Vitamin D supplementation and incident preeclampsia: A systematic review and meta-analysis of randomized clinical trials

Fogacci, Silvia, Fogacci, Federica, Banach, Maciej, Michos, Erin D, Hernandez, Adrian V, Lip, Gregory YH ORCID: 0000-0002-7566-1626, Blaha, Michael J, Toth, Peter P, Borghi, Claudio and Cicero, Arrigo FG
(2020) Vitamin D supplementation and incident preeclampsia: A systematic review and meta-analysis of randomized clinical trials. CLINICAL NUTRITION, 39 (6). pp. 1742-1752.

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<h4>Background</h4>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).<h4>Methods</h4>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).<h4>Results</h4>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; I<sup>2</sup> = 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).<h4>Conclusions</h4>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.

Item Type: Article
Uncontrolled Keywords: Vitamin D, Pregnancy, Preeclampsia, Meta-analysis
Depositing User: Symplectic Admin
Date Deposited: 02 Dec 2019 16:15
Last Modified: 19 Jan 2023 00:17
DOI: 10.1016/j.clnu.2019.08.015
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