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Maternal Vitamin D Status and Risk of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis of Prospective Cohort Studies Publisher Pubmed



Milajerdi A1, 2, 3 ; Abbasi F4 ; Mousavi SM2 ; Esmaillzadeh A2, 5, 6
Authors
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Authors Affiliations
  1. 1. Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran
  2. 2. Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Health, Science and Research Branch, AJA University of Medical Sciences, Tehran, Iran
  4. 4. Department of Sports Injuries, Faculty of Physical Education and Sports Sciences, Allameh Tabataba'i University, Tehran, Iran
  5. 5. Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular -Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran

Source: Clinical Nutrition Published:2021


Abstract

Background: No earlier systematic review and meta-analysis have been done on the association between maternal serum vitamin D status and risk of GDM among prospective studies. The current study was done to systematically review prospective cohort studies (with several years of follow-up) on the association between maternal serum vitamin D deficiency or insufficiency and risk of GDM. Methods: Relevant papers published up to January 2020 were searched through PubMed, MEDLINE, SCOPUS, EMBASE, and Google Scholar using suitable keywords. All prospective cohort studies reporting Hazard Ratios (HRs) or Relative Risks (RRs) and 95% Confidence Intervals (CI) for GDM across categories of maternal serum vitamin D status were included. Results: A total of 29 prospective and nested case–control studies were included in the current systematic review, of which 27 studies had sufficient data for the meta-analysis. Individuals with vitamin D deficiency had a 26% greater risk of developing GDM than those with normal serum vitamin D concentrations (OR: 1.26; 95% CI: 1.13, 1.41). In addition, a significant positive association was seen between combined vitamin D insufficiency and deficiency and risk of developing GDM (OR: 1.23; 95% CI: 1.11, 1.35). Dose–response analysis showed a significant U-shaped non-linear association between serum vitamin D concentrations and risk of developing GDM (P < 0.001), such that those with serum vitamin D concentrations between 40 and 90 nmol/L had significantly reduced risk of GDM. Conclusions: We found a significant association between vitamin D deficiency and an increased risk of GDM. The lowest risk of GDM was found among those with a serum vitamin D levels of 40–90 nmol/L. Further studies, including randomized clinical trials, are needed to confirm our findings. Registration: PROSPERO (ID: 180722), https://www.crd.york.ac.uk/prospero/. © 2021
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