Elizabeth A Jasper1, Nichole L Nidey2, Marin L Schweizer3, Kelli K Ryckman4. 1. Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA. Electronic address: elizabeth-jasper@uiowa.edu. 2. Cincinnati Children's Hospital Medical Center, Division of Biostatistics and Epidemiology, Cincinnati, OH; Cincinnati Children's Hospital Medical Center, Division of Developmental and Behavioral Pediatrics, Cincinnati, OH; University of Cincinnati College of Medicine, Cincinnati, OH. 3. Department of General Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA; Center for Access and Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, IA. 4. Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA.
Abstract
PURPOSE: Our objective was to systematically review and meta-analyze studies that assessed the association between gestational vitamin D levels and risk of multiple sclerosis (MS) in offspring. METHODS: Embase and Pubmed databases were searched from inception to May 2018. Original, observational studies that investigated both clinically defined MS (in offspring) and vitamin D levels in utero or shortly after birth were included. Two reviewers independently abstracted data and assessed the quality of studies using the Newcastle-Ottawa Quality Assessment Scale. Summary effect estimates and 95% confidence intervals were calculated with random effects models using inverse variance weighting. Determinants of heterogeneity were evaluated. RESULTS: Four case-control studies of moderate to low risk of bias were included. Summary effect estimates of the effect of higher levels of gestational vitamin D on risk of offspring MS demonstrated a significant protective effect in random effects (OR: 0.63, 95% CI: 0.47, 0.84) models and in a stratified analysis based on study quality. Factors identified as determinants of heterogeneity were the definitions of vitamin D deficiency, the characteristics of study participants, and the quality of the study. CONCLUSIONS: Sufficient levels of vitamin D during pregnancy may be protective against offspring's development of multiple sclerosis later in life.
PURPOSE: Our objective was to systematically review and meta-analyze studies that assessed the association between gestational vitamin D levels and risk of multiple sclerosis (MS) in offspring. METHODS: Embase and Pubmed databases were searched from inception to May 2018. Original, observational studies that investigated both clinically defined MS (in offspring) and vitamin D levels in utero or shortly after birth were included. Two reviewers independently abstracted data and assessed the quality of studies using the Newcastle-Ottawa Quality Assessment Scale. Summary effect estimates and 95% confidence intervals were calculated with random effects models using inverse variance weighting. Determinants of heterogeneity were evaluated. RESULTS: Four case-control studies of moderate to low risk of bias were included. Summary effect estimates of the effect of higher levels of gestational vitamin D on risk of offspring MS demonstrated a significant protective effect in random effects (OR: 0.63, 95% CI: 0.47, 0.84) models and in a stratified analysis based on study quality. Factors identified as determinants of heterogeneity were the definitions of vitamin D deficiency, the characteristics of study participants, and the quality of the study. CONCLUSIONS: Sufficient levels of vitamin D during pregnancy may be protective against offspring's development of multiple sclerosis later in life.
Authors: P Stridh; J Huang; A K Hedström; L Alfredsson; T Olsson; J Hillert; A Manouchehrinia; I Kockum Journal: Mult Scler J Exp Transl Clin Date: 2021-12-22