A systematic review and meta-analysis of prevalence of vitamin D deficiency among Indonesian pregnant women: a public health emergency

OBJECTIVE: There are few in-depth investigations or meta-analyses determining the prevalence of vitamin D insufficiency in expectant Indonesian mothers. This systematic review and meta-analysis aims to determine this prevalence. DATA SOURCES: We searched information using the following databases: MEDLINE, PubMed, Google Scholar, Cochrane Library, ScienceDirect, Neliti, Indonesia Onesearch, Indonesian Scientific Journal Database, bioRxiv, and medRxiv. STUDY ELIGIBILITY CRITERIA: The inclusion criteria included cross-sectional studies or observational studies published in any language, studying Indonesian pregnant women whose vitamin D levels were measured. METHODS: Vitamin D deficiency in this review was defined as serum 25-hydroxyvitamin D <50 nmol/L, whereas vitamin D insufficiency was defined as serum 25-hydroxyvitamin D between 50 and 75 nmol/L. The analysis was done using Stata software with the Metaprop command. RESULTS: The meta-analysis included 6 studies involving 830 pregnant women aged 27.6–30.6 years. Prevalence of vitamin D deficiency among Indonesian pregnant women was 63% (95% confidence interval, 40–86; I(2), 98.9%; P<.0001). The prevalence rates of vitamin D insufficiency and hypovitaminosis D were 25% (95% confidence interval, 16–34; I(2), 83.37%; P<.01) and 78% (95% confidence interval, 60–96; I(2), 96.81%; P<.01), respectively. The mean serum vitamin D level was 40.59 nmol/L (95% confidence interval, 26.04–55.13; I(2), 99.57%; P<.01). CONCLUSION: Pregnant women in Indonesia are at risk for vitamin D deficiency, which constitutes a public health issue. Possible unwanted consequences, including preeclampsia and small-for-gestational-age newborns, are more likely to occur when vitamin D deficiency in pregnant women is left untreated. However, more studies are needed to prove these relationships.