta el resultado.
Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2018-05-29 · JAMA Pediatr · vol. 172 · número 7 · pág. 635
- Editorial
- American Medical Association
- Citado
- 211 citas · más que el 99% de estudios similares · 11.1× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 67 trabajos
- Acceso
- Acceso abierto (revista híbrida) · CC-BY
- Áreas de investigación
- Vitamin D Research Studies · Birth, Development, and Health · Vitamin K Research Studies
- Palabras clave
- vitamin D supplementation, pregnancy, prenatal supplementation, offspring growth, small for gestational age, fetal death, neonatal mortality, congenital malformations, neonatal intensive care admission, birth weight, 25-hydroxyvitamin D, preterm birth, infant anthropometry, childhood respiratory morbidity, maternal vitamin D status, infant morbidity and mortality
- MeSH
- humans, fetal death, vitamin d, pregnancy outcome, prenatal care, child development, growth, pregnancy, dose-response relationship, drug, dietary supplements, infant, infant, small for gestational age, female, congenital abnormalities, randomized controlled trials as topic, infant death
6 autores
- Wei Guang Bi🇨🇦Centre Hospitalier Universitaire Sainte-Justine; Université de Montréal
- Anne Monique Nuyt🇨🇦Centre Hospitalier Universitaire Sainte-Justine; Université de Montréal
- Hope Alberta Weiler🇨🇦McGill University
- Line Leduc🇨🇦Centre Hospitalier Universitaire Sainte-Justine; Université de Montréal
- Christina Santamaria🇨🇦Centre Hospitalier Universitaire Sainte-Justine; Université de Montréal
- Shu Qin Wei🇨🇦 · autor de correspondenciaCentre Hospitalier Universitaire Sainte-Justine; Université de Montréal
Resumen
El texto original del estudio, en el idioma en que se publicó.
Importance
Whether vitamin D supplementation during pregnancy is beneficial and safe for offspring is unclear.
Objective
To systematically review studies of the effects of vitamin D supplementation during pregnancy on offspring growth, morbidity, and mortality.
Data sources
Searches of Medline, Embase, and the Cochrane Database of Systematic Reviews were conducted up to October 31, 2017. Key search terms were vitamin D, pregnancy, randomized controlled trials, and offspring outcomes.
Study selection
Randomized clinical trials of vitamin D supplementation during pregnancy and offspring outcomes.
Data extraction and synthesis
Two authors independently extracted data, and the quality of the studies was assessed. Summary risk ratio (RR), risk difference (RD) or mean difference (MD), and 95% CI were calculated using fixed-effects or random-effects meta-analysis.
Main outcomes and measures
Main outcomes were fetal or neonatal mortality, small for gestational age (SGA), congenital malformation, admission to a neonatal intensive care unit, birth weight, Apgar scores, neonatal 25-hydroxyvitamin D (25[OH]D) and calcium concentrations, gestational age, preterm birth, infant anthropometry, and respiratory morbidity during childhood.
Results
Twenty-four clinical trials involving 5405 participants met inclusion criteria. Vitamin D supplementation during pregnancy was associated with a lower risk of SGA (RR, 0.72; 95% CI, 0.52 to 0.99; RD, -5.60%; 95% CI, -0.86% to -10.34%) without risk of fetal or neonatal mortality (RR, 0.72; 95% CI, 0.47 to 1.11) or congenital abnormality (RR, 0.94; 95% CI, 0.61 to 1.43). Neonates with prenatal vitamin D supplementation had higher 25(OH)D levels (MD, 13.50 ng/mL; 95% CI, 10.12 to 16.87 ng/mL), calcium levels (MD, 0.19 mg/dL; 95% CI, 0.003 to 0.38 mg/dL), and weight at birth (MD, 75.38 g; 95% CI, 22.88 to 127.88 g), 3 months (MD, 0.21 kg; 95% CI, 0.13 to 0.28 kg), 6 months (MD, 0.46 kg; 95% CI, 0.33 to 0.58 kg), 9 months (MD, 0.50 kg; 95% CI, 0.01 to 0.99 kg), and 12 months (MD, 0.32 kg; 95% CI, 0.12 to 0.52 kg). Subgroup analysis by doses showed that low-dose vitamin D supplementation (≤2000 IU/d) was associated with a reduced risk of fetal or neonatal mortality (RR, 0.35; 95% CI, 0.15 to 0.80), but higher doses (>2000 IU/d) did not reduce this risk (RR, 0.95; 95% CI, 0.59 to 1.54).
Conclusions and relevance
Vitamin D supplementation during pregnancy is associated with a reduced risk of SGA and improved infant growth without risk of fetal or neonatal mortality or congenital abnormality. Vitamin D supplementation with doses of 2000 IU/d or lower during pregnancy may reduce the risk of fetal or neonatal mortality.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial (CC BY).
Confianza de la comunidad
Cargando…
¿Cuánto confías en los hallazgos de este estudio?
Comentarios
¿Algo está mal aquí?
Señala este estudio si su información, etiquetas o financiación parecen incorrectas. Un editor revisa cada señalamiento.
Información educativa sobre investigación publicada. No es consejo médico ni una recomendación para empezar o dejar nada.