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Meta-Analysis
. 2022 Jan-Dec:18:17455057221111066.
doi: 10.1177/17455057221111066.

Vitamin D supplementation higher than 2000 IU/day compared to lower dose on maternal-fetal outcome: Systematic review and meta-analysis

Rima Irwinda  1 , Rabbania Hiksas  2 , Angga Wiratama Lokeswara  3 , Noroyono Wibowo  1
Affiliations
Meta-Analysis

Vitamin D supplementation higher than 2000 IU/day compared to lower dose on maternal-fetal outcome: Systematic review and meta-analysis

Rima Irwinda et al. Womens Health (Lond). 2022 Jan-Dec.

Abstract

Introduction: Although vitamin D is widely known as an essential micronutrient during pregnancy, the exact supplementation dose to prevent maternal-fetal outcomes remains a question. This study aims to provide a systematic review and a meta-analysis of data from randomized controlled trial on > 2000 IU/day vitamin D supplementation compared to ⩽ 2000 IU/day; and ⩽ 2000 IU/day compared to placebo, on their effects on the incidence of preeclampsia, gestational diabetes mellitus, preterm birth, and differences on birth weight.

Methods: A systematic literature search on PubMed, EBSCO-MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials databases was carried out to evaluate randomized controlled trial studies on the effects of oral vitamin D > 2000 IU/day versus ⩽ 2000 IU/day; and ⩽ 2000 IU/day versus placebo, on preeclampsia, gestational diabetes mellitus, preterm birth and birth weight. Risk ratio, mean difference, and 95% confidence interval were calculated.

Results: There were a total of 27 randomized controlled trials selected. Maternal vitamin D supplementation > 2000 IU/day had a positive effect only on gestational diabetes mellitus (seven randomized controlled trials; risk ratio = 0.70, 95% confidence interval: 0.51-0.95, I2 = 0). Vitamin D supplementation ⩽ 2000 IU/day has reduced the risk of preeclampsia (three randomized controlled trials; risk ratio = 0.29, 95% confidence interval: 0.09-0.95, I2 = 0), with no significant difference when compared to > 2000 IU/day (eight randomized controlled trials; risk ratio = 0.80, 95% confidence interval: 0.51-1.24, I2 = 31). No difference in preterm birth risk and birth weight after vitamin D supplementation. The quality of evidence varies from moderate to very low certainty. The risk of preeclampsia and gestational diabetes mellitus after high-dose versus low-dose vitamin D supplementation was the ones with moderate certainty.

Conclusion: Vitamin D supplementation > 2000 IU/day might be important to reduce the risk of gestational diabetes mellitus. Lower dose vitamin D supplementation (⩽ 2000 IU/day) seemed adequate to reduce the risk of preeclampsia, with no significant difference compared to the higher dose.

Keywords: birth weight; gestational diabetes mellitus; preeclampsia; preterm birth; vitamin D.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
PRISMA flow diagram of study selection.
Figure 2.
Figure 2.
Forest plot of different vitamin D dosage on the occurrence of PE. (a) ⩽ 2000 IU/day versus placebo. (b) ⩾ 2001 versus ⩽ 2000 IU/day.
Figure 3.
Figure 3.
Forest plot of different vitamin D dosage on the occurrence of gestational diabetes mellitus: (a) ⩾ 2001 IU/day versus placebo. (b) > 2000 versus ⩾ 2001 IU/day.
Figure 4.
Figure 4.
Forest plot of different vitamin D dosage on the occurrence of PTB. (a) ⩾ 2001 IU/day versus placebo. (b) > 2000 versus ⩽ 2000 IU/day.
Figure 5.
Figure 5.
Forest plot of different vitamin D dosage on birth weight. (a) ⩾ 2001 IU/day versus placebo. (b) ⩾ 2001 versus ⩽ 2000 IU/day.
Figure 6.
Figure 6.
Risk of bias assessment 2.0 of randomized controlled trials included in the meta-analysis: (a) risk of bias summary and (b) graph.
See this image and copyright information in PMC

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