Circulating vitamin D and the risk of gestational diabetes: a systematic review and dose-response meta-analysis

Abstract

Purpose Several meta-analyses of observational studies revealed a modest increase in the risk of gestational diabetes (GDM) among pregnant women with low levels of serum vitamin D. However, no study examined a dose-response meta-analysis as well as a high versus low analysis in this regard. Methods We systematically searched PubMed, Embase, ISI Web of Science, and Scopus up to August 2019 to find prospective observational studies investigating the association of serum 25(OH)D with the risk of developing GDM. Using a random-effects model, the reported risk estimates were pooled. Results Nine cohort studies and six nested case-control studies were included in the final analysis (40,788 participants and 1848 cases). Considering linear analysis, each 10 nmol/L increase in circulating 25(OH)D was associated with a 2 lower risk of GDM (effect size (ES): 0.98; 95 CI: 0.98, 0.99;I-2 = 85.0,P < 0.001). highest compared with the lowest category of circulating 25(OH)D was associated with a 29 lower risk of GDM, with low evidence of heterogeneity (I-2 = 45.0,P = 0.079). Conclusions In conclusion, lower levels of serum 25(OH)D were associated with a higher chance of GDM. Differential results existed between the overall and subgroup analysis, either based on vitamin D detection methods or based on maternal age, although these subgroups partially lowered the heterogeneity.