A comparison of the risk of cesarean section in gestational diabetes mellitus patients supplemented antenatally with vitamin D containing supplements versus placebo: A systematic review and meta-analysis of double-blinded randomized controlled trials

Abstract

The aim of this study was to study the role of vitamin D containing supplements in the risk of cesarean section (CS), a common complicationin gestational diabetes mellitus (GDM) patients. An additional objective was to assess the risk of developing pre-eclampsia, preterm delivery,macrosomia, and polyhydramnios in these participants. Various electronic databases were searched for double-blinded parallel-arm randomizedcontrolled trials that reported the incidence of CS in adult, non-insulin treated GDM patients who received vitamin D and placebo in differenttreatment arms, respectively. Next, each eligible trial’s risk of bias was assessed, and the effects of the above interventions on the respectiveoutcomes were compared meta-analytically across the trials. This review included five Iranian trials sourcing data from nearly 380 participants.The risk of bias in the trials was primarily low. In contrast to the placebo group, the risk of CS [risk ratio (RR): 0.61, p=0.002, 95% confidenceinterval (CI): 0.44,0.83; I2=0%, p-value of Cochrane’s Q: 0.373) and macrosomia (RR: 0.31, p=0.006, 95% CI: 0.13,0.72; I2=0%, p-value of Cochrane’sQ: 0.935] was less in the vitamin D supplemented group. The remaining outcomes did not differ between the intervention groups. The antenataluse of vitamin D containing supplements in non-insulin treated GDM patients might reduce the risk of CS and macrosomia. (J Turk Ger GynecolAssoc 2020; 21: 201-12)