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Open AccessFeature PaperReview

Associations of Maternal Vitamin D Deficiency with Pregnancy and Neonatal Complications in Developing Countries: A Systematic Review

1
Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong 3220, Australia
2
School of Exercise and Nutrition Sciences, Deakin University, Burwood 3125, Australia
3
School of Allied Health, College of Science, Health and Engineering, La Trobe University, Bundoora 3083, Australia
*
Author to whom correspondence should be addressed.
Nutrients 2018, 10(5), 640; https://doi.org/10.3390/nu10050640
Received: 7 March 2018 / Revised: 16 April 2018 / Accepted: 12 May 2018 / Published: 18 May 2018
(This article belongs to the Special Issue Changing Times for Vitamin D and Health)
Pregnant women in Asia, the Middle East, Africa and Latin America are at risk of vitamin D deficiency (VDD) and prevalence throughout these regions are among the highest, globally. Maternal VDD has been associated with increased risk of a number of adverse maternal and neonatal health outcomes, yet research from developing countries is limited. We assessed the associations of maternal VDD during pregnancy with adverse health outcomes by synthesizing the literature from observational studies conducted in developing countries. Six electronic databases were searched for English-language studies published between 2000 and 2017. Thirteen studies from seven countries were included in the review. Prevalence of VDD ranged from 51.3% to 100%. Six studies assessed both maternal and neonatal outcomes, four studies assessed only maternal outcomes and three studies assessed only neonatal outcomes. Ten studies showed at least one significant association between VDD and adverse maternal and/or neonatal health outcomes including pre-eclampsia (n = 3), gestational diabetes mellitus (n = 1), postpartum depression (n = 1), emergency cesarean section delivery (n = 1), low birth weight babies (n = 4), small for gestational age (n = 2), stunting (n = 1). However most of these studies (n = 6) also showed no association with multiple health outcomes. Vitamin D assessment methods, criteria applied to define VDD, season and trimester in which studies were conducted varied considerably across studies. In conclusion, this study highlights the need to improve maternal vitamin D status in developing countries in an effort to support best maternal and child health outcomes across these regions. Future research should focus on more unified approaches to vitamin D assessment and preventative approaches that may be embedded into already existing antenatal care settings. View Full-Text
Keywords: vitamin D; pregnancy; obstetric; maternal; neonatal; developing countries; pre-eclampsia; gestational diabetes mellitus; low birth weight; small for gestational age vitamin D; pregnancy; obstetric; maternal; neonatal; developing countries; pre-eclampsia; gestational diabetes mellitus; low birth weight; small for gestational age
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Van der Pligt, P.; Willcox, J.; Szymlek-Gay, E.A.; Murray, E.; Worsley, A.; Daly, R.M. Associations of Maternal Vitamin D Deficiency with Pregnancy and Neonatal Complications in Developing Countries: A Systematic Review. Nutrients 2018, 10, 640.

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