Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark.
Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark.
Clin Nutr. 2022 Aug;41(8):1808-1817. doi: 10.1016/j.clnu.2022.06.040. Epub 2022 Jun 30.
BACKGROUND & OBJECTIVE: It has been suggested that prenatal vitamin D plays a role in the development of childhood asthma and wheeze. Several systematic reviews have been conducted, but the results are inconsistent, and the methodological quality has not been studied. Therefore, the objective of this umbrella review was to assess the internal validity of the evidence base and the evidence for an association between prenatal vitamin D and asthma or wheezing in the offspring.
We searched the electronic databases Embase, PubMed, and Cochrane Library for studies on prenatal vitamin D using search words such as vitamin D, 25-hydroxyvitamin D, calcidiol, fetal, and neonatal. The search was conducted in June 2020, and the databases were searched from their date of establishment. We included systematic reviews and/or meta-analyses of experimental and observational studies assessing the association between prenatal vitamin D or asthma and wheeze. We excluded narrative reviews, commentaries, and other umbrella reviews. The methodological quality of systematic reviews was assessed using AMSTAR 2 tool. PROSPERO reg. no. CRD42020151329.
We identified 22 eligible systematic reviews (17 on asthma and 20 on wheeze). Using the AMSTAR 2 quality assessment tool, the methodological quality was rated as critically low in 21 out of 22 systematic reviews, suggesting that previous reviews and meta-analyses did not provide accurate and comprehensive summaries of the included studies and that conclusions reached were potentially flawed. The majority of the included reviews reported that prenatal vitamin D reduces the risk of wheeze in the offspring.
Prior to informing public guidelines, high-quality systematic reviews of the current evidence are greatly warranted.
有研究表明，产前维生素 D 可能在儿童哮喘和喘息的发生发展中发挥作用。已有多项系统评价，但结果不一致，且其方法学质量尚未得到研究。因此，本 umbrella 综述的目的是评估产前维生素 D 与后代哮喘或喘息之间关联的证据基础的内部有效性。
我们使用维生素 D、25-羟维生素 D、钙二醇、胎儿和新生儿等关键词，在 Embase、PubMed 和 Cochrane Library 电子数据库中搜索关于产前维生素 D 的研究。检索于 2020 年 6 月进行，数据库自建立之日起进行检索。我们纳入了评估产前维生素 D 与哮喘和喘息之间关联的实验和观察性研究的系统评价和/或荟萃分析。我们排除了叙述性综述、评论和其他 umbrella 综述。使用 AMSTAR 2 工具评估系统评价的方法学质量。PROSPERO 注册号 CRD42020151329。
我们确定了 22 项符合条件的系统评价（17 项关于哮喘，20 项关于喘息）。使用 AMSTAR 2 质量评估工具，22 项系统评价中有 21 项的方法学质量被评为极低，这表明先前的综述和荟萃分析并未对纳入研究进行准确和全面的总结，得出的结论可能存在缺陷。大多数纳入的综述报告称，产前维生素 D 降低了后代喘息的风险。
在为公众指南提供信息之前，非常需要对当前证据进行高质量的系统评价。
