The Effect of Maternal Vitamin D Status on Fetal Growth and Stunting: A Systematic Review

Abstract

Background and Objective: Impaired fetal growth and stunting remain immense public health problems involving maternal nutrition during pregnancy, as linear growth failure in children is the most common form of undernutrition across the world. Although both are preventable through adequate prenatal care and nutrition, impaired fetal growth and stunting continue to be implicated in multiple child health morbidities, physical, and psychological functioning. Recent knowledge and requirements for normal fetal and neonatal development are lacking. This systematic review investigates the effects of maternal vitamin D status on fetal growth and stunting. Methods: We reviewed three widely-used publications databases: the National Institutes of Health’s PubMed, Clarivate Analytics’ Web of Science, and Google Scholar using pre-established inclusion and exclusion criteria and keyword search strategy. Studies from 2010 to 2020 were included if they reported vitamin D levels on pregnant women, indicated growth outcomes and used quantitative measurements. We excluded nonEnglish language studies, studies with ambiguous outcomes, studies that did not specify vitamin D intake, and studies that involved other maternal health complications. The search was implemented using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results: Out of a total of 2,481 studies reviewed, we identified 8 studies on vitamin D and fetal growth and stunting. Published literature addressing maternal vitamin D status on fetal growth and stunting remains ambiguous. Five studies demonstrated improvements in fetal and humerus z-scores, which are known proxies for fetal growth, in groups with higher vitamin D status. Three studies found no statistical significance between vitamin D levels and fetal growth. Vitamin D status and ethnicity were correlated; vitamin D interacts with calcium levels in pregnant mothers to improve bone mineralization and fetal growth. Conclusion and Implications for Translation: Further studies are needed to understand the relationship between maternal vitamin D, ethnicity, and fetal growth and the long-term effects of maternal vitamin D levels on neonatal, early childhood, and adolescent growth.