Gerovasili Eleni, Sarantaki Antigoni, Bothou Anastasia, Deltsidou Anna, Dimitrakopoulou Aikaterini, Diamanti Athina
Department of Midwifery, Faculty of Health and Caring Sciences, University of West Attica, Egaleo, Greece.
Metabol Open. 2025 Jan 31;25:100350. doi: 10.1016/j.metop.2025.100350. eCollection 2025 Mar.
Vitamin D plays a critical role in pregnancy, supporting placental function via angiogenesis, immune regulation, and nutrient transport. Deficiency in vitamin D during gestation is associated with complications such as preeclampsia, intrauterine growth restriction (IUGR), and preterm birth. However, the mechanisms linking vitamin D deficiency to placental dysfunction remain inadequately understood, highlighting the need for systematic evaluation.
A systematic review was conducted in adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, with searches in PubMed, Scopus, and Web of Science for studies published within the last 20 years. Inclusion criteria targeted human studies examining the association between vitamin D and placental function, including randomized controlled trials, cohort studies, and case-control studies. A total of 10 studies were included following rigorous screening and quality assessment.
Findings from human studies indicate that maternal vitamin D deficiency significantly impairs placental function by reducing vascular integrity, downregulating nutrient transporters, and promoting inflammation. Mechanistic evidence highlights decreased expression of vascular endothelial growth factor (VEGF) and increased inflammatory cytokines in vitamin D-deficient pregnancies. Supplementation with active vitamin D [1α,25(OH)2D3] mitigated these adverse effects, restoring placental growth, improving nutrient transport, and reducing inflammation. Notably, population-specific differences and sex-specific responses to vitamin D sufficiency were observed.
Vitamin D is essential for optimal placental function and pregnancy outcomes. This review underscores the need for standardized supplementation protocols and further research into long-term and population-specific effects of vitamin D. Addressing these gaps can inform targeted interventions to reduce pregnancy complications and improve maternal-fetal health.
维生素D在孕期起着关键作用，通过血管生成、免疫调节和营养物质转运来支持胎盘功能。孕期维生素D缺乏与子痫前期、胎儿生长受限（IUGR）和早产等并发症相关。然而，维生素D缺乏与胎盘功能障碍之间的联系机制仍未得到充分理解，这凸显了进行系统评估的必要性。
按照系统评价和Meta分析的首选报告项目（PRISMA）指南进行系统评价，在PubMed、Scopus和Web of Science中检索过去20年内发表的研究。纳入标准针对研究维生素D与胎盘功能之间关联的人体研究，包括随机对照试验、队列研究和病例对照研究。经过严格筛选和质量评估，共纳入10项研究。
人体研究结果表明，母体维生素D缺乏会通过降低血管完整性、下调营养物质转运蛋白和促进炎症反应，显著损害胎盘功能。机制证据显示，维生素D缺乏的妊娠中血管内皮生长因子（VEGF）表达降低，炎症细胞因子增加。补充活性维生素D[1α,25(OH)2D3]可减轻这些不良影响，恢复胎盘生长，改善营养物质转运，并减轻炎症。值得注意的是，观察到了人群特异性差异以及对维生素D充足状态的性别特异性反应。
维生素D对于最佳胎盘功能和妊娠结局至关重要。本综述强调了制定标准化补充方案的必要性，以及对维生素D的长期和人群特异性影响进行进一步研究。填补这些空白可为减少妊娠并发症和改善母婴健康的针对性干预措施提供依据。
