García-Serna Azahara M, Morales Eva
Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain.
University of Murcia, Murcia, Spain.
Mol Psychiatry. 2020 Oct;25(10):2468-2481. doi: 10.1038/s41380-019-0357-9. Epub 2019 Jan 29.
Diverse studies have investigated the impact of prenatal exposure to vitamin D levels on brain development; however, evidence in humans has never been systematically reviewed. This article summarized evidence of the association between 25-hydroxyvitamin D [25(OH)D] levels in maternal blood in pregnancy or newborn blood at birth and neurodevelopmental outcomes, including cognition, psychomotor performance, language development, behavioral difficulties, attention deficit and hyperactivity disorder (ADHD), and autistic traits. PubMed, Web of Science and SCOPUS databases were systematically searched for epidemiologic studies published through May 2018 using keywords. Random-effects meta-analyses were conducted. Of 260 identified articles, 25 were included in the present review. Comparing the highest vs. the lowest category of prenatal 25(OH)D levels, the pooled beta coefficients were 0.95 (95% CI -0.03, 1.93; p = 0.05) for cognition, and 0.88 (95% CI -0.18, 1.93; p = 0.10) for psychomotor development. The pooled relative risk for ADHD was 0.72 (95% CI, 0.59, 0.89; p = 0.002), and the pooled odds ratio for autism-related traits was 0.42 (95% CI, 0.25, 0.71; p = 0.001). There was little evidence for protective effects of high prenatal 25(OH)D for language development and behavior difficulties. This meta-analysis provides supporting evidence that increased prenatal exposure to 25(OH)D levels is associated with improved cognitive development and reduced risk of ADHD and autism-related traits later in life. Associations represent a potentially high public health burden given the current prevalence of vitamin D deficiency and insufficiency among childbearing aging and pregnant women.
多项研究调查了孕期维生素D水平对大脑发育的影响；然而，人类研究证据从未得到系统综述。本文总结了孕期母体血液或新生儿出生时血液中25-羟基维生素D[25(OH)D]水平与神经发育结局之间关联的证据，这些结局包括认知、精神运动表现、语言发育、行为困难、注意力缺陷多动障碍（ADHD）和自闭症特征。通过使用关键词，系统检索了PubMed、科学网和Scopus数据库中截至2018年5月发表的流行病学研究。进行了随机效应荟萃分析。在260篇已识别的文章中，本综述纳入了25篇。比较产前25(OH)D水平的最高类别与最低类别，认知方面的合并β系数为0.95（95%CI -0.03, 1.93；p = 0.05），精神运动发育方面为0.88（95%CI -0.18, 1.93；p = 0.10）。ADHD的合并相对风险为0.72（95%CI，0.59, 0.89；p = 0.002），自闭症相关特征的合并比值比为0.42（95%CI，0.25, 0.71；p = 0.001）。几乎没有证据表明产前高25(OH)D水平对语言发育和行为困难有保护作用。这项荟萃分析提供了支持性证据，表明孕期增加25(OH)D水平暴露与改善认知发育以及降低晚年患ADHD和自闭症相关特征的风险有关。鉴于目前育龄期和孕妇中维生素D缺乏和不足的普遍情况，这些关联代表了潜在的高公共卫生负担。
