The impact of vitamin D on fetal and neonatal lung maturation. A systematic review

Area of Science:

• Neonatal Medicine
• Pulmonology
• Nutritional Science

Background:

• Respiratory distress syndrome (RDS) and bronchopulmonary dysplasia (BPD) are significant complications of preterm birth.
• Pregnancy is often associated with hypovitaminosis D (vitamin D deficiency).

Purpose of the Study:

• To systematically review the evidence on vitamin D's impact on fetal lung development, surfactant synthesis, RDS, and BPD.
• To evaluate vitamin D's potential role as a modifiable risk factor for these neonatal respiratory complications.

Main Methods:

• A systematic literature search was conducted in PubMed, Embase, and Cochrane databases.
• Included studies comprised human, animal, and laboratory investigations examining vitamin D and lung health outcomes.

Main Results:

• Human studies provided limited evidence, preventing definitive conclusions.
• Animal and laboratory studies demonstrated significant beneficial effects of vitamin D on alveolar type II cells, fibroblast proliferation, surfactant synthesis, and alveolarization.
• No association was found between BPD and vitamin D receptor polymorphism in fully adjusted analyses.

Conclusions:

• Hypovitaminosis D may be a frequent, modifiable risk factor for RDS and BPD.
• Further randomized controlled trials are warranted to test vitamin D interventions in pregnant women and preterm neonates.
• Future research should determine optimal vitamin D dosages and timing for preventing adverse respiratory outcomes.