Association between maternal vitamin D supplementation during pregnancy and the risk of acute respiratory infections in offspring: a systematic review and meta-analysis
Notice bibliographique
Résumé
Background Acute respiratory infections (ARIs) are a leading cause of mortality in infants. Vitamin D supports innate antimicrobial effector mechanisms in leucocytes and respiratory epithelium. Maternal vitamin D supplementation during pregnancy has been proposed as a preventive strategy, however, an up-to-date synthesis of available data from randomised controlled trials (RCTs) has not been conducted. Methods We conducted a systematic review and meta-analysis of aggregate data from RCTs of maternal vitamin D supplementation for prevention of ARIs in offspring. Data were analysed using a random-effects model. We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science and the ClinicalTrials.gov from database inception to 5th August 2025. No language restrictions were imposed. Double-blind RCTs of maternal vitamin D supplementation, with placebo or lower-dose vitamin D control, were eligible if approved by Research Ethics Committee and if ARI incidence in offspring was collected prospectively and pre-specified as an efficacy outcome. Sub-group analyses were done to determine whether effects of maternal vitamin D supplementation on offspring ARI risk varied according to maternal baseline circulating 25-hydroxyvitamin D (25 [OH]D) concentrations (<25 nmol/L, 25–49.9 nmol/L, 50–74.9 nmol/L, or ≥75 nmol/L). The study was registered with PROSPERO, CRD42024527191. Findings Our search identified 405 unique studies, of which 4 RCTs (3678 participants) were eligible and included. For the primary comparison of any maternal vitamin D supplementation vs. placebo, the intervention did not significantly affect overall ARI risk in offspring (incidence rate ratio [IRR] 1.01, 95% CI 0.98–1.03, P=0.66; 4 studies; I 2 14.5%, absolute effects from GRADE assessment: 0.05 higher rate in vitamin D arm; moderate quality finding). Pre-specified subgroup analysis did not reveal evidence of effect modification by maternal baseline vitamin D status: <25 nmol/L group: IRR 1.12, 95% CI 0.98–1.27 (607 participants in 4 studies, I 2 47.8%) vs. 25–49.9 nmol/L group: IRR 1.04, 95% CI 0.96–1.13 (1154 participants in 4 studies, I 2 68.5%) vs. 50–74.9 nmol/L group: IRR 1.00, 95% CI 0.93–1.08 (789 participants in 4 studies, I 2 64.9%) vs. ≥75 nmol/L group: IRR 0.97, 95% CI 0.89–1.06 (505 participants in 4 studies, I 2 47.6%). A funnel plot did not indicate the presence of publication bias or small-study effects (P = 0.71, Egger's test). Interpretation Our analysis of current data does not support routine antenatal vitamin D supplementation for the prevention of ARI in offspring. Key limitations of the study were the administration of a low dose vitamin D standard-of-care in some populations which may have attenuated effects of the intervention, and heterogeneity in ARI case definitions which may have introduced misclassification bias. Targeted supplementation in deficient populations may warrant further investigation. Funding None.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,002 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».