Nutrition and health

Objectives:
Does dietary protein supplementation augment resistance exercise training (RET)-induced gains in muscle mass and strength?

Study design:
This review article included 49 RCTs with RET ≥6 weeks in duration, involving 1,863 participants.

Results and conclusions:
The investigators found that during periods of prolonged RET, dietary protein supplementation significantly increased changes in:
-strength-one-repetition-maximum [2.49 kg, 95% CI = 0.64 to 4.33];
-FFM (fat free mass) [0.30 kg, 95 BI = 0.09 to 0.52];
-muscle size-muscle fibre cross-sectional area [CSA = 310 µm², 95% CI = 51 to 570] and
-mid-femur [CSA = 7.2 mm², 95% CI = 0.20 to 14.30]

The investigators found that the impact of protein supplementation on gains in fat free mass (FFM) was reduced with increasing age [-0.01 kg, 95% CI = -0.02 to -0.00, p = 0.002] and was more effective in resistance-trained individuals [0.75 kg, 95% CI = 0.09 to 1.40, p = 0.03].

The investigators found that protein supplementation beyond total protein intakes of 1.62 g/kg/day resulted in no further RET-induced gains in fat free mass.

The investigators concluded dietary protein supplementation (1.62 g/kg/day) enhances changes in muscle strength and size during prolonged resistance exercise training in healthy adults.

Original title:
A systematic review, meta-analysis and meta-regression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adults by Morton RW, Murphy KT, […], Phillips SM.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28698222

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Objectives:
Whether iron is associated with the development of gestational diabetes mellitus (GDM) is not clear. Therefore, this review article (meta-analysis) has been conducted.

Do increased dietary intake of iron and body iron status increase risk of gestational diabetes mellitus in pregnant women? 

Study design:
This review article included 12 case-control  studies, 9 cohort studies and  2  randomized  controlled  studies (RCT) with in total, 3,034 gestational diabetes mellitus pregnant women and 26,344 non-gestational diabetes mellitus pregnant women.

Results and conclusions:
The investigators found high dietary intake of heme iron was significantly associated with a 65% gestational diabetes mellitus risk [RR = 1.65, 95% CI = 1.28 to 2.12, I2 = 0%].

The investigators found for each 1 mg/day increment of dietary heme iron intake a significantly 38% gestational diabetes mellitus risk [RR = 1.38, 95% CI = 1.19 to 1.61, I2 = 0%].

The investigators found higher body iron stores, as represented by serum ferritin level, were correlated with a significantly increased gestational diabetes mellitus risk of 64% [RR = 1.64, 95% CI = 1.27 to 2.11, I2% = 7%].

The investigators found no association between gestational diabetes mellitus and the intakes of nonheme iron, total iron or supplemental iron.

The investigators concluded increased dietary intake of heme iron (at least 1 mg/day) and body iron status are positively associated with the risk of gestational diabetes mellitus development in pregnant women. Future studies are warranted to better understand the role of iron in gestational diabetes mellitus development.

Original title:
Dietary intake of heme iron and body iron status are associated with the risk of gestational diabetes mellitus: a systematic review and meta-analysis by Zhao L, Lian J, [...], Wang F.

Link:
http://apjcn.nhri.org.tw/server/APJCN/26/6/1092.pdf

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Gestational diabetes mellitus is a condition in which a woman without diabetes develops high blood sugar levels during pregnancy. Gestational diabetes mellitus affects between 2% and 5% of pregnant women.

Objectives:
The association between vitamin D deficiency and early spontaneous pregnancy loss (SPL) is unclear. Therefore, this review article (meta-analysis) has been conducted.

Does a vitamin D deficiency increase risk of early spontaneous pregnancy loss?

Study design:
This review article included 5 studies (case-control and cohort studies), including 10,630 pregnant women.

Results and conclusions:
The investigators found no significant association between a low 25(OH)D level (vitamin D level in blood) and an increased risk of early spontaneous pregnancy loss.

However, the investigators found in subgroup analysis, an extremely low 25(OH)D level (20 ng/mL) was significantly associated with an 124% increased risk of early spontaneous pregnancy loss in the first trimester [relative risk = 2.24, 95% CI = 1.15-4.37, I2 = 0.0%, p = 0.355].

The investigators concluded that severe vitamin D deficiency (20 ng/mL) could be detrimental to early embryonic development and increases risk of early spontaneous pregnancy loss.

Original title:
Meta-analysis of the effect of the maternal vitamin D level on the risk of spontaneous pregnancy loss by Zhang H, Huang Z, [...], Wei Y.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28500757

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Objectives:
Does resistance training reduce blood pressure in prehypertensive and hypertensive subjects?

Study design:
This review article included 5 RCTs provided data on 201 individuals.

Results and conclusions:
The investigators found when compared to group control, resistance training alone significantly reduced systolic blood pressure with 8.2 mmHg in prehypertensive and hypertensive subjects [95% CI = -10.9 to -5.5, I2 = 22.5%, p for heterogeneity = 0.271 and effect size = -0.97].

The investigators found when compared to group control, resistance training alone significantly reduced diastolic blood pressure with 4.1 mmHg in prehypertensive and hypertensive subjects [95% CI = -6.3 to -1.9, I2 = 46.5%, p for heterogeneity = 0.113 and effect size = -0.60].

The investigators concluded resistance training alone reduces systolic and diastolic blood pressure in prehypertensive and hypertensive subjects. These findings support the recommendation of resistance training as a tool for management of systemic hypertension.

Original title:
Resistance training alone reduces systolic and diastolic blood pressure in prehypertensive and hypertensive individuals: meta-analysis by de Sousa EC, Abrahin O, […], Vieira RP.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28769100

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Objectives:
Are there differences in serum ceruloplasmin levels between patients with preeclampsia and healthy controls?

Study design:
This review article included 15 studies, with a total number of 1927 women.

Results and conclusions:
The investigators found that maternal serum ceruloplasmin concentration was significantly higher in preeclamptic than in the healthy pregnant women [MD = 12.57 mg/dL, 95% CI = 8.81 to 16.33].

The investigators found that ceruloplasmin levels were significantly higher both in mild [MD = 13.8 mg/dL, 95% CI = 2.64 to 23.53] and severe [MD = 21.84 mg/dL, 95% CI = 0.97 to 42.71] preeclampsia, when compared to the control group.

The investigators found that the severity of the disease did not significantly affect the levels of protein [MD = -9.34 mg/dL, 95% CI = -20.93 to 2.26].

The investigators concluded that serum ceruloplasmin may be a useful screening and follow-up tool for the evaluation of pregnant women with an indicative history of developing preeclampsia. Future studies are needed to evaluate the levels of this specific protein throughout the pregnancy course and provide data on its sensitivity and specificity by introducing cut-off values.

Original title:
Serum ceruloplasmin levels in preeclampsia: a meta-analysis by Bellos I, Papantoniou N and Pergialiotis V.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28605950

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Ceruloplasmin carries 65% to 90% of the copper found in blood.

Objectives:
What is the effect of aerobic exercise performed in the fasted versus fed states on fat and carbohydrate metabolism in adults?

Study design:
This review article included 27 studies with a total of 273 participants.

Results and conclusions:
The investigators found a significant increase in fat oxidation during aerobic exercise (duration ≤120 min) performed in the fasted state compared with fed state [WMD = -3.08 g, 95% CI = -5.38 to -0.79, I2 = 39.1%].

The investigators found the weighted mean difference of onesterified fatty acids (NEFA) concentrations was not significantly different between states [WMD = 0.00 mmol/L, 95 % CI = -0.07 to 0.08, I2 = 72.7 %].

The investigators found, however, the weighted mean differences of glucose [WMD = 0.78 mmol/L, 95% CI = 0.43 to 1.14, I2 = 90.8%] and insulin concentrations [WMD = 104.5 pmol/L, 95% CI = 70.8 to 138.2, I2 = 94.5%] were significantly higher for aerobic exercise (duration ≤120 min) performed in the fed state.

The investigators concluded that aerobic exercise (duration ≤120 min) performed in the fasted state induces higher fat oxidation than aerobic exercise performed in the fed state.

Original title:
Effects of aerobic exercise performed in fasted v. fed state on fat and carbohydrate metabolism in adults: a systematic review and meta-analysis by Vieira AF, Costa RR, […], Kruel LF.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/27609363

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Aerobic exercise is any exercise that raises the heart rate and increases respiration (breathing). Examples of aerobic exercise are:

• Cross-country skiing
• Cycling
• Dancing
• Fast walking
• Hiking
• Jogging or running
• Swimming
   

Objectives:
Although exercise can improve insulin sensitivity, no adequate synthesis exists of exercise intervention studies with regard to their effect on insulin sensitivity. Therefore, this review article (meta-analysis) has beeen conducted.

Does exercise improve insuline sensitivity?

Study design:
This review article included data found across 2509 subjects (115 samples, 78 reports).
The median of mean age was 43 years.
The median of mean preintervention fasting insulin was 8 mU/L.

Results and conclusions:
The investigators found the overall mean effect size for 2-group postintervention comparisons was 0.38 [95% CI = 0.25-0.51, I2 = 0%] and for 2-group pre-post comparisons was 0.43 [95% CI = 0.30-0.56, I2 = 52%].

The investigators found higher mean insulin sensitivity for treatment than control subjects.

The investigators found the postintervention mean of 0.38 was consistent with treatment subjects ending studies with a mean fasting insulin of 6.8 mU/L if control participants’ mean fasting insulin were 7.9 mU/L.
Exploratory moderator analyses did not document different insulin sensitivity effect sizes across intervention characteristics or sample attributes.

The investigators concluded exercise is a valuable primary care and community health strategy for healthy adults to improve insulin sensitivity and lower the risk for diabetes conferred by insulin resistance.

Original title:
Insulin Sensitivity Following Exercise Interventions: Systematic Review and Meta-Analysis of Outcomes Among Healthy Adults by Conn VS, Koopman RJ, […], Hafdahl AR.

Link:
http://journals.sagepub.com/doi/pdf/10.1177/2150131913520328

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Objectives:
Although pre-exercise consumption of a low-glycemic-index (LGI) carbohydrate meal is generally recommended, the findings regarding subsequent exercise performance are inconsistent. Therefore, this review article (meta-analysis) has been conducted.

Does a pre-exercise low-glycemic-index carbohydrate meal lead to greater endurance performance than a pre-exercise high-glycemic-index (HGI) meal?

Study design:
This review article included 15 trials (randomized controlled or crossover trials).
All included studies were of low research quality.

Results and conclusions:
The investigators found the synthesized effect size [d  = 0.42, z  = 3.40, p  = 0.001] indicated that the endurance performance following a low-glycemic-index carbohydrate meal was superior to that following a high-glycemic-index meal.

The investigators found subgroup analyses demonstrated that the treatment effect did not vary across outcome measures (exercise to exhaustion, time trial and work output) or athletic status (trained or recreational participants).

The investigators concluded weak evidence supports the claim that endurance performance following pre-exercise consumption of a low-glycemic-index (LGI) carbohydrate meal is superior to that following pre-exercise consumption of a high-glycemic-index (HGI) meal. Further high-quality research in this area is warranted.

Original title:
Effect of pre-exercise carbohydrate diets with high vs low glycemic index on exercise performance: a meta-analysis by Heung-Sang Wong S, Sun FH, […], Ya-Jun Huang W.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28383695

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A low-glycemic-index (LGI) carbohydrate diet is a diet with a lot of products with GI lower than 55. Products with GI lower than 55 are called low-glycemic-index carbohydrate products. These products are low-glycemic-index carbohydrate products.
 

Objectives:
Epidemiological studies evaluating the associations between serum copper and ratios of copper/zinc (Cu/Zn) and the preeclampsia (PE) risk in Asian population have produced inconsistent results. Therefore, this review article (meta-analysis) has been conducted.

Do a higher serum copper and ratios of Cu/Zn increase the preeclampsia risk in Asian population?

Study design:
This review article included relevant studies up to November 2016.
Pooled standardized mean difference (SMD) was calculated with random effects model.

Results and conclusions:
The investigators found that preeclampsia patients significantly had a higher serum copper level [SMD = 1.05, 95% CI = 0.34 to 1.77, I2 = 96.9%, p 0.0001] compared with healthy pregnancy controls.

The investigators found in subgroup analyses, a higher serum copper level in preeclampsia patients was observed in case-control studies [SMD = 1.39, 95% CI = 0.44 to 2.34]. However, no significant difference was found between preeclampsia patients and healthy pregnancy controls for ratios of Cu/Zn [SMD = 0.26, 95% CI = -0.77 to 1.29, I2 = 95.8%, p 0.0001].

The investigators concluded that a higher serum copper level is associated with an increased risk of preeclampsia in Asian population. However, further studies are needed to confirm these results.

Original title:
High serum copper level is associated with an increased risk of preeclampsia in Asians: A meta-analysis by Song X, Li B, [...], Zhang D.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28385285

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Objectives:
Zinc sulfate may be a promising approach to treat neonatal jaundice. However, the results remain controversial. Therefore, this review article (meta-analysis) has been conducted.

Does zinc sulfate supplementation reduce neonatal jaundice?

Study design:
This review article included 5 RCTs involving 645 patients.

Results and conclusions:
The investigators found overall, compared with placebo, zinc sulfate supplementation failed to significantly reduce total serum bilirubin on 3 days [mean difference = 0.09 mg/dL, 95% CI = -0.49 to 0.67, p = 0.77]. Non-significant because p-value of 0.77 was greater than p-value of 0.05.

The investigators found overall, compared with placebo, zinc sulfate supplementation failed to significantly reduce total serum bilirubin on 7 days [mean difference= -0.37 mg/dL, 95% CI= -98 to 0.25, p  = 0.25].

The investigators found overall, compared with placebo, zinc sulfate supplementation failed to significantly reduce the incidence of hyperbilirubinemia [OR = 1.14, 95% CI = 0.74 to 1.76, p = 0.56].

The investigators found overall, compared with placebo, zinc sulfate supplementation showed no influence on phototherapy requirement [OR = 0.90, 95% CI = 0.41 to 1.98, p = 0.79]. Non-significant because OR of 1 was found in the OR of 0.41 to 1.98. OR of 1 means no risk/association.

The investigators found overall, compared with placebo, zinc sulfate supplementation significantly decreased duration of phototherapy [mean difference = -16.69 h, 95% CI = -25.09 to -8.3 h, p 0.000].

The investigators concluded zinc sulphate supplementation does not reduce the total serum bilirubin on 3 days and 7 days, the incidence of hyperbilirubinemia and phototherapy requirement, but significantly decreases duration of phototherapy.

Original title:
The influence of zinc sulfate on neonatal jaundice: a systematic review and meta-analysis by Yang L, Wu, [...], Tang J.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28372469

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Neonatal jaundice occurs when a baby has a high level of bilirubin in the blood. Bilirubin is a yellow substance that the body creates when it replaces old red blood cells. The liver helps break down the substance so it can be removed from the body in the stool.

A high level of bilirubin makes a baby's skin and whites of the eyes look yellow. This is called neonatal jaundice.

Jaundice is a common and usually harmless condition in newborn babies.
The symptoms of neonatal jaundice usually develop 2 to 3 days after the birth and tend to get better without treatment by the time the baby is about 2 weeks old.

Objectives:
It has been suggested that prenatal exposure to n-3 long-chain fatty acids protects against asthma and other allergy-related diseases later in childhood. The extent to which fish intake in pregnancy protects against child asthma and rhinitis symptoms remains unclear. Therefore, this review article (meta-analysis) has been conducted.

Does fish consumption during pregnancy reduce risk of asthma and other allergy-related diseases later in childhood?

Study design:
This review article included data from 60,774 mother-child pairs participating in 18 European and US birth cohort studies.
Information on wheeze, asthma and allergic rhinitis prevalence was collected using validated questionnaires.
The time periods of interest were: infancy (0-2 years), preschool age (3-4 years) and school age (5-8 years).
The median fish consumption during pregnancy ranged from 0.44 times/week in The Netherlands to 4.46 times/week in Spain.

Results and conclusions:
The investigators found maternal fish intake during pregnancy was not associated with offspring wheeze symptoms in any age group nor with the risk of child asthma [adjusted meta-analysis relative risk per 1-time/week = 1.01, 95% CI = 0.97-1.05] and allergic rhinitis at school age [RR = 1.01, 95% CI = 0.99-1.03].

These results were consistently found in further analyses by type of fish and seafood consumption and in sensitivity analyses.

The investigators concluded maternal fish intake during pregnancy is not associated with offspring wheeze symptoms in any age group (0-2 years, 3-4 years and 5-8 years) or with the risk of child asthma and allergic rhinitis at school age (5-8 years).

Original title:
Fish and seafood consumption during pregnancy and the risk of asthma and allergic rhinitis in childhood: a pooled analysis of 18 European and US birth cohorts by Stratakis N, Roumeliotaki T, […], Chatzi L.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28338907

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Objectives:
Does polyphenol supplementation increase sport performance?

Study design:
This review article included 14 studies. Of these, the studied populations were predominately-trained males with an average intervention dose of 688 ± 478mg polyphenols per day.

Results and conclusions:
The investigators found pooled results demonstrated polyphenol supplementation for at least 7 days significantly increased performance by 1.90% [95% CI = 0.40-3.39].

The investigators found sub-analysis of 7 studies using quercetin significantly increased performance by 2.82% [95% CI = 2.05-3.58].

The investigators found no adverse effects reporting in studies in relation to the intervention.

The investigators concluded daily 688mg polyphenol supplementation, preferably quercetin supplementation for at least 7 days increases performance in healthy individuals.

Original title:
Polyphenols and Performance: A Systematic Review and Meta-Analysis by Somerville V, Bringans C and Braakhuis A.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28097488

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Objectives:
Does iron supplementation during pregnancy improve maternal haematological status and birth weight?

Study design:
This review article included 48 RCTs (17,793 women) and 44 cohort studies (1,851,682 women).

The dose of iron in RCTs ranged from 10 mg to 240 mg daily. Duration of supplementation varied from 7 to 8 weeks up to 30 weeks during pregnancy.

Significant heterogeneity existed for several outcomes that could not be explained substantially by pre-specified subgroups.

Results and conclusions:
The investigators found iron supplementation during pregnancy increased maternal mean haemoglobin concentration by 4.59 g/L [95% CI = 3.72 to 5.46] compared with controls.

The investigators found iron with folic acid was associated with a significant increase in mean haemoglobin concentration of 10.41 g/L [95% CI = 5.36 to 15.46, I2 = 0%, 9 trials] and reduction in risk of anaemia in the third trimester or at delivery of 56% [95% CI = 0.37 to 0.53, I2 = 44%, 5 trials]. Significant means there is an association with a 95% confidence.

The investigators found iron supplementation during pregnancy significantly reduced the risk of anaemia with 50% [95% CI = 0.42 to 0.59] compared with controls.

The investigators found iron supplementation during pregnancy significantly reduced the risk of iron deficiency (of the mother) with 41% [95% CI = 0.46 to 0.79] compared with controls.

The investigators found iron supplementation during pregnancy significantly reduced the risk of iron deficiency anaemia with 60% [95% CI = 0.26 to 0.60] compared with controls.

The investigators found iron supplementation during pregnancy significantly reduced the risk of low birth weight (2500 g) with 19% [95% CI = 0.71 to 0.93] compared with controls.

However, the investigators found iron supplementation during pregnancy non-significantly reduced the risk of preterm birth with 16% [95% CI = 0.68 to 1.03] compared with controls. Non-significant means there is no association with a 95% confidence.

The investigators found in cohort studies that anaemia in the first or second trimester was significantly associated with a higher risk for low birth weight of 29% [adjusted odds ratio 1.29, 95% CI = 1.09 to 1.53] and preterm birth with 21% [adjusted odds ratio = 1.21, 95% CI = 1.13 to 1.30].

The investigators found in exposure-response analysis that for every 10 mg increase in iron dose/day, up to 66 mg/day, the relative risk of maternal anaemia was significantly 0.88 [95% CI = 0.84 to 0.92, p for linear trend 0.001].

The investigators found in exposure-response analysis that birth weight increased by 15.1 g [95% CI = 6.0 to 24.2, p for linear trend = 0.005] and risk of low birth weight significantly decreased by 3% [relative risk = 0.97, 95% CI = 0.95 to 0.98, p for linear trend 0.001] every 10 mg increase in dose/day.

Furthermore, the investigators found for each 1 g/L increase in mean haemoglobin, birth weight increased by 14.0 g [95% CI = 6.8 to 21.8, p for linear trend = 0.002]. However, mean haemoglobin was not associated with the risk of low birth weight and preterm birth.

The investigators found no evidence of a significant effect on duration of gestation, small for gestational age births and birth length and duration of iron use was not significantly associated with the outcomes after adjustment for dose.

The investigators concluded daily prenatal use of iron substantially improved birth weight in a linear dose-response fashion, probably leading to a reduction in risk of low birth weight. An improvement in prenatal mean haemoglobin concentration linearly increased birth weight and a linear decrease in maternal anaemia with higher doses of iron, up to 66 mg/day.

Original title:
Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysis by Haider BA, Olofin I, […], Fawzi WW.

Link:
http://www.bmj.com/content/346/bmj.f3443

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Iron deficiency anaemia occurs when there isn't enough iron in the body. Anaemia is a condition where the amount of haemoglobin in the blood is below the normal level.
Iron deficiency anaemia has been defined as haemoglobin 110 g/L and serum ferritin 12 µg/L.

Objectives:
Is supplementation of formula milk with LCPUFA (long-chain polyunsaturated fatty acids) both safe and beneficial for full-term infants, while focusing on effects on visual function, neurodevelopment and physical growth?

Study design:
This review article included 15 RCTs (n = 1889).
9 studies assessed visual acuity, 6 of which used visual evoked potentials (VEP), 2 Teller cards and 1 both. 4 studies reported beneficial effects and the remaining 5 did not.
GRADE analysis of the outcomes indicated that the overall quality of evidence was low.

Results and conclusions:
The investigators found a meta-analysis of 3 RCTs (n = 244) showed significant benefit for sweep VEP acuity at 12 months (log of the minimum angle of resolution) [MD = -0.15, 95% CI = -0.17 to -0.13, I2 = 0%, low-quality of evidence].
However, the meta-analysis of 3 other RCTs (n = 256) showed no benefit for visual acuity measured with Teller cards at 12 months (cycles/degree) [MD = -0.01, 95% CI = -0.12 to 0.11, I2 = 0%, low-quality of evidence].

The investigators found meta-analysis of 4 RCTs (n = 661) revealed no significant differences between LCPUFA and placebo groups in BSID Mental Developmental Index scores at 18 months [MD = 0.06, 95% CI = -2.01 to 2.14, I2 = 75%, low-quality of evidence] and no significant differences in BSID Psychomotor Development Index scores at 18 months [MD = 0.69, 95% CI = -0.78 to 2.16, I2 = 61%, low-quality of evidence].

There were also no significant differences between the two groups in BSID-II scores at one year and two years of age.

The investigators found meta-analysis of 5 RCTs (n = 521) showed that the supplemented group had lower weight (z scores) at one year of age [MD = -0.23, 95% CI = -0.40 to -0.06, I2 = 83%, low-quality of evidence] and that the two groups showed no significant differences with respect to length and head circumference (z scores).

The investigators found meta-analysis at 18 months and at two years revealed no significant differences between the two groups with respect to weight (kg), length (cm) and head circumference (cm).

The investigators concluded there are no beneficial effects or harms of LCPUFA supplementation on neurodevelopmental outcomes of formula-fed full-term infants and no consistent beneficial effects on visual acuity. Therefore, routine supplementation of full-term infant milk formula with LCPUFA cannot be recommended at this time.

Original title:
Long chain polyunsaturated fatty acid supplementation in infants born at term by Jasani B, Simmer K, […], Rao SC.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28281303

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Objectives:
Is a low maternal circulating 25 hydroxyvitamin D (25-OHD) associated with an increased risk of preterm birth or spontaneous preterm birth and can vitamin D supplementation alone during pregnancy reduce risk of preterm birth?

Study design:
This review article included 6 RCTs and 18 observational studies.

Results and conclusions:
The investigators found maternal circulating 25-OHD deficiency significantly increased risk of preterm birth with 25% [pooled OR = 1.25, 95% CI = 1.13-1.38]. However, maternal circulating 25-OHD insufficiency was not associated with an increased risk of preterm birth [pooled OR = 1.09, 95% CI = 0.89-1.35]. Not associated because OR of 1 was found in 95% CI of 0.89 to 1.35. OR of 1 means no risk/association.

The investigators found vitamin D supplementation alone during pregnancy significantly reduced risk of preterm birth with 43% [pooled RR = 0.57, 95% CI = 0.36-0.91]. Significantly because RR of 1 was not found in 95% CI of 0.36 to 0.91. RR of 1 means no risk/association.

The investigators found maternal circulating 25-OHD 50 nmol/L significantly increased risk of spontaneous preterm birth with 45% [pooled OR = 1.45, 95% CI = 1.20-1.75]. 

The investigators concluded a maternal circulating 25-OHD 50 nmol/L increases risk of spontaneous preterm birth and vitamin D supplementation alone during pregnancy reduces risk of preterm birth. However, extrapolation of the results must be done with caution and there is urgent need for larger, better-designed RCT to confirm this effect.

Original title:
Vitamin D and risk of preterm birth: Up-to-date meta-analysis of randomized controlled trials and observational studies by Zhou SS, Tao YH, […], Tao FB.

Link:
https://www.ncbi.nlm.nih.gov/pubmed/28150405

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