Vitamin D Supplementation and Vitamin D Status during Pregnancy and the Risk of Congenital Anomalies—A Systematic Review and Meta-Analysis

Karen Christina Walker*, Fanney Thorsteinsdottir, Henrik Thybo Christesen, Vibeke Elisabeth Hjortdal, Berit Lilienthal Heitmann, Ina Olmer Specht, Mina Nicole Händel

*Corresponding author for this work

Research output: Contribution to journalReviewResearchpeer-review

2 Citations (Scopus)
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Abstract

Maternal dietary factors have been suggested as possible contributing influences for congenital anomalies (CAs). We aimed to assess the association between vitamin D supplementation or vitamin D status (s-25OHD) during pregnancy and CAs in the offspring. A comprehensive literature search was conducted in the three electronic databases: PubMed, Embase, and Cochrane Library. Included studies were critically appraised using appropriate tools (risk of bias 2, ROBINS-I). A protocol was registered in the International Prospective Register of Systematic Reviews (CRD42019127131). A meta-analysis of four randomised controlled trials (RCTs) including 3931 participants showed no effect of vitamin D supplementation on CAs, a relative risk of 0.76 (95% CI 0.45; 1.30), with moderate certainty in the effect estimates by GRADE assessment. Of the nine identified observational studies, six were excluded due to a critical risk of bias in accordance with ROBINS-I. Among the included observational studies, two studies found no association, whereas one case-control study identified an association between s-25OHD < 20 nmol/L and neural tube defects, with an adjusted odds ratio of 2.34 (95% CI: 1.07; 5.07). Interpretation of the results should be cautious given the low prevalence of CAs, RCTs with onset of supplementation after organogenesis, and low-quality observational studies.

Original languageEnglish
Article number2125
JournalNutrients
Volume15
Issue number9
Number of pages16
ISSN2072-6643
DOIs
Publication statusPublished - 2023

Bibliographical note

Publisher Copyright:
© 2023 by the authors.

Keywords

  • congenital anomalies
  • prenatal exposure
  • systematic review
  • vitamin D

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