The effect of vitamin D supplementation on oxidative stress and inflammatory biomarkers in pregnant women: a systematic review and meta-analysis of clinical trials

Soudabe Motamed; Bahareh Nikooyeh; Razieh Anari; Somayeh Motamed; Zeinab Mokhtari; Tirang Neyestani

doi:10.1186/s12884-022-05132-w

The effect of vitamin D supplementation on oxidative stress and inflammatory biomarkers in pregnant women: a systematic review and meta-analysis of clinical trials

BMC Pregnancy Childbirth. 2022 Nov 5;22(1):816. doi: 10.1186/s12884-022-05132-w.

Authors

Soudabe Motamed¹, Bahareh Nikooyeh², Razieh Anari², Somayeh Motamed³, Zeinab Mokhtari⁴, Tirang Neyestani⁵

Affiliations

¹ Asadabad School of Medical Sciences, Asadabad, Iran.
² National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
³ Tehran University of Medical Sciences, School of Medicine, Tehran, Iran.
⁴ Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
⁵ National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. t.neyestani@sbmu.ac.ir.

Abstract

Background: Vitamin D deficiency, a common problem among pregnant women, is linked with maternal inflammation, oxidative stress and consequent adverse pregnancy outcomes. The aim of this systematic review was to evaluate the effect of vitamin D supplementation on oxidative stress and inflammatory biomarkers in pregnant women according to the PRISMA guidance.

Methods: Four databases including PubMed/MEDLINE, Scopus, Web of Science and Cochrane were used for searching papers published until 25^th July 2022. Clinical trials that assessed 25-Hydroxyvitamin D (25(OH)D), inflammatory markers (including high sensitivity C-reactive protein (hs-CRP) and certain cytokines) and oxidative stress markers (including malondialdehyde (MDA), total antioxidant capacity (TAC) and glutathione (GSH)) in pregnant women, were included in this review. The primary search of three databases displayed 21571 records. After removing duplicates and irrelevant articles, 17 eligible RCTs included for more evaluation. Random effect model and Der Simonian-Laird method were used to pool the data of studies. Risk of bias assessed according to version 2 of the Cochrane risk-of-bias tool for randomized trials.

Results: According to the meta-analysis result, vitamin D supplementation caused a significant increase in the maternal circulating concentrations of 25(OH)D (SMD 2.07; 95%, CI 1.51, 2.63; p < 0.001), TAC (SMD 2.13, 95% CI 1.04 to 3.23, p < 0.001) and GSH (SMD 4.37, 95% CI 2.9 to 5.74, p < 0.001) as well as a significant decrease in the levels of MDA (SMD -0.46, 95% CI -0.87 to -0.05, p = 0.02). However, it had no significant impact on hs-CRP concentrations (SMD 0.24; 95% CI, -0.55, 1.03; p = 0.50).

Conclusion: In the present study, vitamin D supplementation led to increased levels of 25(OH)D, TAC and GSH and also decreased concentration of MDA. Nevertheless, because of low certainty of evidence, these findings have to be declared conservatively.

Trial registration: Registration code in PROSPERO website: CRD42020202600.

Keywords: Inflammation; Meta-analysis; Oxidative stress; Pregnancy; Vitamin D.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Antioxidants / metabolism
Biomarkers / metabolism
C-Reactive Protein* / metabolism
Dietary Supplements*
Female
Humans
Oxidative Stress
Pregnancy
Pregnant Women
Vitamin D / therapeutic use

Substances

C-Reactive Protein
Biomarkers
Vitamin D
Antioxidants