Saha Sumanta, Saha Sujata
Department of Community Medicine, R. G. Kar Medical College, Kolkata 700004, West Bengal, India.
Department of Mathematics, Mankar College, Mankar 713144, West Bengal, India.
World J Methodol. 2022 May 20;12(3):164-178. doi: 10.5662/wjm.v12.i3.164.
The role of vitamin D supplementation in gestational diabetes mellitus (GDM) patients is unclear.
To determine the burden and risk of post-randomization GDM patient attrition from vitamin D-supplemented arms of randomized controlled trials (RCTs). The auxiliary aim was to compare the effects of nutritional supplements on their fasting blood glucose (FPG) levels and perinatal outcomes.
RCTs were searched in the PubMed, Embase, and Scopus databases. Random-effect prevalence and pairwise meta-analysis were performed for the primary objective. The auxiliary aim was to compare the effects of nutritional supplements on their fasting blood glucose (FPG) levels and perinatal outcomes. Fixed-effect network meta-analyses were undertaken for the secondary goals. All analyses were performed using Stata software, and statistical significance was determined at < 0.05.
Thirteen RCTs from Iran and China were reviewed. The participant attrition burden in vitamin D recipients was 6% [95% confidence interval (CI): 0.03, 0.10], and its risk did not vary from non-recipients. Vitamin D and calcium co-supplementation reduced the cesarean section incidence in GDM patients [risk ratio (RR): 0.37; 95%CI: 0.18, 0.74]. The hyperbilirubinemia or hospitalization risk in their newborns decreased with vitamin D supplementation (RR: 0.47; 95%CI: 0.27, 0.83) and co-supplementation with calcium (RR: 0.35; 95%CI: 0.16, 0.77) or omega-3 fatty acids (RR: 0.25; 95%CI: 0.08, 0.77). Vitamin D and probiotics co-supplementation decreased newborn hyperbilirubinemia risk (RR: 0.28; 95%CI: 0.09, 0.91). FPG levels and macrosomia risk did not vary across interventions.
In RCTs, vitamin D supplementation or co-supplementation in GDM patients showed a low participant attrition burden and low risk of cesarean section, newborn hyperbilirubinemia, and newborn hospitalization.
维生素D补充剂在妊娠期糖尿病（GDM）患者中的作用尚不清楚。
确定随机对照试验（RCT）中维生素D补充组随机分组后GDM患者的失访负担和风险。辅助目的是比较营养补充剂对其空腹血糖（FPG）水平和围产期结局的影响。
在PubMed、Embase和Scopus数据库中检索RCT。对主要目标进行随机效应患病率和成对荟萃分析。辅助目的是比较营养补充剂对其空腹血糖（FPG）水平和围产期结局的影响。对次要目标进行固定效应网络荟萃分析。所有分析均使用Stata软件进行，统计学显著性设定为<0.05。
对来自伊朗和中国的13项RCT进行了综述。维生素D接受者的参与者失访负担为6%[95%置信区间（CI）：0.03，0.10]，其风险与非接受者无差异。维生素D和钙联合补充降低了GDM患者的剖宫产发生率[风险比（RR）：0.37；95%CI：0.18，0.74]。补充维生素D（RR：0.47；95%CI：0.27，0.83）以及与钙联合补充（RR：0.35；95%CI：0.16，0.77）或ω-3脂肪酸联合补充（RR：0.25；95%CI：0.08，0.77）可降低其新生儿高胆红素血症或住院风险。维生素D与益生菌联合补充可降低新生儿高胆红素血症风险（RR：0.28；95%CI：0.09，0.91）。不同干预措施下FPG水平和巨大儿风险无差异。
在RCT中，GDM患者补充维生素D或联合补充显示出较低的参与者失访负担以及较低的剖宫产、新生儿高胆红素血症和新生儿住院风险。
