Published online May 20, 2022. doi: 10.5662/wjm.v12.i3.164
Peer-review started: December 1, 2021
First decision: January 12, 2022
Revised: January 20, 2022
Accepted: March 26, 2022
Article in press: March 26, 2022
Published online: May 20, 2022
The role of vitamin D supplementation in gestational diabetes mellitus (GDM) patients is unclear.
To determine the burden and risk of post-randomization GDM patient attrition from vitamin D-supplemented arms of randomized controlled trials (RCTs). The auxiliary aim was to compare the effects of nutritional supplements on their fasting blood glucose (FPG) levels and perinatal outcomes.
RCTs were searched in the PubMed, Embase, and Scopus databases. Random-effect prevalence and pairwise meta-analysis were performed for the primary objective. The auxiliary aim was to compare the effects of nutritional supplements on their fasting blood glucose (FPG) levels and perinatal outcomes. Fixed-effect network meta-analyses were undertaken for the secondary goals. All analyses were performed using Stata software, and statistical significance was determined at P < 0.05.
Thirteen RCTs from Iran and China were reviewed. The participant attrition burden in vitamin D recipients was 6% [95% confidence interval (CI): 0.03, 0.10], and its risk did not vary from non-recipients. Vitamin D and calcium co-supplementation reduced the cesarean section incidence in GDM patients [risk ratio (RR): 0.37; 95%CI: 0.18, 0.74]. The hyperbilirubinemia or hospitalization risk in their newborns decreased with vitamin D supplementation (RR: 0.47; 95%CI: 0.27, 0.83) and co-supplementation with calcium (RR: 0.35; 95%CI: 0.16, 0.77) or omega-3 fatty acids (RR: 0.25; 95%CI: 0.08, 0.77). Vitamin D and probiotics co-supplementation decreased newborn hyperbilirubinemia risk (RR: 0.28; 95%CI: 0.09, 0.91). FPG levels and macrosomia risk did not vary across interventions.
In RCTs, vitamin D supplementation or co-supplementation in GDM patients showed a low participant attrition burden and low risk of cesarean section, newborn hyperbilirubinemia, and newborn hospitalization.
Core Tip: This meta-analysis was conducted on efficacy trials testing the effect of vitamin D in gestational diabetes mellitus (GDM) patients and/or their neonates. The post-randomization attrition burden of GDM patients from vitamin D-supplemented trial arms was low. The risk of hyperbilirubinemia and hospitalization in newborns was low with vitamin D and its omega-3 fatty acids and calcium co-supplemented forms. Vitamin D co-supplementation with calcium and probiotics reduced the risk of cesarean section and newborn hyperbilirubinemia, respectively. Compared to omega-3 fatty acids, the risk of hyperbilirubinemia and hospitalization among neonates was low when it was co-supplemented with vitamin D.