Changes in anthropometric and blood 25-hydroxyvitamin D measurements in antenatal vitamin supplemented gestational diabetes mellitus patients: A systematic review and meta-analysis of randomized controlled trials.

Gestation weight (GW), body mass index (BMI), and the blood 25-hydroxyvitamin D (25(OH)D) level during pregnancy are important determinants of the gestational outcomes. This study aims to study how these parameters vary between antenatal vitamin D recipients and non-recipients in gestational diabetes mellitus (GDM) patients. The randomized controlled trials comparing these outcomes between vitamin D recipient and non-recipient GDM patients were searched in electronic databases (PubMed, Embase, and Scopus). The reviewed studies' data were abstracted and critically appraised by the Cochrane tool. The estimation of the weighted mean difference for GW and BMI and standardized mean difference (SMD) for 25(OH)D levels occurred by juxtaposing the interventions meta-analytically (random-effect model). The statistical inconsistency was determined by Chi2 and I2 method. The statistical significance was estimated at p<0.05 and 95% confidence interval (CI). Eleven eligible trials (all Iran-based, except one) sourcing data from about 875 GDM patients were reviewed. Overall, the risk of bias was low, except for selection and performance bias. On random-effect model meta-analysis, the 25(OH)D levels of the GDM patients favored the vitamin D recipients when compared to non-vitamin D (SMD: 1.97, 95%CI, 1.06, 2.88, p, <0.001, I2, 96.2%, p of Chi2, <0.001) and placebo (SMD, 1.86, 95% CI, 0.95, 2.77, p,<0.001, I2, 95.3%, p of Chi2,<0.001) recipients, respectively. On meta-regression, sample size was a predictor of the observed heterogeneity. For GW and BMI the interventions did not differ statistically significantly. In GDM patients, antenatal use of vitamin D aids in the rise of blood 25(OH)D levels; however, it doesn't influence GW and BMI change. PROSPERO registration number: CRD42020149613.