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Maternal serum 25-hydroxy vitamin D levels and risk of autism spectrum and attention-deficit hyperactivity disorders in offspring: A systematic review and dose-response meta-analysis

Tirani S, Balali A, Askari G, Saneei P (2024) Psychiatry Research Jan:319:114977 doi: 10.1016/j.psychres.2022.114977. 

Web URL: Read this article on Science Direct

Abstract:

This systematic review and dose-response meta-analyses was performed to quantify the link between maternal serum vitamin D levels with risk of offspring autism spectrum disease (ASD) and attention-deficient hyperactivity disorder (ADHD).

A systematic search was done using MEDLINE (PubMed), ISI (Web of Science), Embase databases, and Google Scholar up to May 2022. A total of 10 eligible studies were included in the analysis for ASD (containing 9,125 individuals and 2,671 ASD cases) and ADHD (containing 5,451 subjects and 1,267 ADHD cases).

We found significant inverse associations between maternal serum vitamin D levels with risk of offspring ASD (OR=0.57; 95%CI: 0.33–0.99) and ADHD (RR=0.59; 95%CI: 0.44–0.81), when the highest versus the lowest level of maternal serum vitamin D was compared.

Furthermore, linear dose-response analysis revealed that each 25 nmol/L (or 10 ng/mL) increase in maternal serum vitamin D level was associated with a 19% and 18% reduced risk of offspring ASD (OR=0.81; 95%CI: 0.76–0.87) and ADHD (RR=0.82; 95%CI: 0.73–0.92). A significant non-linear association was also found between maternal serum 25 (OH)D status with risk of ASD and ADHD.

This meta-analysis demonstrated that maternal serum vitamin D levels were inversely associated with odds of offspring ASD and ADHD in a dose-response manner.

FAB RESEARCH COMMENT:

Vitamin D's effects on health and development go far beyond its long-established essentiality for strong bones and teeth - and among many other functions, Vitamin D is essential for normal brain development.

Animal studies have long shown that even transient maternal deficiencies in Vitamin D during pregnancy can permanently impair brain structure and function in ways known to raise risks for neurodevelopmental conditions including ADHD, autism and schizophrenia.

Firm evidence of causality is much more difficult to obtain in humans, for both ethical and practical reasons. However, a large and ever-growing literature points to Vitamin D deficiencies in pregnancy as a risk factor for these conditions in humans too.

This systematic review and meta-analysis provides additional support for that proposal - as results showed a clear inverse dose-response relationship between maternal serum vitamin D levels in pregnancy, and the chances of ASD and ADHD in the resulting children.

Vitamin D deficiences and insufficiencies have become widespread in modern human populations - largely owing to indoor lifestyles, as skin exposure to bright sunshine, not diet, is the main natural source.

These new findings add weight to the increasing calls for public health authorities to do more to

(1) raise awareness of the importance of adequate Vitamin D intakes in women of childbearing age and the need for supplementation - not only in the winter months but all year round in the UK and other countries at similar latitudes.

(2) take effective action to reduce the high rates of insufficiency and deficiency - via mandatory fortification of basic foodstuffs, and/or targeted supplementation.

For more inormation on this subject, please see the following lists of articles, which are frequently updated: