Open AccessEfficacy of vitamin D supplementation in gestational diabetes mellitus: Systematic review and meta-analysis of randomized trials
Author(s) -
Meline Rossetto Kron Rodrigues,
Silvana Andréa Molina Lima,
Gláucia Maria Ferreira da Silva Mazeto,
Iracema de Mattos Paranhos Calderon,
Cláudia Garcia Magalhães,
Guilherme Augusto Rago Ferraz,
Ana Molina,
Roberto Antônio de Araújo Costa,
Vânia dos Santos Nunes Nogueira,
Marilza Vieira Cunha Rudge
Publication year - 2019
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0213006
Subject(s) - medicine , gestational diabetes , randomized controlled trial , placebo , preeclampsia , meta analysis , vitamin d and neurology , pregnancy , obstetrics , diabetes mellitus , pediatrics , gestation , endocrinology , alternative medicine , genetics , pathology , biology
Background Trials have examined on the benefits of vitamin D supplementation in pregnant women. Objective This review aimed to evaluate whether oral vitamin D supplements, when given to pregnant women with gestational diabetes mellitus (GDM), would improve maternal and neonatal outcomes, compared with no treatment or placebo. Method We performed a systematic review following Cochrane methodology, and randomized trials were included where pregnant women with GDM received vitamin D supplementation versus placebo/no treatment or vitamin D and calcium versus placebo/no treatment. Primary outcomes were preeclampsia, preterm birth, cesarean delivery, gestational hypertension, and adverse events related to vitamin D supplementation. The search strategies were applied to the following databases: MEDLINE, Embase, LILACS, and CENTRAL. Similar outcomes in at least two trials were plotted using Review Manager 5.3 software. The quality of evidence was generated according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results The total of 1224 references were identified, eleven trials were potentially eligible, and six were included in this review (totaling 456 women). The meta-analysis of frequency of cesarean deliveries did not show significant differences between groups, none of the trials evaluated the remaining primary outcomes. For secondary outcomes, our results suggest that vitamin D supplementation in pregnant women with GDM may reduce newborn complications such as hyperbilirubinemia, polyhydramnios (RR: 0.40, 95% CI: 0.23 to 0.68; RR: 0.17, 95% CI: 0.03 to 0.89; respectively), and the need for maternal or infant hospitalization (RR: 0.13; 95% CI: 0.02 to 0.98; RR: 0.40, 95% CI: 0.23 to 0.69). However, the evidence was of low or very low quality. Conclusion We did not find moderate or high quality evidence indicating that vitamin D supplementation, when compared with placebo, improves glucose metabolism, adverse maternal and neonatal outcomes related to GDM in pregnant women.