The Effect of Vitamin D Supplementation on Oxidative Stress and Inflammatory Biomarkers in Pregnant Women: a Systematic Review and Meta-analysis of Clinical Trials

Overview

Journal BMC Pregnancy Childbirth

Publisher Biomed Central

Specialty Gynecology & Obstetrics

Date 2022 Nov 6

PMID 36335311

Authors

Soudabe Motamed

Bahareh Nikooyeh

Razieh Anari

Somayeh Motamed

Zeinab Mokhtari

Tirang Neyestani

Affiliations

Soon will be listed here.

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 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.

Citing Articles

Comparative Effects of Vitamin D Supplementation on Oxidative Stress in Relapsing-Remitting Multiple Sclerosis.

Lis M, Niedziela N, Adamczyk-Zostawa J, Zalejska-Fiolka J, Szczygiel J, Sowa A Curr Issues Mol Biol. 2024; 46(12):14119-14131.

PMID: 39727973 PMC: 11674365. DOI: 10.3390/cimb46120845.

Serum Vitamin D3 as a Potential Biomarker for Neuronal Damage in Smoldering Multiple Sclerosis.

Niedziela N, Nowak-Kiczmer M, Malciene L, Stasiolek M, Niedziela J, Czuba Z Int J Mol Sci. 2024; 25(19).

PMID: 39408830 PMC: 11476431. DOI: 10.3390/ijms251910502.

Associations of serum 25-hydroxyvitamin D with hsCRP and other novel inflammatory biomarkers in children: a cross-sectional study.

Dong H, Wang F, Gao L, Xu X, Ni Y BMJ Open. 2024; 14(9):e083227.

PMID: 39242162 PMC: 11381719. DOI: 10.1136/bmjopen-2023-083227.

Antioxidant Functions of Vitamin D and CYP11A1-Derived Vitamin D, Tachysterol, and Lumisterol Metabolites: Mechanisms, Clinical Implications, and Future Directions.

Vazquez-Lorente H, Herrera-Quintana L, Jimenez-Sanchez L, Fernandez-Perea B, Plaza-Diaz J Antioxidants (Basel). 2024; 13(8).

PMID: 39199241 PMC: 11351441. DOI: 10.3390/antiox13080996.

Effects of vitamin D in pregnancy on maternal and offspring health-related outcomes: An umbrella review of systematic review and meta-analyses.

Chien M, Huang C, Wang J, Shih C, Wu P Nutr Diabetes. 2024; 14(1):35.

PMID: 38816412 PMC: 11139885. DOI: 10.1038/s41387-024-00296-0.

References

Haidari F, Jalali M, Shahbazian N, Haghighizadeh M, Azadegan E . Comparison of Serum Levels of Vitamin D and Inflammatory Markers Between Women With Gestational Diabetes Mellitus and Healthy Pregnant Control. J Family Reprod Health. 2016; 10(1):1-8. PMC: 4930448. View

Zhang Y, Leung D, Richers B, Liu Y, Remigio L, Riches D . Vitamin D inhibits monocyte/macrophage proinflammatory cytokine production by targeting MAPK phosphatase-1. J Immunol. 2012; 188(5):2127-35. PMC: 3368346. DOI: 10.4049/jimmunol.1102412. View

Mousa A, Abell S, Shorakae S, Harrison C, Naderpoor N, Hiam D . Relationship between vitamin D and gestational diabetes in overweight or obese pregnant women may be mediated by adiponectin. Mol Nutr Food Res. 2017; 61(11). DOI: 10.1002/mnfr.201700488. View

Chen N, Wan Z, Han S, Li B, Zhang Z, Qin L . Effect of vitamin D supplementation on the level of circulating high-sensitivity C-reactive protein: a meta-analysis of randomized controlled trials. Nutrients. 2014; 6(6):2206-16. PMC: 4073144. DOI: 10.3390/nu6062206. View

Motamed S, Nikooyeh B, Kashanian M, Chamani M, Hollis B, Neyestani T . Evaluation of the efficacy of two doses of vitamin D supplementation on glycemic, lipidemic and oxidative stress biomarkers during pregnancy: a randomized clinical trial. BMC Pregnancy Childbirth. 2020; 20(1):619. PMC: 7556979. DOI: 10.1186/s12884-020-03311-1. View

Samimi M, Kashi M, Foroozanfard F, Karamali M, Bahmani F, Asemi Z . The effects of vitamin D plus calcium supplementation on metabolic profiles, biomarkers of inflammation, oxidative stress and pregnancy outcomes in pregnant women at risk for pre-eclampsia. J Hum Nutr Diet. 2015; 29(4):505-15. DOI: 10.1111/jhn.12339. View

Sebekova K, Sturmer M, Fazeli G, Bahner U, Stab F, Heidland A . Is vitamin D deficiency related to accumulation of advanced glycation end products, markers of inflammation, and oxidative stress in diabetic subjects?. Biomed Res Int. 2015; 2015:958097. PMC: 4426896. DOI: 10.1155/2015/958097. View

Perez-Lopez F, Pasupuleti V, Mezones-Holguin E, Benites-Zapata V, Thota P, Deshpande A . Effect of vitamin D supplementation during pregnancy on maternal and neonatal outcomes: a systematic review and meta-analysis of randomized controlled trials. Fertil Steril. 2015; 103(5):1278-88.e4. DOI: 10.1016/j.fertnstert.2015.02.019. View

Adela R, Borkar R, Mishra N, Bhandi M, Vishwakarma G, Varma B . Lower Serum Vitamin D Metabolite Levels in Relation to Circulating Cytokines/Chemokines and Metabolic Hormones in Pregnant Women with Hypertensive Disorders. Front Immunol. 2017; 8:273. PMC: 5346572. DOI: 10.3389/fimmu.2017.00273. View

10.

McManus R, Summers K, de Vrijer B, Cohen N, Thompson A, Giroux I . Maternal, umbilical arterial and umbilical venous 25-hydroxyvitamin D and adipocytokine concentrations in pregnancies with and without gestational diabetes. Clin Endocrinol (Oxf). 2013; 80(5):635-41. DOI: 10.1111/cen.12325. View

11.

Higgins J, Thompson S, Deeks J, Altman D . Measuring inconsistency in meta-analyses. BMJ. 2003; 327(7414):557-60. PMC: 192859. DOI: 10.1136/bmj.327.7414.557. View

12.

Jamilian M, Mirhosseini N, Eslahi M, Bahmani F, Shokrpour M, Chamani M . The effects of magnesium-zinc-calcium-vitamin D co-supplementation on biomarkers of inflammation, oxidative stress and pregnancy outcomes in gestational diabetes. BMC Pregnancy Childbirth. 2019; 19(1):107. PMC: 6440090. DOI: 10.1186/s12884-019-2258-y. View

13.

Razavi M, Jamilian M, Samimi M, Afshar Ebrahimi F, Taghizadeh M, Bekhradi R . The effects of vitamin D and omega-3 fatty acids co-supplementation on biomarkers of inflammation, oxidative stress and pregnancy outcomes in patients with gestational diabetes. Nutr Metab (Lond). 2018; 14:80. PMC: 5745759. DOI: 10.1186/s12986-017-0236-9. View

14.

Sepehrmanesh Z, Kolahdooz F, Abedi F, Mazroii N, Assarian A, Asemi Z . Vitamin D Supplementation Affects the Beck Depression Inventory, Insulin Resistance, and Biomarkers of Oxidative Stress in Patients with Major Depressive Disorder: A Randomized, Controlled Clinical Trial. J Nutr. 2015; 146(2):243-8. DOI: 10.3945/jn.115.218883. View

15.

Saponaro F, Saba A, Zucchi R . An Update on Vitamin D Metabolism. Int J Mol Sci. 2020; 21(18). PMC: 7554947. DOI: 10.3390/ijms21186573. View

16.

Zhang Q, Chen H, Wang Y, Zhang C, Tang Z, Li H . Severe vitamin D deficiency in the first trimester is associated with placental inflammation in high-risk singleton pregnancy. Clin Nutr. 2018; 38(4):1921-1926. DOI: 10.1016/j.clnu.2018.06.978. View

17.

Atkins D, Eccles M, Flottorp S, Guyatt G, Henry D, Hill S . Systems for grading the quality of evidence and the strength of recommendations I: critical appraisal of existing approaches The GRADE Working Group. BMC Health Serv Res. 2004; 4(1):38. PMC: 545647. DOI: 10.1186/1472-6963-4-38. View

18.

Colin E, Asmawidjaja P, van Hamburg J, Mus A, van Driel M, Hazes J . 1,25-dihydroxyvitamin D3 modulates Th17 polarization and interleukin-22 expression by memory T cells from patients with early rheumatoid arthritis. Arthritis Rheum. 2009; 62(1):132-42. DOI: 10.1002/art.25043. View

19.

Zhang Q, Cheng Y, He M, Li T, Ma Z, Cheng H . Effect of various doses of vitamin D supplementation on pregnant women with gestational diabetes mellitus: A randomized controlled trial. Exp Ther Med. 2016; 12(3):1889-1895. PMC: 4998009. DOI: 10.3892/etm.2016.3515. View

20.

Duval S, Tweedie R . Trim and fill: A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics. 2000; 56(2):455-63. DOI: 10.1111/j.0006-341x.2000.00455.x. View