Evidence for prenatal vitamin D supplementation too weak to make recommendations

A review of data from 43 trials suggests that prenatal vitamin D has positive neonatal outcomes, but the current evidence base does not cover all aspects of outcomes and safety

There is conflicting evidence and guidance as to whether all women should routinely take vitamin D supplements during pregnancy.

In a paper in the BMJ (29 November 2017), researchers performed a systematic review and meta-analysis on data from 43 trials including a total of 8,406 participants to assess the impact of prenatal vitamin D supplementation on maternal, neonatal and infant outcomes[1].

They found that prenatal vitamin D was associated with increased maternal and cord serum vitamin D concentrations, as well as positive neonatal outcomes, such as increased mean birth weight and reduced risk of small-for-gestational-age births.

However, there was a lack of clear evidence from the available trials on the benefits of supplementation on maternal health outcomes, preterm birth or on safety outcomes. Furthermore, many of the trials were small and at high risk of bias.

The team concluded that the current evidence base is insufficient to make recommendations on prenatal vitamin D supplementation.

Citation: Clinical Pharmacist DOI: 10.1211/CP.2018.20204215

Readers' comments (1)

  • Unfortunately, vitamin D clinical trials have been done incorrectly for many years. Most have been based solely on vitamin D dose. However, it is 25-hydroxyvitamin D [25(OH)D] that is related to health outcomes. Observational studies may provide better evidence for now. This paper shows that higher 25(OH)D concentrations are associated with reduced risk of preterm birth:
    McDonnell SL, Baggerly KA, Baggerly CA, Aliano JL, French CB, Baggerly LL, Ebeling MD, Rittenberg CS, Goodier CG, Mateus Niño JF, Wineland RJ, Newman RB, Hollis BW, Wagner CL. Maternal 25(OH)D concentrations ≥40 ng/mL associated with 60% lower preterm birth risk among general obstetrical patients at an urban medical center. PLoS One. 2017 Jul 24;12(7):e0180483.

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