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

the Lipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group, Silvia Fogacci, Federica Fogacci, Maciej Banach, Erin D. Michos, Adrian V. Hernandez, Gregory Y.H. Lip, Michael J. Blaha, Peter P. Toth, Claudio Borghi, Arrigo F.G. Cicero

Resultado de la investigación: Contribución a una revistaArtículoInvestigaciónrevisión exhaustiva

Resumen

Background: 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). Methods: 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). Results: 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; I2 = 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). Conclusions: 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.
Idioma originalInglés
PublicaciónClinical Nutrition
DOI
EstadoAceptada/en prensa - 1 ene 2019

Huella dactilar

Pre-Eclampsia
Vitamin D
Meta-Analysis
Randomized Controlled Trials
Odds Ratio
Confidence Intervals
Pregnancy
Vitamin D Deficiency
Maternal Age
Health Personnel
Pregnant Women
Regression Analysis
Mothers
Databases
Calcium
Incidence

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the Lipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group, Fogacci, S., Fogacci, F., Banach, M., Michos, E. D., Hernandez, A. V., ... Cicero, A. F. G. (Aceptado/En prensa). Vitamin D supplementation and incident preeclampsia: A systematic review and meta-analysis of randomized clinical trials. Clinical Nutrition. https://doi.org/10.1016/j.clnu.2019.08.015
the Lipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group ; Fogacci, Silvia ; Fogacci, Federica ; Banach, Maciej ; Michos, Erin D. ; Hernandez, Adrian V. ; Lip, Gregory Y.H. ; Blaha, Michael J. ; Toth, Peter P. ; Borghi, Claudio ; Cicero, Arrigo F.G. / Vitamin D supplementation and incident preeclampsia : A systematic review and meta-analysis of randomized clinical trials. En: Clinical Nutrition. 2019.
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title = "Vitamin D supplementation and incident preeclampsia: A systematic review and meta-analysis of randomized clinical trials",
abstract = "Background: 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). Methods: 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). Results: 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; I2 = 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). Conclusions: 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.",
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the Lipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group, Fogacci, S, Fogacci, F, Banach, M, Michos, ED, Hernandez, AV, Lip, GYH, Blaha, MJ, Toth, PP, Borghi, C & Cicero, AFG 2019, 'Vitamin D supplementation and incident preeclampsia: A systematic review and meta-analysis of randomized clinical trials', Clinical Nutrition. https://doi.org/10.1016/j.clnu.2019.08.015

Vitamin D supplementation and incident preeclampsia : A systematic review and meta-analysis of randomized clinical trials. / the Lipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group; Fogacci, Silvia; Fogacci, Federica; Banach, Maciej; Michos, Erin D.; Hernandez, Adrian V.; Lip, Gregory Y.H.; Blaha, Michael J.; Toth, Peter P.; Borghi, Claudio; Cicero, Arrigo F.G.

En: Clinical Nutrition, 01.01.2019.

Resultado de la investigación: Contribución a una revistaArtículoInvestigaciónrevisión exhaustiva

TY - JOUR

T1 - Vitamin D supplementation and incident preeclampsia

T2 - A systematic review and meta-analysis of randomized clinical trials

AU - the Lipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group

AU - Fogacci, Silvia

AU - Fogacci, Federica

AU - Banach, Maciej

AU - Michos, Erin D.

AU - Hernandez, Adrian V.

AU - Lip, Gregory Y.H.

AU - Blaha, Michael J.

AU - Toth, Peter P.

AU - Borghi, Claudio

AU - Cicero, Arrigo F.G.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: 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). Methods: 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). Results: 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; I2 = 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). Conclusions: 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.

AB - Background: 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). Methods: 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). Results: 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; I2 = 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). Conclusions: 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.

KW - Meta-analysis

KW - Preeclampsia

KW - Pregnancy

KW - Vitamin D

UR - http://www.scopus.com/inward/record.url?scp=85072061282&partnerID=8YFLogxK

U2 - 10.1016/j.clnu.2019.08.015

DO - 10.1016/j.clnu.2019.08.015

M3 - Artículo

JO - Clinical Nutrition

JF - Clinical Nutrition

SN - 0261-5614

ER -

the Lipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group, Fogacci S, Fogacci F, Banach M, Michos ED, Hernandez AV y otros. Vitamin D supplementation and incident preeclampsia: A systematic review and meta-analysis of randomized clinical trials. Clinical Nutrition. 2019 ene 1. https://doi.org/10.1016/j.clnu.2019.08.015