Association between maternal serum 25-hydroxyvitamin D level and pregnancy and neonatal outcomes: systematic review and meta-analysis of observational studies
Association between maternal serum 25-hydroxyvitamin D level and pregnancy and neonatal outcomes: systematic review and meta-analysis of observational studies
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DOI：
10.1136/bmj.f1169
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发表时间：
2013-03-26
影响因子：
105.7
通讯作者：
Rabi, Doreen M.
中科院分区：
文献类型：
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作者：
Aghajafari, Fariba;Nagulesapillai, Tharsiya;Rabi, Doreen M.
目的评估25-羟基维生素D（25-OHD）水平对妊娠结局和出生变量的影响。设计系统性回顾和荟萃分析。数据来源Medline（1966年至2012年8月），PubMed（2008年至2012年8月），Embase（1980年至2012年8月），CINAHL（1981年至2012年8月），系统评价的科克伦数据库，和科克伦注册临床试验数据库。研究选择报告妊娠期间血清25-OHD水平与关注结局之间相关性的研究（先兆子痫、妊娠糖尿病、细菌性阴道病、剖腹产、小于胎龄儿、出生体重、出生身长和头围）。数据提取两位作者独立地从原始研究文章中提取数据，包括研究质量的关键指标。我们汇总了调整后的优势比和加权平均差异。在代表不同患者特征和研究质量的亚组中进行关联性测试，确定了3357项研究并对其进行了资格审查。最终分析中纳入了31项合格研究。血清25-OHD水平不足与妊娠期糖尿病（合并比值比1.49，95%置信区间1.18 - 1.89）、先兆子痫（1.79，1.25 - 2.58）和小于胎龄儿（1.85，1.52 - 2.26）相关。血清25-OHD水平低的孕妇有细菌性阴道病和低出生体重儿的风险增加，但不通过剖腹产delivery by cearosynotes.Conclusion维生素D不足与妊娠期糖尿病，先兆子痫，小于胎龄儿的风险增加。25-OHD水平低的孕妇患细菌性阴道病和低出生体重儿的风险增加，但剖腹产的风险不增加。
Objective To assess the effect of 25-hydroxyvitamin D (25-OHD) levels on pregnancy outcomes and birth variables.Design Systematic review and meta-analysis.Data sources Medline (1966 to August 2012), PubMed (2008 to August 2012), Embase (1980 to August 2012), CINAHL (1981 to August 2012), the Cochrane database of systematic reviews, and the Cochrane database of registered clinical trials.Study selection Studies reporting on the association between serum 25-OHD levels during pregnancy and the outcomes of interest (pre-eclampsia, gestational diabetes, bacterial vaginosis, caesarean section, small for gestational age infants, birth weight, birth length, and head circumference).Data extraction Two authors independently extracted data from original research articles, including key indicators of study quality. We pooled the most adjusted odds ratios and weighted mean differences. Associations were tested in subgroups representing different patient characteristics and study quality.Results 3357 studies were identified and reviewed for eligibility. 31 eligible studies were included in the final analysis. Insufficient serum levels of 25-OHD were associated with gestational diabetes (pooled odds ratio 1.49, 95% confidence interval 1.18 to 1.89), pre-eclampsia (1.79, 1.25 to 2.58), and small for gestational age infants (1.85, 1.52 to 2.26). Pregnant women with low serum 25-OHD levels had an increased risk of bacterial vaginosis and low birthweight infants but not delivery by caesarean section.Conclusion Vitamin D insufficiency is associated with an increased risk of gestational diabetes, pre-eclampsia, and small for gestational age infants. Pregnant women with low 25-OHD levels had an increased risk of bacterial vaginosis and lower birth weight infants, but not delivery by caesarean section.