Vitamin D supplementation and incident preeclampsia: A systematic review and meta-analysis of randomized clinical trials
- PMID:31526611
- DOI: 10.1016/j.clnu.2019.08.015
Vitamin D supplementation and incident preeclampsia: A systematic review and meta-analysis of randomized clinical trials
Abstract
Background: Maternal vitamin D deficiency has been associated with an increased risk for preeclampsia. Despite this, the current evidence regarding the efficacy of vitamin D supplementation in preventing preeclampsia is controversial. To assess the impact of vitamin D supplementation on the risk of preeclampsia, we performed a systematic review of the literature and a meta-analysis of the available randomized clinical trials (RCTs).
Methods: The primary outcome was preeclampsia. Subgroup analyses were carried out considering the timing of the supplementation, type of intervention and the study design. Meta-regression analysis, including the amount of vitamin D and maternal age, were planned to explore heterogeneity (PROSPERO database registration number: CRD42019119207).
Results: Data were pooled from 27 RCTs comprising 59 arms, which included overall 4777 participants, of whom 2487 were in the vitamin D-treated arm and 2290 in the control arm. Vitamin D administration in pregnancy was associated with a reduced risk of preeclampsia (odd ratio [OR] 0.37, 95% confidence interval [CI]: 0.26, 0.52; I2 = 0%). If the vitamin D supplementation was started up to 20 weeks' gestation, the odds was a little lower (OR 0.35, 95% CI: 0.24, 0.50, p < 0.001). The effect was largely independent of the supplementation cessation (until delivery or not), type of intervention (vitamin D alone or in association with calcium), and study design. Increasing dose of vitamin D was associated with reduced incidence of preeclampsia (slope of log OR: -1.1, 95% CI: -1.73, -0.46; p < 0.001).
Conclusions: Results suggest that vitamin D supplementation may be useful in preventing preeclampsia. These data are especially useful for health-care providers who engage in the management of pregnant women at risk for preeclampsia. Our findings are a call for action to definitively address vitamin D supplementation as a possible intervention strategy in preventing preeclampsia in pregnancy.
Keywords: Meta-analysis; Preeclampsia; Pregnancy; Vitamin D.
Copyright © 2019 The Author(s). Published by Elsevier Ltd.. All rights reserved.
Comment in
- Reply - Seek methodological rigor & beware of imitations.Fogacci F, Cicero AFG.Fogacci F, et al.Clin Nutr. 2022 Aug;41(8):1854. doi: 10.1016/j.clnu.2022.06.027. Epub 2022 Jun 30.Clin Nutr. 2022.PMID:35811233No abstract available.
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