Association between vitamin D status and bacterial vaginosis in non-pregnant women of reproductive age: a systematic review and meta-analysis
Yang D, Gong X
European journal of obstetrics, gynecology, and reproductive biology · 0 citas
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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
- 2026-05-25 · Eur J Obstet Gynecol Reprod Biol · vol. 324 · pág. 115208
- Editorial
- Elsevier BV
- Citado
- 0 citas · más que el 22% de estudios similares · 0.0× el promedio de su campo
- Referencias
- 25 trabajos
- Acceso
- De pago
- Áreas de investigación
- Reproductive tract infections research · Vitamin D Research Studies · Gut microbiota and health
- Palabras clave
- bacterial vaginosis, vitamin D deficiency, vitamin D supplementation, vaginal dysbiosis, vaginal microbiota, mucosal immunity, low-quality evidence, Iranian women, Western women, African women, Asian women, Latin American women, North American women, Australian women, New Zealand women
- MeSH
- humans, vaginosis, bacterial, vitamin d deficiency, vitamin d, adult, female
2 autores
- Dongdong Yang · autor de correspondencia
- Xingzi Gong · autor de correspondencia
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
Bacterial vaginosis (BV) is the most common vaginal dysbiosis in women of reproductive age, and vitamin D (VD) has been implicated in mucosal immune regulation. However, the relationship between VD deficiency (VDD) and BV remains inconclusive, with prior reviews limited by inclusion of pregnant populations and incomplete literature coverage.
Objective
To systematically evaluate the association between VD status and BV in non-pregnant women of reproductive age, and to assess the effect of VD supplementation on BV outcomes.
Methods
PubMed, Embase, Cochrane Library, Web of Science, and CNKI were searched from inception through January 2025. Observational studies and intervention trials reporting VD status and BV outcomes in non-pregnant reproductive-age women were eligible. Random-effects meta-analysis with restricted maximum likelihood (REML) estimation and Hartung-Knapp adjustment was performed. Heterogeneity was assessed using I2 and Cochran Q statistics. Subgroup and sensitivity analyses were pre-specified by geographic region, VDD cutoff, BV diagnostic method, and risk of bias.
Results
Thirteen studies (9 observational, 4 interventional) met inclusion criteria. Among observational studies (7 entries from 5 studies; n = 6,862), the pooled odds ratio (OR) for BV with VDD was 1.00 (95% CI: 0.71-1.42; I2 = 63.9%; prediction interval: 0.66-1.53), indicating no overall association. Substantial geographic heterogeneity was observed: the single Iranian study showed a strong positive association (OR = 4.34), whereas Western (OR = 0.96) and African (OR = 1.01) studies were null. Among intervention studies (4 studies; n = 281), VD supplementation was associated with a non-significant trend toward reduced BV persistence (pooled RR = 0.68; 95% CI: 0.28-1.63; I2 = 85.7%). However, excluding the sole null US trial revealed a consistent protective effect across three non-US studies (RR = 0.47; 95% CI: 0.37-0.60; I2 = 0%). GRADE certainty of evidence was very low for both outcomes.
Conclusions
The VDD-BV relationship is population-dependent. In VDD-prevalent populations, both observational and intervention evidence suggested an association: VD supplementation reduced BV persistence in the Iran subgroup (RR = 0.45, I2 = 0%). In the limited US data available, no such association was detected, although this finding may not generalize to all Western populations. These findings support targeted VD supplementation for women with documented deficiency rather than universal use, though GRADE certainty is very low and confirmatory RCTs are needed.
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