A systematic review and meta analysis on the effect of vitamin D in preeclampsia and gestational diabetes mellitus in pregnancy

Martha Irene Kartasurya; Tomasina Stacey; Naintina Lisnawati; Andi Rispah Sulistianingsih; Martha Irene Kartasurya; Tomasina Stacey; Naintina Lisnawati; Andi Rispah Sulistianingsih

doi:10.3934/publichealth.2025062

AIMS Public Health

2025, Volume 12, Issue 4: 1223-1239. doi: 10.3934/publichealth.2025062

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Review

A systematic review and meta analysis on the effect of vitamin D in preeclampsia and gestational diabetes mellitus in pregnancy

1.
Department of Public Health Nutrition, Faculty of Public Health, Universitas Diponegoro, Indonesia
2.
Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's Collage London, 57 Waterloo Road, London, SE1 8WA, UK
3.
Doctoral Program of Public Health, Faculty of Public Health, Universitas Diponegoro, Indonesia

Received: 25 September 2025 Revised: 03 December 2025 Accepted: 15 December 2025 Published: 18 December 2025

Background
Preeclampsia and gestational diabetes mellitus (GDM) are significant contributors to maternal and neonatal morbidity and mortality, particularly in low- and middle-income countries. Vitamin D might play a role in the pregnancy complication prevention. However, findings across studies remain inconsistent. In this review, we aimed to evaluate vitamin D deficiency effect on preeclampsia and GDM risks, and the effect of vitamin D supplementation during pregnancy in reducing preeclampsia and GDM incidences.
Methods
We followed the PRISMA guidelines and registered the protocol with PROSPERO (CRD42024609276). Database PubMed, Scopus, and EBSCO-Medline were used to search cohort and randomized controlled trial (RCT) studies published between 1993 and 2025. Two reviewers independently assessed the article quality with the Joanna Briggs Institute checklists and extracted data. Meta-analyses were performed using RevMan 5.4. The results were reported in pooled odds ratios (OR) or standardized mean differences (SMD) with 95% confidence intervals.
Results
A total of 52,372 participants from 24 studies were included in this review. Vitamin D supplementation appeared to reduce the preeclampsia risk by 42% (OR = 0.58; 95%CI: 0.43–0.78; I² = 45%) and GDM by 45% (OR = 0.55; 95%CI: 0.36–0.87; I² = 0%) in RCTs. Vitamin D supplementation is most effective in reducing the risk of recurrent preeclampsia in women with vitamin D deficiency. In cohort studies, vitamin D deficiency was associated with a higher risk of GDM (OR = 1.29; 95% CI: 1.16 to 1.43; I² = 7%), but was not significantly associated with preeclampsia (OR = 1.67; 95% CI: 0.92 to 3.01; I² = 85%).
Conclusion
Vitamin D supplementation in pregnancy, especially in the first trimester, decreased preeclampsia and GDM risks, while vitamin D deficiency in pregnancy increased GDM risk but not preeclampsia. These findings support the potential benefit of vitamin D supplementation in the routine antenatal care to improve pregnancy outcomes.
- vitamin D,
- preeclampsia,
- gestational diabetes,
- pregnancy,
- blood pressure,
- meta-analysis
Citation: Martha Irene Kartasurya, Tomasina Stacey, Naintina Lisnawati, Andi Rispah Sulistianingsih. A systematic review and meta analysis on the effect of vitamin D in preeclampsia and gestational diabetes mellitus in pregnancy[J]. AIMS Public Health, 2025, 12(4): 1223-1239. doi: 10.3934/publichealth.2025062

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Abstract

Background

Preeclampsia and gestational diabetes mellitus (GDM) are significant contributors to maternal and neonatal morbidity and mortality, particularly in low- and middle-income countries. Vitamin D might play a role in the pregnancy complication prevention. However, findings across studies remain inconsistent. In this review, we aimed to evaluate vitamin D deficiency effect on preeclampsia and GDM risks, and the effect of vitamin D supplementation during pregnancy in reducing preeclampsia and GDM incidences.

Methods

We followed the PRISMA guidelines and registered the protocol with PROSPERO (CRD42024609276). Database PubMed, Scopus, and EBSCO-Medline were used to search cohort and randomized controlled trial (RCT) studies published between 1993 and 2025. Two reviewers independently assessed the article quality with the Joanna Briggs Institute checklists and extracted data. Meta-analyses were performed using RevMan 5.4. The results were reported in pooled odds ratios (OR) or standardized mean differences (SMD) with 95% confidence intervals.

Results

A total of 52,372 participants from 24 studies were included in this review. Vitamin D supplementation appeared to reduce the preeclampsia risk by 42% (OR = 0.58; 95%CI: 0.43–0.78; I² = 45%) and GDM by 45% (OR = 0.55; 95%CI: 0.36–0.87; I² = 0%) in RCTs. Vitamin D supplementation is most effective in reducing the risk of recurrent preeclampsia in women with vitamin D deficiency. In cohort studies, vitamin D deficiency was associated with a higher risk of GDM (OR = 1.29; 95% CI: 1.16 to 1.43; I² = 7%), but was not significantly associated with preeclampsia (OR = 1.67; 95% CI: 0.92 to 3.01; I² = 85%).

Conclusion

Vitamin D supplementation in pregnancy, especially in the first trimester, decreased preeclampsia and GDM risks, while vitamin D deficiency in pregnancy increased GDM risk but not preeclampsia. These findings support the potential benefit of vitamin D supplementation in the routine antenatal care to improve pregnancy outcomes.

Acknowledgments

This study was funded by 2025' Article Review Research grant from Diponegoro University, with the contract number of: 222–027/UN7.D2/PPIV/2025.

Authors' contributions

Martha Irene Kartasurya: conceptualization, methodology, validation, investigation, writing-review and editing. Tomasina Stacey: conceptualization, methodology. Writing-review and editing. Andi Rispah Sulistianingsih: data curation, selecting the studies, quality assessment, investigation, writing original draft, writing-review and editing, visualization, and analyzing the meta-analysis. Naintina Lisnawati: data curation, selecting the studies, quality assessment, writing-review & editing.

Conflict of interest

All authors declare no conflicts of interest in this paper.

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