Neurodevelopmental effects of prenatal vitamin D in humans: systematic review and meta-analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational/epidemiologic studies
PubMed 30696940 · doi:10.1038/s41380-019-0357-9
What was done
Authors conducted a systematic review and random-effects meta-analysis of epidemiologic studies searching PubMed, Web of Science, and SCOPUS through May 2018. They assessed the association between prenatal 25-hydroxyvitamin D [25(OH)D] concentrations (measured in maternal pregnancy blood or newborn blood) and neurodevelopmental outcomes: cognition, psychomotor performance, language development, behavioral difficulties, attention deficit and hyperactivity disorder (ADHD), and autistic traits.
What was found
Twenty-five studies were included from 260 identified records. Comparing the highest versus lowest prenatal 25(OH)D categories: - Cognition: pooled beta = 0.95 (95% CI -0.03 to 1.93; p = 0.05) - Psychomotor development: pooled beta = 0.88 (95% CI -0.18 to 1.93; p = 0.10) - ADHD: pooled relative risk = 0.72 (95% CI 0.59 to 0.89; p = 0.002) - Autism-related traits: pooled odds ratio = 0.42 (95% CI 0.25 to 0.71; p = 0.001) There was little evidence of association for language development or behavioral difficulties.
Why it matters
This synthesis provides consolidated evidence that adequate maternal and neonatal vitamin D status is associated with reduced risk of neurodevelopmental conditions, particularly ADHD and autism-related traits. These findings underscore the clinical relevance of monitoring and addressing vitamin D insufficiency during pregnancy.
Limits
The underlying evidence base consists solely of observational studies, which cannot establish causality and remain vulnerable to residual confounding (such as maternal diet, socioeconomic factors, and sun exposure). Total individual participant count, specific cutoff thresholds for vitamin D categories, and heterogeneity metrics across the 25 included studies were not reported in the abstract.
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