Deficiência e insuficiência de vitamina D em mulheres na idade reprodutiva: Uma revisão sistemática e meta-análise

Lucchetta, Rosa Camila; Lemos, Isabele Held; Gini, Ana Luísa Rodriguez; Cavicchioli, Sophia de Andrade; Forgerini, Marcela; Varallo, Fabiana Rossi; Nadai, Mariane Nunes de; Fernandez-Llimos, Fernando; Mastroianni, Patricia de Carvalho

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Brasil

Revista Brasileira de Ginecologia e Obstetrícia

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Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Review Article • Rev. Bras. Ginecol. Obstet. 44 (04) • Abr 2022 • https://doi.org/10.1055/s-0042-1742409 copiar

Deficiência e insuficiência de vitamina D em mulheres na idade reprodutiva: Uma revisão sistemática e meta-análise

Autoria SCIMAGO INSTITUTIONS RANKINGS

Resumo

Objetivo

Estimar a prevalência de níveis inadequados de vitamina D e seus fatores associados para mulheres em idade fértil no Brasil.

Métodos

Uma revisão sistemática foi realizada (última atualização em maio de 2020). As meta-análises foram realizadas usando o inverso da variância para o modelo fixo com cálculo de proporção sumarizada por transformação arco-seno duplo de Freeman-Tukey. A qualidade metodológica e de reporte foi avaliada usando a ferramenta do Joanna Briggs Institute para estudos de prevalência.

Resultados

Nossa revisão identificou 31 estudos, compreendendo 4.006 participantes. Todos os estudos apresentaram pelo menos uma limitação, principalmente devido ao uso de amostra de conveniência e tamanho amostral pequeno. As prevalências gerais de deficiência, insuficiência e deficiência de vitamina D foram 35% (intervalo de confiança, IC 95%: 34-37%), 42% (IC 95%: 41-44%) e 72% (IC 95%: 71-74%), respectivamente.

Conclusão

Embora a magnitude da prevalência de níveis inadequados de vitamina D seja incerta, a evidência sugere que presença de deficiência ou insuficiência de vitamina D em mulheres em idade reprodutiva pode causar problemas moderados a graves.

Palavras-chave:
colecalciferol; deficiência de vitamina D; epidemiologia nutricional; nutrição materna; saúde da mulher

Study	Inclusion period	State/region	Setting	Cutoff values	Funding
Cross-sectional studies
Araújo et al. (2017),³²32 Santos Araújo EPD, Queiroz DJM, Neves JPR, Lacerda LM, Gonçalves MDCR, Carvalho AT. Prevalence of hypovitaminosis D and associated factors in adolescent students of a capital ofnortheastern Brazil. Nutr Hosp. 2017;34(05):1416-1423. Doi: 10.20960/nh.1097 https://doi.org/10.20960/nh.1097... Queiroz (2016),³³33 Queiroz DJ. Relação entre insuficiência/deficiência da vitamina D, inflamação e estresse oxidativo em adolescentes escolares com excesso de peso [dissertação]. João Pessoa: Universidade Federal da Paraíba; 2016 and Queiroz et al. (2019)³⁴34 Queiroz DJM, Silva AS, Diniz ADS, Carvalho AT, Araújo EP, Neves JP, et al. Vitamin D insufficiency/deficiency and its association with cardiometabolic risk factors in Brazilian adolescents. Nutr Hosp. 2019;36(01):142-148. Doi: 10.20960/nh.1884 https://doi.org/10.20960/nh.1884...	Jun–Aug 2015	PB/NE	School	< 75 nmol/L	NR
Chrisostomo et al. (2018)³⁸38 Chrisostomo KR, Skare TL, Kulak J Jr, Urbanetz AA, Chrisostomo ER, Nisihara R. The prevalence and clinical associations of hypovitaminosis D in pregnant women from Brazil. Int J Gynaecol Obstet. 2018;143(01):66-70. Doi: 10.1002/ijgo.12575 https://doi.org/10.1002/ijgo.12575...	Jan–Mar or Jul–Aug 2016	PR/S	Obstetrical care	< 75 nmol/L50–75 nmol/L< 50 nmol/L	NR
Duran de Campos et al. (2008)³⁹39 Duran de Campos C, Dalcanale L, Pajecki D, Garrido AB Jr, Halpern A. Calcium intake and metabolic bone disease after eight years of Roux-en-Y gastric bypass. Obes Surg. 2008;18(04):386-390. Doi: 10.1007/s11695-007-9393-7 https://doi.org/10.1007/s11695-007-9393-...	Oct 1995–Jan 1999	SP/SE	Outpatient	25–50 nmol/L12.5–25 nmol/L	NR
de Oliveira et al. (2020)³⁵35 de Oliveira CL, Cureau FV, Cople-Rodrigues CDS, Giannini DT, Bloch KV, Kuschnir MC, et al. Prevalence and factors associated with hypovitaminosis D in adolescents from a sunny country: Findings fromthe ERICA survey. J Steroid Biochem Mol Biol. 2020; 199:105609. Doi: 10.1016/j.jsbmb.2020.105609 https://doi.org/10.1016/j.jsbmb.2020.105...	Feb 2013–Nov 2014	DF, RJ, RS, SC/S, SE, CW	School	< 75 nmol/L50–75 nmol/L< 50 nmol/L	Brazilian Funding Authority for Studies and Projects, and CNPq
Souza et al. (2019)⁴⁰40 Souza JR, Silva TS, Figueredo ED. Hypovitaminosis D in pregnancy: is it a public health issue? Rev Bras Saúde Matern Infant. 2019;19 (01):197-205. Doi: 10.1590/1806-93042019000100011 https://doi.org/10.1590/1806-93042019000...	Jan–Feb 2017	MA/NE	Outpatient	< 75 nmol/L50–75 nmol/L< 50 nmol/L	NR
Delmonico et al. (2018)⁴¹41 Delmonico L, CostaMASM, Azevedo CM, Silvestre RT, Scherrer LR, Ornellas MH, et al. Low levels of Vitamin D in a cohort of women with impalpable breast lesions from Rio de Janeiro/Brazil. Asian Pac J Cancer Prev. 2018;19(11):3087-3092. Doi: 10.31557/APJCP.2018.19.11.3087 https://doi.org/10.31557/APJCP.2018.19.1...	2008–2016	RJ/SE	Outpatient	< 75 nmol/L	CAPES
Prado et al. (2015)³3 do Prado MR, Oliveira FdeC, Assis KF, Ribeiro SA, Prado Jr. PP, Sant'Ana LF, et al. Prevalência de deficiência de vitamina D e fatores associados em mulheres e seus recém-nascidos no período pós-parto. Rev Paul Pediatr. 2015;33(03):287-294. Doi: 10.1016/j.rpped.2015.01.006 https://doi.org/10.1016/j.rpped.2015.01....	Dec 2011–Nov 2012	MG/SE	Obstetrical care	< 50 nmol/L	FAPEMIG
Ferreira et al. (2015)⁴²42 Ferreira TdaS, Rocha TM, Klein MR, Sanjuliani AF. Vitamin d deficiency is associated with insulin resistance independent of intracellular calcium, dietary calcium and serum levels of parathormone, calcitriol and calcium in premenopausal women. Nutr Hosp. 2015;31(04):1491-1498. Doi: 10.3305/nh.2015.31.4.8490 https://doi.org/10.3305/nh.2015.31.4.849...	NR	RJ/SE	Outpatient	< 50 nmol/L	FAPERJ
Flauzino et al. (2017)⁴³43 Flauzino T, Simao ANC, de Almeida ERD, Morimoto HK, Oliveira SR, Alfieri DF, et al. Association between Vitamin D status, oxidative stress biomarkers and viral load in human immunodeficiency virus type 1 infection. Curr HIV Res. 2017;15(05): 336-344. Doi: 10.2174/1570162X15666171005170227 https://doi.org/10.2174/1570162X15666171...	Jul 2010–Mar 2011	PR/S	Outpatient	< 75 nmol/L	CAPES, CNPq, and UEL
Lopes et al. (2015)⁴⁴44 Lopes MP, Giudici KV, Marchioni DM, Fisberg RM, Martini LA. Relationships between n-3 polyunsaturated fatty acid intake, serum 25 hydroxyvitamin D, food consumption, and nutritional status among adolescents. Nutr Res. 2015;35(08):681-688. Doi: 10.1016/j.nutres.2015.05.018 https://doi.org/10.1016/j.nutres.2015.05...	2011–2013	SP/SE	Outpatient	< 75 nmol/L	FAPESP
Lopes et al. (2016)⁴⁵45 Lopes VM, Lopes JR, Brasileiro JP, Oliveira I, Lacerda RP, Andrade MR, et al. Highly prevalence of vitamin D deficiency among Brazilian women of reproductive age. Arch Endocrinol Metab. 2017;61(01):21-27. Doi: 10.1590/2359-3997000000216 https://doi.org/10.1590/2359-39970000002...	Jan–May 2012	DF/CW	Outpatient	< 75 nmol/L50–75 nmol/L< 50 nmol/L	NR
Machado et al. (2013)⁴⁶46 Machado RH, Bonafe S, Castelo A, Patin RV. Vitamin profile of pregnant women living with HIV/AIDS. ESPEN J. 2013;8(03): e108-e112. Doi: 10.1016/j.clnme.2013.03.002 https://doi.org/10.1016/j.clnme.2013.03....	May 2010–Dec 2011	SP/SE	University	< 75 nmol/L50–80 nmol/L< 50 nmol/L	UNIFESP
Martins et al. (2018)³⁷37 Martins MEP, Esmeraldo CUP, Sabiá JPD, Carvalho JHL, Suano- Souza FI, Sarni ROS. Vitamin D postpartum concentrations: relationship with nutritional condition and morbidities during pregnancy. J Pregnancy. 2018;2018:1070528. Doi: 10.1155/2018/1070528 https://doi.org/10.1155/2018/1070528...	Oct–Dec 2016	CE/NE	Obstetrical care	< 75 nmol/L50–75 nmol/L< 50 nmol/L	NR
Mendes et al. (2019)⁴⁷47 Mendes MM, Hart KH, Lanham-New SA, Botelho PB. Association between 25-Hydroxyvitamin D, parathyroid hormone, Vitamin D and calcium intake, and bone density in healthy adult women: a cross-sectional analysis fromthe D-SOL study. Nutrients. 2019;11 (06):1267. Doi: 10.3390/nu11061267 https://doi.org/10.3390/nu11061267...	NR	NR	NR	25–50 nmol/L	CNPq
Pena et al. (2015)⁴⁸48 Pena HR, de Lima MC, Brandt KG, de Antunes MM, da Silva GA. Influence of preeclampsia and gestational obesity inmaternal and newborn levels of vitamin D. BMC Pregnancy Childbirth. 2015;15 (01):112. Doi: 10.1186/s12884-015-0547-7 https://doi.org/10.1186/s12884-015-0547-...	Nov 2012–Mar 2013	PE/NE	Obstetrical care	< 75 nmol/L50–75 nmol/L< 50 nmol/L	CNPq
Pereira-Santos (2014)⁴⁹49 Pereira-Santos M. Determinantes socioambientais das concentrações séricas de vitamina D em gestantes [dissertação]. Salvador: Universidade Federal da Bahia; 2014 and Pereira-Santos et al. (2018)⁵⁰50 Pereira-Santos M, Queiroz Carvalho G, David Couto R, Barbosa Dos Santos D, Marlucia Oliveira A. Vitamin Ddeficiency and associated factors among pregnant women of a sunny city in Northeast of Brazil. Clin Nutr ESPEN. 2018;23:240-244. Doi: 10.1016/j.clnesp.2017.09.007 https://doi.org/10.1016/j.clnesp.2017.09...	NR	BA/NE	Obstetrical care	< 75 nmol/L50–75 nmol/L< 50 nmol/L	CNPq and CAPES
Peters et al. (2009)⁵¹51 Peters BS, dos Santos LC, Fisberg M, Wood RJ, Martini LA. Prevalence of vitamin D insufficiency in Brazilian adolescents. Ann Nutr Metab. 2009;54(01):15-21. Doi: 10.1159/000199454 https://doi.org/10.1159/000199454...	Apr–May 2006	SP/SE	Outpatient/Rural	25–75 nmol/L	FAPESP
Santos et al. (2013)⁵²52 Santos BR, Mascarenhas LP, Boguszewski MC, Spritzer PM. Variations in the vitamin D-binding protein (DBP) gene are related to lower 25-hydroxyvitamin D levels in healthy girls: a cross-sectional study. Horm Res Paediatr. 2013;79(03):162-168. Doi: 10.1159/000348847 https://doi.org/10.1159/000348847...	Apr 2008–Sep 2010	PR/S	School	< 75 nmol/L50–75 nmol/L< 50 nmol/L	CNPq
Santos et al. (2017)⁵³53 Santos BR, Lecke SB, Spritzer PM. Genetic variant in vitamin Dbinding protein is associatedwithmetabolic syndrome and lower 25-hydroxyvitamin D levels in polycystic ovary syndrome: A cross-sectional study. PLoS One. 2017;12(03):e0173695. Doi: 10.1371/journal.pone.0173695 https://doi.org/10.1371/journal.pone.017...	NR	RS/S	Outpatient	< 75 nmol/L50–75 nmol/L< 50 nmol/L	CNPq and CAPES
Santos et al. (2019)⁵⁴54 Santos BR, Costa NC, Silva TR, Oppermann K, Magalhães JA, Casanova G, et al. Prevalence of vitamin D deficiency in women from southern Brazil and association with vitamin D-binding protein levels and GC-DBP gene polymorphisms. PLoS One. 2019; 14(12):e0226215. Doi: 10.1371/journal.pone.0226215 https://doi.org/10.1371/journal.pone.022...	2005–2012	RS/S	NR	< 50 nmol/L	CNPq, FAPERGS, and CAPES
Schtscherbyna et al. (2016)⁵⁵55 Schtscherbyna A, Gouveia C, Pinheiro MF, Luiz RR, Farias ML, Machado ES. Vitamin D status in a Brazilian cohort of adolescents and young adults with perinatally acquired human immunodeficiency virus infection. Mem Inst Oswaldo Cruz. 2016;111(02): 128-133. Doi: 10.1590/0074-02760150403 https://doi.org/10.1590/0074-02760150403...	Apr 2008–May 2011	RJ/SE	Outpatient	< 75 nmol/L	CAPES, FAPERJ, and CNPq
Shinjo et al. (2011)⁵⁶56 Shinjo SK, Bonfá E, de Falco Caparbo V, Pereira RM. Low bone mass in juvenile onset sclerosis systemic: the possible role for 25- hydroxyvitamin D insufficiency. Rheumatol Int. 2011;31(08): 1075-1080. Doi: 10.1007/s00296-010-1421-6 https://doi.org/10.1007/s00296-010-1421-...	NR	SP/SE	Outpatient	< 50 nmol/L	CNPq and Federico Foundation
Simões et al. (2016)⁵⁷57 Simões FF, Castro NP, Euclydes VV, Luzia LA, Paiva AA, Rondó PH. Maternal adiposity and maternal and cord blood concentrations of vitamin D. [25(OH)D3]Clin Nutr Exp. 2016;9:3-12. Doi: 10.1016/j.yclnex.2016.08.001 https://doi.org/10.1016/j.yclnex.2016.08...	Apr 2013–Jun 2013	SP/SE	Obstetrical care	< 75 nmol/L50–75 nmol/L< 50 nmol/L	FAPESP and CAPES
Case-control
Dutra et al. (2019)⁵⁸58 Dutra LV, Affonso-Kaufman FA, Cafeo FR, Kassai MS, Barbosa CP, Santos Figueiredo FW, et al. Association between vitamin D plasma concentrations and VDR gene variants and the risk of premature birth. BMC Pregnancy Childbirth. 2019;20(01):3. Doi: 10.1186/s12884-019-2671-2 https://doi.org/10.1186/s12884-019-2671-...	Sep 2016–Dec 2017	SP/SE	Obstetrical care	< 75 nmol/L50–75 nmol/L< 50 nmol/L	CAPES, CNPq, and FAPESP
Menegati et al. (2016)¹⁷17 Menegati GC, de Oliveira LC, Santos AL, Cohen L, Mattos F, Mendonça LM, et al. Nutritional status, body composition, and bone health in women after bariatric surgery at a University Hospital in Rio de Janeiro. Obes Surg. 2016;26(07):1517-1524. Doi: 10.1007/s11695-015-1910-5 https://doi.org/10.1007/s11695-015-1910-...	2006–2010	RJ/SE	Outpatient	< 75 nmol/L50–75 nmol/L< 50 nmol/L	CAPES
Prospective cohorts
Benaim et al. (2019)⁵⁹59 Benaim C, Cocate PG, de Barros EG, Alves-Santos NH, Figueiredo AC, Franco-Sena AB, et al. Longitudinal association of 25-hydroxyvitamin D with adipokines and markers of glucose metabolism among Brazilian pregnant women. Br J Nutr. 2019;121(01): 42-54. Doi: 10.1017/S0007114518003057 https://doi.org/10.1017/S000711451800305...	Nov 2009–Oct 2011	RJ/SE	Outpatient	< 75 nmol/L50–75 nmol/L< 50 nmol/L	CNPq and FAPERJ
Lepsch et al. (2017)⁶⁰60 Lepsch J, Eshriqui I, Farias DR, Vaz JS, Figueiredo AC, Adegboye AR, et al. Association between early pregnancy vitamin D status and changes in serum lipid profiles throughout pregnancy.Metabolism. 2017;70:85-97. Doi: 10.1016/j.metabol.2017.02.004 https://doi.org/10.1016/j.metabol.2017.0... and Figueiredo et al. (2017, 2018, 2020)⁶¹61 Figueiredo ACC, Cocate PG, Adegboye ARA, Franco-Sena AB, Farias DR, deCastro MBT, et al. Changes in plasma concentrations of 25- hydroxyvitamin D and 1,25-dihydroxyvitamin D during pregnancy: a Brazilian cohort. Eur J Nutr. 2018;57(03):1059-1072. Doi: 10.1007/s00394-017-1389-z https://doi.org/10.1007/s00394-017-1389-... ⁶²62 Cunha Figueiredo AC, Trujillo J, Freitas-Vilela AA, Franco-Sena AB, Rebelo F, Cunha GM, et al. Association between plasma concentrations of vitamin D metabolites and depressive symptoms throughout pregnancy in a prospective cohort of Brazilian women. J Psychiatr Res. 2017;95:1-8. Doi: 10.1016/j.jpsychires.2017.07.009 https://doi.org/10.1016/j.jpsychires.201... ⁶³63 Figueiredo ACC, Carrilho TRB, Batalha MA, Farias DR, Barros EG, Kac G. Association between vitamin D status during pregnancy and total gestational weight gain and postpartum weight retention: a prospective cohort. Eur J Clin Nutr. 2020;74(01):126-134. Doi: 10.1038/s41430-019-0465-2 https://doi.org/10.1038/s41430-019-0465-...	Nov 2009–Oct 2011	RJ/SE	Obstetrical care	< 75 nmol/L50–75 nmol/L< 50 nmol/L	CNPq and FAPERJ
Medeiros et al. (2016)⁶⁴64 Medeiros M, Matos AC, Pereira SE, Saboya C, Ramalho A. Vitamin D and its relation with ionic calcium, parathyroid hormone, maternal and neonatal characteristics in pregnancy after roux-en-Y gastric bypass. Arch Gynecol Obstet. 2016;293(03):539-547. Doi: 10.1007/s00404-015-3861-4 https://doi.org/10.1007/s00404-015-3861-...	Mar 2010–Jul 2013	RJ/SE	Outpatient	< 75 nmol/L50–75 nmol/L< 50 nmol/L	NR
Weinert et al. (2014, 2016)⁶⁵65 Weinert LS, Reichelt AJ, Schmitt LR, Boff R, Oppermann ML, Camargo JL, et al. Serum vitamin D insufficiency is related to blood pressure in diabetic pregnancy. Am J Hypertens. 2014;27 (10):1316-1320. Doi: 10.1093/ajh/hpu043 https://doi.org/10.1093/ajh/hpu043... ⁶⁶66 Weinert LS, Reichelt AJ, Schmitt LR, Boff R, Oppermann ML, Camargo JL, et al. Vitamin D deficiency increases the risk of adverse neonatal outcomes in gestational diabetes. PLoS One. 2016;11(10):e0164999. Doi: 10.1371/journal.pone.0164999 https://doi.org/10.1371/journal.pone.016...	Nov 2009–May 2012	RS/S	Obstetrical care	< 75 nmol/L50–75 nmol/L< 50 nmol/L	Hospital de Clínicas de Porto Alegre
Retrospective studies
Cruz et al. (2018, 2020)¹⁸18 Cruz S, de Matos AC, da Cruz SP, Pereira S, Saboya C, Ramalho A. Maternal anthropometry and its relationshipwith the nutritional status of Vitamin D, calcium, and parathyroid hormone in pregnant women after Roux-en-Y gastric bypass. Obes Surg. 2018;28 (10):3116-3124. Doi: 10.1007/s11695-018-3331-8 https://doi.org/10.1007/s11695-018-3331-... ¹⁹19 Cruz S, de Matos AC, da Cruz SP, Pereira S, Saboya C, Ramalho A. Non-pregnant women have a lower Vitamin D than pregnant women after gastric bypass. Obes Surg. 2020;30(07):2558-2565. Doi: 10.1007/s11695-020-04512-5 https://doi.org/10.1007/s11695-020-04512... ⁶⁷67 da Cruz SP, Matos A, Pereira S, Saboya C, da Cruz SP, Ramalho A. Roux-en-Y gastric bypass aggravates Vitamin A deficiency in the mother-child group. Obes Surg. 2018;28(01):114-121. Doi: 10.1007/s11695-017-2791-6 https://doi.org/10.1007/s11695-017-2791-...	Jan 2011–Jul 2015	RJ/SE	Outpatient	< 75 nmol/L50–75 nmol/L< 50 nmol/L	FAPERJ
Rosa et al. (2013)⁶⁸68 da Rosa CL, Dames Olivieri Saubermann AP, Jacqueline J, Pereira SE, Saboya C, Ramalho A. Routine supplementation does not warrant the nutritional status of vitamin d adequate after gastric bypass Roux-en-Y. Nutr Hosp. 2013;28(01):169-172. Doi: 10.3305/nh.2013.28.1.6166 https://doi.org/10.3305/nh.2013.28.1.616...	NR	RJ/SE	NR	38–225 nmol/L	NR

Study	Main characteristic (N)	Ethnicity	Comorbidities	Medicine/supplement	Body mass index, kg/m²	Mean age, years
Araújo et al. (2017),³²32 Santos Araújo EPD, Queiroz DJM, Neves JPR, Lacerda LM, Gonçalves MDCR, Carvalho AT. Prevalence of hypovitaminosis D and associated factors in adolescent students of a capital ofnortheastern Brazil. Nutr Hosp. 2017;34(05):1416-1423. Doi: 10.20960/nh.1097 https://doi.org/10.20960/nh.1097... Queiroz (2016),³³33 Queiroz DJ. Relação entre insuficiência/deficiência da vitamina D, inflamação e estresse oxidativo em adolescentes escolares com excesso de peso [dissertação]. João Pessoa: Universidade Federal da Paraíba; 2016 and Queiroz et al. (2019)³⁴34 Queiroz DJM, Silva AS, Diniz ADS, Carvalho AT, Araújo EP, Neves JP, et al. Vitamin D insufficiency/deficiency and its association with cardiometabolic risk factors in Brazilian adolescents. Nutr Hosp. 2019;36(01):142-148. Doi: 10.20960/nh.1884 https://doi.org/10.20960/nh.1884...	Adolescents (136)	Brown (62%)	NR (Excluded some conditions)^a	NR/None	Normal weight (72%)	17 (±SD 1)^b
Benaim et al. (2019)⁵⁹59 Benaim C, Cocate PG, de Barros EG, Alves-Santos NH, Figueiredo AC, Franco-Sena AB, et al. Longitudinal association of 25-hydroxyvitamin D with adipokines and markers of glucose metabolism among Brazilian pregnant women. Br J Nutr. 2019;121(01): 42-54. Doi: 10.1017/S0007114518003057 https://doi.org/10.1017/S000711451800305...	Pregnant women (181)	Mixed (47%)	NR (Excluded some conditions)^c	NR/Yes	Median: 24 (IQR 22–27)	Median: 26 (IQR 22–31)
Chrisostomo et al. (2018)³⁸38 Chrisostomo KR, Skare TL, Kulak J Jr, Urbanetz AA, Chrisostomo ER, Nisihara R. The prevalence and clinical associations of hypovitaminosis D in pregnant women from Brazil. Int J Gynaecol Obstet. 2018;143(01):66-70. Doi: 10.1002/ijgo.12575 https://doi.org/10.1002/ijgo.12575...	Pregnant women (520)	Euro-descendant (52%)	Preeclampsia; GDM; HIV+	Antiretroviral/None	Median 31 (IQR: 27; 35)	Median: 30 (IQR: 25–35)
Cruz et al. (2018, 2020)¹⁸18 Cruz S, de Matos AC, da Cruz SP, Pereira S, Saboya C, Ramalho A. Maternal anthropometry and its relationshipwith the nutritional status of Vitamin D, calcium, and parathyroid hormone in pregnant women after Roux-en-Y gastric bypass. Obes Surg. 2018;28 (10):3116-3124. Doi: 10.1007/s11695-018-3331-8 https://doi.org/10.1007/s11695-018-3331-... ¹⁹19 Cruz S, de Matos AC, da Cruz SP, Pereira S, Saboya C, Ramalho A. Non-pregnant women have a lower Vitamin D than pregnant women after gastric bypass. Obes Surg. 2020;30(07):2558-2565. Doi: 10.1007/s11695-020-04512-5 https://doi.org/10.1007/s11695-020-04512... ⁶⁷67 da Cruz SP, Matos A, Pereira S, Saboya C, da Cruz SP, Ramalho A. Roux-en-Y gastric bypass aggravates Vitamin A deficiency in the mother-child group. Obes Surg. 2018;28(01):114-121. Doi: 10.1007/s11695-017-2791-6 https://doi.org/10.1007/s11695-017-2791-...	Pregnant and nonpregnant women (121)	NR	RYGB (Excluded some conditions)^d	NR/Yes^e	43 (±SD 3) to 44 (±SD 6)	30 (±SD 4) to 32 (±SD 4)
Rosa et al. (2013)⁶⁸68 da Rosa CL, Dames Olivieri Saubermann AP, Jacqueline J, Pereira SE, Saboya C, Ramalho A. Routine supplementation does not warrant the nutritional status of vitamin d adequate after gastric bypass Roux-en-Y. Nutr Hosp. 2013;28(01):169-172. Doi: 10.3305/nh.2013.28.1.6166 https://doi.org/10.3305/nh.2013.28.1.616...	Women of childbearing age (56)	NR	RYGB	NR/Yes^f	46 (±SD 8)	35 (±SD 9)
Duran de Campos et al. (2008)³⁹39 Duran de Campos C, Dalcanale L, Pajecki D, Garrido AB Jr, Halpern A. Calcium intake and metabolic bone disease after eight years of Roux-en-Y gastric bypass. Obes Surg. 2008;18(04):386-390. Doi: 10.1007/s11695-007-9393-7 https://doi.org/10.1007/s11695-007-9393-...	Women of childbearing age (30)	NR (excluded nonwhite)	RYGB	NR	29 (±SD 2.3) to 47 (±SD 8.6)	46 (±SD 3)
de Oliveira et al. (2020)³⁵35 de Oliveira CL, Cureau FV, Cople-Rodrigues CDS, Giannini DT, Bloch KV, Kuschnir MC, et al. Prevalence and factors associated with hypovitaminosis D in adolescents from a sunny country: Findings fromthe ERICA survey. J Steroid Biochem Mol Biol. 2020; 199:105609. Doi: 10.1016/j.jsbmb.2020.105609 https://doi.org/10.1016/j.jsbmb.2020.105...	Adolescents (100)	Nonwhite (54%)	NR	NR	Normal weight (71%)	15–17 (59%)
Souza et al. (2019)⁴⁰40 Souza JR, Silva TS, Figueredo ED. Hypovitaminosis D in pregnancy: is it a public health issue? Rev Bras Saúde Matern Infant. 2019;19 (01):197-205. Doi: 10.1590/1806-93042019000100011 https://doi.org/10.1590/1806-93042019000...	Pregnant women (71)	Dart (62%)	Healthy	NR/None	NR	26 (±SD 6)
Delmonico et al. (2018)⁴¹41 Delmonico L, CostaMASM, Azevedo CM, Silvestre RT, Scherrer LR, Ornellas MH, et al. Low levels of Vitamin D in a cohort of women with impalpable breast lesions from Rio de Janeiro/Brazil. Asian Pac J Cancer Prev. 2018;19(11):3087-3092. Doi: 10.31557/APJCP.2018.19.11.3087 https://doi.org/10.31557/APJCP.2018.19.1...	Women of childbearing age (20)	NR	Malignant breast lesions	NR	NR	37
Prado et al. (2015)³3 do Prado MR, Oliveira FdeC, Assis KF, Ribeiro SA, Prado Jr. PP, Sant'Ana LF, et al. Prevalência de deficiência de vitamina D e fatores associados em mulheres e seus recém-nascidos no período pós-parto. Rev Paul Pediatr. 2015;33(03):287-294. Doi: 10.1016/j.rpped.2015.01.006 https://doi.org/10.1016/j.rpped.2015.01....	Postpartum women (226)	White (52%)	NR	NR/Yes (97%)	NR	28 (range 20–44)
Dutra et al. (2019)⁵⁸58 Dutra LV, Affonso-Kaufman FA, Cafeo FR, Kassai MS, Barbosa CP, Santos Figueiredo FW, et al. Association between vitamin D plasma concentrations and VDR gene variants and the risk of premature birth. BMC Pregnancy Childbirth. 2019;20(01):3. Doi: 10.1186/s12884-019-2671-2 https://doi.org/10.1186/s12884-019-2671-...	Postpartum women (126)^g	NR	Hypertension (23%)	NR/Yes	26 (±SD 6) to 27 (±SD 5)	25 (±SD 7) to 26 (±SD 7)
Ferreira et al. (2015)⁴²42 Ferreira TdaS, Rocha TM, Klein MR, Sanjuliani AF. Vitamin d deficiency is associated with insulin resistance independent of intracellular calcium, dietary calcium and serum levels of parathormone, calcitriol and calcium in premenopausal women. Nutr Hosp. 2015;31(04):1491-1498. Doi: 10.3305/nh.2015.31.4.8490 https://doi.org/10.3305/nh.2015.31.4.849...	Women of childbearing age (73)	White (68%)	NR (Excluded some conditions)^h	NR/None	26 (±SD 1)	32 (±SD 1)
Flauzino et al. (2017)⁴³43 Flauzino T, Simao ANC, de Almeida ERD, Morimoto HK, Oliveira SR, Alfieri DF, et al. Association between Vitamin D status, oxidative stress biomarkers and viral load in human immunodeficiency virus type 1 infection. Curr HIV Res. 2017;15(05): 336-344. Doi: 10.2174/1570162X15666171005170227 https://doi.org/10.2174/1570162X15666171...	Women of childbearing age (205)	Caucasian (71–78%)^b	HIV+	Antiretroviral/None	25 (±SD 0) to 26 (±SD 0)^b	40 (±SD 1)^b
Lepsch et al. (2017)⁶⁰60 Lepsch J, Eshriqui I, Farias DR, Vaz JS, Figueiredo AC, Adegboye AR, et al. Association between early pregnancy vitamin D status and changes in serum lipid profiles throughout pregnancy.Metabolism. 2017;70:85-97. Doi: 10.1016/j.metabol.2017.02.004 https://doi.org/10.1016/j.metabol.2017.0... and Figueiredo et al. (2017, 2018, 2020)⁶¹61 Figueiredo ACC, Cocate PG, Adegboye ARA, Franco-Sena AB, Farias DR, deCastro MBT, et al. Changes in plasma concentrations of 25- hydroxyvitamin D and 1,25-dihydroxyvitamin D during pregnancy: a Brazilian cohort. Eur J Nutr. 2018;57(03):1059-1072. Doi: 10.1007/s00394-017-1389-z https://doi.org/10.1007/s00394-017-1389-... ⁶²62 Cunha Figueiredo AC, Trujillo J, Freitas-Vilela AA, Franco-Sena AB, Rebelo F, Cunha GM, et al. Association between plasma concentrations of vitamin D metabolites and depressive symptoms throughout pregnancy in a prospective cohort of Brazilian women. J Psychiatr Res. 2017;95:1-8. Doi: 10.1016/j.jpsychires.2017.07.009 https://doi.org/10.1016/j.jpsychires.201... ⁶³63 Figueiredo ACC, Carrilho TRB, Batalha MA, Farias DR, Barros EG, Kac G. Association between vitamin D status during pregnancy and total gestational weight gain and postpartum weight retention: a prospective cohort. Eur J Clin Nutr. 2020;74(01):126-134. Doi: 10.1038/s41430-019-0465-2 https://doi.org/10.1038/s41430-019-0465-...	Pregnant women (199)	Mixed (46%)	NR (Excluded some conditions)	None/None	< 25 (60%)	27 (±SD 6)
Lopes et al. (2015)⁴⁴44 Lopes MP, Giudici KV, Marchioni DM, Fisberg RM, Martini LA. Relationships between n-3 polyunsaturated fatty acid intake, serum 25 hydroxyvitamin D, food consumption, and nutritional status among adolescents. Nutr Res. 2015;35(08):681-688. Doi: 10.1016/j.nutres.2015.05.018 https://doi.org/10.1016/j.nutres.2015.05...	Adolescents (97)	NR	NR	NR	26 (±SD 9)	16 (±SD 1)
Lopes et al. (2016)⁴⁵45 Lopes VM, Lopes JR, Brasileiro JP, Oliveira I, Lacerda RP, Andrade MR, et al. Highly prevalence of vitamin D deficiency among Brazilian women of reproductive age. Arch Endocrinol Metab. 2017;61(01):21-27. Doi: 10.1590/2359-3997000000216 https://doi.org/10.1590/2359-39970000002...	Women of childbearing age (369)	NR	Infertility and control	NR/None	NR	36 (±SD 4) to 37 (±SD 4)
Machado et al. (2013)⁴⁶46 Machado RH, Bonafe S, Castelo A, Patin RV. Vitamin profile of pregnant women living with HIV/AIDS. ESPEN J. 2013;8(03): e108-e112. Doi: 10.1016/j.clnme.2013.03.002 https://doi.org/10.1016/j.clnme.2013.03....	Pregnant women (49)	NR	HIV+	Antiretroviral/None	Excessive gestational weight (35%)	30 (±SD 7)
Martins et al. (2018)³⁷37 Martins MEP, Esmeraldo CUP, Sabiá JPD, Carvalho JHL, Suano- Souza FI, Sarni ROS. Vitamin D postpartum concentrations: relationship with nutritional condition and morbidities during pregnancy. J Pregnancy. 2018;2018:1070528. Doi: 10.1155/2018/1070528 https://doi.org/10.1155/2018/1070528...	Postpartum women (225)	Dark (79%)	Urinary tract infection (32%), hypertension (9%), GDM (1%), and bleeding (8%)	NR/Yes (64%)	Overweight or obesity (34%)	26 (±SD 7)
Medeiros et al. (2016)⁶⁴64 Medeiros M, Matos AC, Pereira SE, Saboya C, Ramalho A. Vitamin D and its relation with ionic calcium, parathyroid hormone, maternal and neonatal characteristics in pregnancy after roux-en-Y gastric bypass. Arch Gynecol Obstet. 2016;293(03):539-547. Doi: 10.1007/s00404-015-3861-4 https://doi.org/10.1007/s00404-015-3861-...	Pregnant women (46)	NR	RYGB	NR/Yesⁱ	28 to 44 (±SD 6)	31 (±SD 5)
Mendes et al. (2019)⁴⁷47 Mendes MM, Hart KH, Lanham-New SA, Botelho PB. Association between 25-Hydroxyvitamin D, parathyroid hormone, Vitamin D and calcium intake, and bone density in healthy adult women: a cross-sectional analysis fromthe D-SOL study. Nutrients. 2019;11 (06):1267. Doi: 10.3390/nu11061267 https://doi.org/10.3390/nu11061267...	Women of childbearing age (79)	White (63%)	NR	NR/None	24 (±SD 5)	Median: 27 (IQR 24–31)
Menegati et al. (2016)¹⁷17 Menegati GC, de Oliveira LC, Santos AL, Cohen L, Mattos F, Mendonça LM, et al. Nutritional status, body composition, and bone health in women after bariatric surgery at a University Hospital in Rio de Janeiro. Obes Surg. 2016;26(07):1517-1524. Doi: 10.1007/s11695-015-1910-5 https://doi.org/10.1007/s11695-015-1910-...	Women of childbearing age (58)	NR	RYGB and control (obesity) (Excluded some conditions)^j	NR/Yes (calcium)	35 (CI 95% 33–37) to 52 (CI 95% 40–73)	39 (CI 95% 36–42) to 40 (CI 95% 38–42)
Pena et al. (2015)⁴⁸48 Pena HR, de Lima MC, Brandt KG, de Antunes MM, da Silva GA. Influence of preeclampsia and gestational obesity inmaternal and newborn levels of vitamin D. BMC Pregnancy Childbirth. 2015;15 (01):112. Doi: 10.1186/s12884-015-0547-7 https://doi.org/10.1186/s12884-015-0547-...	Pregnant and nonpregnant (179)	Nonwhite (82%)	Preeclampsia and gestational obesity	NR	IQR: 21–37	IQR: 19–33
Pereira-Santos (2014)⁴⁹49 Pereira-Santos M. Determinantes socioambientais das concentrações séricas de vitamina D em gestantes [dissertação]. Salvador: Universidade Federal da Bahia; 2014 and Pereira-Santos et al. (2018)⁵⁰50 Pereira-Santos M, Queiroz Carvalho G, David Couto R, Barbosa Dos Santos D, Marlucia Oliveira A. Vitamin Ddeficiency and associated factors among pregnant women of a sunny city in Northeast of Brazil. Clin Nutr ESPEN. 2018;23:240-244. Doi: 10.1016/j.clnesp.2017.09.007 https://doi.org/10.1016/j.clnesp.2017.09...	Pregnant women (190)	Nonblack (68%)	NR (Excluded some conditions)^k	NR/Yes (5%)	Overweight (43%)	18–29 (63%)
Peters et al. (2009)⁵¹51 Peters BS, dos Santos LC, Fisberg M, Wood RJ, Martini LA. Prevalence of vitamin D insufficiency in Brazilian adolescents. Ann Nutr Metab. 2009;54(01):15-21. Doi: 10.1159/000199454 https://doi.org/10.1159/000199454...	Adolescents (71)	NR (excluded nonwhite)	NR (Excluded some conditions)^l	NR	22 (±SD 0)	18 (±SD 1)
Santos et al. (2013)⁵²52 Santos BR, Mascarenhas LP, Boguszewski MC, Spritzer PM. Variations in the vitamin D-binding protein (DBP) gene are related to lower 25-hydroxyvitamin D levels in healthy girls: a cross-sectional study. Horm Res Paediatr. 2013;79(03):162-168. Doi: 10.1159/000348847 https://doi.org/10.1159/000348847...	Adolescents (198)	NR	Healthy	NR/None	Normal weight (76%)	13 (±SD 2)
Santos et al. (2017)⁵³53 Santos BR, Lecke SB, Spritzer PM. Genetic variant in vitamin Dbinding protein is associatedwithmetabolic syndrome and lower 25-hydroxyvitamin D levels in polycystic ovary syndrome: A cross-sectional study. PLoS One. 2017;12(03):e0173695. Doi: 10.1371/journal.pone.0173695 https://doi.org/10.1371/journal.pone.017...	Women of childbearing age (102)	White (94%)	Polycystic ovary syndrome and controls	NR	27 (±SD 6) to 30 (±SD 6)	23 (±SD 7) to 25 (±SD 8)
Santos et al. (2019)⁵⁴54 Santos BR, Costa NC, Silva TR, Oppermann K, Magalhães JA, Casanova G, et al. Prevalence of vitamin D deficiency in women from southern Brazil and association with vitamin D-binding protein levels and GC-DBP gene polymorphisms. PLoS One. 2019; 14(12):e0226215. Doi: 10.1371/journal.pone.0226215 https://doi.org/10.1371/journal.pone.022...	Women of childbearing age (61)	Caucasian (80%)	Healthy	NR/Yes (calcium and vitamin D)	29 (±SD 8)	37 (±SD 11)
Schtscherbyna et al. (2016)⁵⁵55 Schtscherbyna A, Gouveia C, Pinheiro MF, Luiz RR, Farias ML, Machado ES. Vitamin D status in a Brazilian cohort of adolescents and young adults with perinatally acquired human immunodeficiency virus infection. Mem Inst Oswaldo Cruz. 2016;111(02): 128-133. Doi: 10.1590/0074-02760150403 https://doi.org/10.1590/0074-02760150403...	Adolescents and young adults (35)	White (35%)^b	HIV+	Antiretroviral/NR	Normal (62%)^b	Around 18 (±SD 2)^b
Shinjo et al. (2011)⁵⁶56 Shinjo SK, Bonfá E, de Falco Caparbo V, Pereira RM. Low bone mass in juvenile onset sclerosis systemic: the possible role for 25- hydroxyvitamin D insufficiency. Rheumatol Int. 2011;31(08): 1075-1080. Doi: 10.1007/s00296-010-1421-6 https://doi.org/10.1007/s00296-010-1421-...	Women of childbearing age (20)	White (75%)	Juvenile onset of systemic sclerosis and controls	NR	NR	21 (±SD 2) to 21 (±SD 2)
Simões et al. (2016)⁵⁷57 Simões FF, Castro NP, Euclydes VV, Luzia LA, Paiva AA, Rondó PH. Maternal adiposity and maternal and cord blood concentrations of vitamin D. [25(OH)D3]Clin Nutr Exp. 2016;9:3-12. Doi: 10.1016/j.yclnex.2016.08.001 https://doi.org/10.1016/j.yclnex.2016.08...	Postpartum women (99)	Blacks or mulatto (58%)	NR (Excluded some conditions)^m	NR/Yes (9%)	Overweight or obese (69%)	26 (±SD 5)
Weinert et al. (2014, 2016)⁶⁵65 Weinert LS, Reichelt AJ, Schmitt LR, Boff R, Oppermann ML, Camargo JL, et al. Serum vitamin D insufficiency is related to blood pressure in diabetic pregnancy. Am J Hypertens. 2014;27 (10):1316-1320. Doi: 10.1093/ajh/hpu043 https://doi.org/10.1093/ajh/hpu043... ⁶⁶66 Weinert LS, Reichelt AJ, Schmitt LR, Boff R, Oppermann ML, Camargo JL, et al. Vitamin D deficiency increases the risk of adverse neonatal outcomes in gestational diabetes. PLoS One. 2016;11(10):e0164999. Doi: 10.1371/journal.pone.0164999 https://doi.org/10.1371/journal.pone.016...	Pregnant women (184)	White (74%)	GDM (100%); Hypertension (22%)	NR/None	27 (±SD 5) to 30 (±SD 7)	32 (±SD 6)

	Question
Study	1	2	3	4	5	6	7	8	9
Araújo et al. (2017),³²32 Santos Araújo EPD, Queiroz DJM, Neves JPR, Lacerda LM, Gonçalves MDCR, Carvalho AT. Prevalence of hypovitaminosis D and associated factors in adolescent students of a capital ofnortheastern Brazil. Nutr Hosp. 2017;34(05):1416-1423. Doi: 10.20960/nh.1097 https://doi.org/10.20960/nh.1097... Queiroz (2016),³³33 Queiroz DJ. Relação entre insuficiência/deficiência da vitamina D, inflamação e estresse oxidativo em adolescentes escolares com excesso de peso [dissertação]. João Pessoa: Universidade Federal da Paraíba; 2016 and Queiroz et al. (2019)³⁴34 Queiroz DJM, Silva AS, Diniz ADS, Carvalho AT, Araújo EP, Neves JP, et al. Vitamin D insufficiency/deficiency and its association with cardiometabolic risk factors in Brazilian adolescents. Nutr Hosp. 2019;36(01):142-148. Doi: 10.20960/nh.1884 https://doi.org/10.20960/nh.1884...	Yes	Yes	No^c	Yes	Yes	N/A	Yes	Yes	No^h
Benaim et al. (2019)⁵⁹59 Benaim C, Cocate PG, de Barros EG, Alves-Santos NH, Figueiredo AC, Franco-Sena AB, et al. Longitudinal association of 25-hydroxyvitamin D with adipokines and markers of glucose metabolism among Brazilian pregnant women. Br J Nutr. 2019;121(01): 42-54. Doi: 10.1017/S0007114518003057 https://doi.org/10.1017/S000711451800305...	Yes	No^a	No^d	No^e	Unclear	N/A	Yes	Yes	Unclearⁱ
Chrisostomo et al. (2018)³⁸38 Chrisostomo KR, Skare TL, Kulak J Jr, Urbanetz AA, Chrisostomo ER, Nisihara R. The prevalence and clinical associations of hypovitaminosis D in pregnant women from Brazil. Int J Gynaecol Obstet. 2018;143(01):66-70. Doi: 10.1002/ijgo.12575 https://doi.org/10.1002/ijgo.12575...	Yes	No^a	No^d	Yes	Yes	N/A	Yes	Yes	Yes^j
Cruz et al. (2018, 2020)¹⁸18 Cruz S, de Matos AC, da Cruz SP, Pereira S, Saboya C, Ramalho A. Maternal anthropometry and its relationshipwith the nutritional status of Vitamin D, calcium, and parathyroid hormone in pregnant women after Roux-en-Y gastric bypass. Obes Surg. 2018;28 (10):3116-3124. Doi: 10.1007/s11695-018-3331-8 https://doi.org/10.1007/s11695-018-3331-... ¹⁹19 Cruz S, de Matos AC, da Cruz SP, Pereira S, Saboya C, Ramalho A. Non-pregnant women have a lower Vitamin D than pregnant women after gastric bypass. Obes Surg. 2020;30(07):2558-2565. Doi: 10.1007/s11695-020-04512-5 https://doi.org/10.1007/s11695-020-04512... ⁶⁷67 da Cruz SP, Matos A, Pereira S, Saboya C, da Cruz SP, Ramalho A. Roux-en-Y gastric bypass aggravates Vitamin A deficiency in the mother-child group. Obes Surg. 2018;28(01):114-121. Doi: 10.1007/s11695-017-2791-6 https://doi.org/10.1007/s11695-017-2791-...	Yes	No^a	No^d	No^e	Unclear	N/A	Yes	No^g	No^h
Rosa et al. (2013)⁶⁸68 da Rosa CL, Dames Olivieri Saubermann AP, Jacqueline J, Pereira SE, Saboya C, Ramalho A. Routine supplementation does not warrant the nutritional status of vitamin d adequate after gastric bypass Roux-en-Y. Nutr Hosp. 2013;28(01):169-172. Doi: 10.3305/nh.2013.28.1.6166 https://doi.org/10.3305/nh.2013.28.1.616...	Yes	No^a	No^d	No^e	Unclear	N/A	No^f	No^g	No^h
Duran de Campos et al. (2008)³⁹39 Duran de Campos C, Dalcanale L, Pajecki D, Garrido AB Jr, Halpern A. Calcium intake and metabolic bone disease after eight years of Roux-en-Y gastric bypass. Obes Surg. 2008;18(04):386-390. Doi: 10.1007/s11695-007-9393-7 https://doi.org/10.1007/s11695-007-9393-...	Yes	No^a	No^d	No^e	Unclear	N/A	No^f	Yes	No^h
de Oliveira et al. (2020)³⁵35 de Oliveira CL, Cureau FV, Cople-Rodrigues CDS, Giannini DT, Bloch KV, Kuschnir MC, et al. Prevalence and factors associated with hypovitaminosis D in adolescents from a sunny country: Findings fromthe ERICA survey. J Steroid Biochem Mol Biol. 2020; 199:105609. Doi: 10.1016/j.jsbmb.2020.105609 https://doi.org/10.1016/j.jsbmb.2020.105...	Yes	Yes	Yes	No^e	Unclear	N/A	Yes	Yes	No^h
Souza et al. (2019)⁴⁰40 Souza JR, Silva TS, Figueredo ED. Hypovitaminosis D in pregnancy: is it a public health issue? Rev Bras Saúde Matern Infant. 2019;19 (01):197-205. Doi: 10.1590/1806-93042019000100011 https://doi.org/10.1590/1806-93042019000...	Yes	No^a	No^d	No^e	Unclear	N/A	Yes	Yes	No^h
Delmonico et al. (2018)⁴¹41 Delmonico L, CostaMASM, Azevedo CM, Silvestre RT, Scherrer LR, Ornellas MH, et al. Low levels of Vitamin D in a cohort of women with impalpable breast lesions from Rio de Janeiro/Brazil. Asian Pac J Cancer Prev. 2018;19(11):3087-3092. Doi: 10.31557/APJCP.2018.19.11.3087 https://doi.org/10.31557/APJCP.2018.19.1...	Yes	No^a	No^c	No^e	Unclear	N/A	Yes	Yes	No^h
Prado et al. (2015)³3 do Prado MR, Oliveira FdeC, Assis KF, Ribeiro SA, Prado Jr. PP, Sant'Ana LF, et al. Prevalência de deficiência de vitamina D e fatores associados em mulheres e seus recém-nascidos no período pós-parto. Rev Paul Pediatr. 2015;33(03):287-294. Doi: 10.1016/j.rpped.2015.01.006 https://doi.org/10.1016/j.rpped.2015.01....	Yes	No^a	No^d	No^e	Unclear	N/A	Yes	Yes	Unclearⁱ
Dutra et al. (2019)⁵⁸58 Dutra LV, Affonso-Kaufman FA, Cafeo FR, Kassai MS, Barbosa CP, Santos Figueiredo FW, et al. Association between vitamin D plasma concentrations and VDR gene variants and the risk of premature birth. BMC Pregnancy Childbirth. 2019;20(01):3. Doi: 10.1186/s12884-019-2671-2 https://doi.org/10.1186/s12884-019-2671-...	Yes	No^a	No^d	No^e	Unclear	N/A	Yes	No^g	No^h
Ferreira et al. (2015)⁴²42 Ferreira TdaS, Rocha TM, Klein MR, Sanjuliani AF. Vitamin d deficiency is associated with insulin resistance independent of intracellular calcium, dietary calcium and serum levels of parathormone, calcitriol and calcium in premenopausal women. Nutr Hosp. 2015;31(04):1491-1498. Doi: 10.3305/nh.2015.31.4.8490 https://doi.org/10.3305/nh.2015.31.4.849...	Yes	No^a	No^d	No^e	Unclear	N/A	Yes	Yes	No^h
Flauzino et al. (2017)⁴³43 Flauzino T, Simao ANC, de Almeida ERD, Morimoto HK, Oliveira SR, Alfieri DF, et al. Association between Vitamin D status, oxidative stress biomarkers and viral load in human immunodeficiency virus type 1 infection. Curr HIV Res. 2017;15(05): 336-344. Doi: 10.2174/1570162X15666171005170227 https://doi.org/10.2174/1570162X15666171...	Yes	No^a	No^d	Yes	Yes	N/A	Yes	No^g	Unclearⁱ
Lepsch et al. (2017)⁶⁰60 Lepsch J, Eshriqui I, Farias DR, Vaz JS, Figueiredo AC, Adegboye AR, et al. Association between early pregnancy vitamin D status and changes in serum lipid profiles throughout pregnancy.Metabolism. 2017;70:85-97. Doi: 10.1016/j.metabol.2017.02.004 https://doi.org/10.1016/j.metabol.2017.0... and Figueiredo et al. (2017, 2018, 2020)⁶¹61 Figueiredo ACC, Cocate PG, Adegboye ARA, Franco-Sena AB, Farias DR, deCastro MBT, et al. Changes in plasma concentrations of 25- hydroxyvitamin D and 1,25-dihydroxyvitamin D during pregnancy: a Brazilian cohort. Eur J Nutr. 2018;57(03):1059-1072. Doi: 10.1007/s00394-017-1389-z https://doi.org/10.1007/s00394-017-1389-... ⁶²62 Cunha Figueiredo AC, Trujillo J, Freitas-Vilela AA, Franco-Sena AB, Rebelo F, Cunha GM, et al. Association between plasma concentrations of vitamin D metabolites and depressive symptoms throughout pregnancy in a prospective cohort of Brazilian women. J Psychiatr Res. 2017;95:1-8. Doi: 10.1016/j.jpsychires.2017.07.009 https://doi.org/10.1016/j.jpsychires.201... ⁶³63 Figueiredo ACC, Carrilho TRB, Batalha MA, Farias DR, Barros EG, Kac G. Association between vitamin D status during pregnancy and total gestational weight gain and postpartum weight retention: a prospective cohort. Eur J Clin Nutr. 2020;74(01):126-134. Doi: 10.1038/s41430-019-0465-2 https://doi.org/10.1038/s41430-019-0465-...	Yes	No^a	No^d	Yes	Yes	N/A	Yes	No^g	Unclearⁱ
Lopes et al. (2015)⁴⁴44 Lopes MP, Giudici KV, Marchioni DM, Fisberg RM, Martini LA. Relationships between n-3 polyunsaturated fatty acid intake, serum 25 hydroxyvitamin D, food consumption, and nutritional status among adolescents. Nutr Res. 2015;35(08):681-688. Doi: 10.1016/j.nutres.2015.05.018 https://doi.org/10.1016/j.nutres.2015.05...	Yes	No^a	No^d	No^e	Unclear	N/A	Yes	Yes	No^h
Lopes et al. (2016)⁴⁵45 Lopes VM, Lopes JR, Brasileiro JP, Oliveira I, Lacerda RP, Andrade MR, et al. Highly prevalence of vitamin D deficiency among Brazilian women of reproductive age. Arch Endocrinol Metab. 2017;61(01):21-27. Doi: 10.1590/2359-3997000000216 https://doi.org/10.1590/2359-39970000002...	Yes	No^a	No^d	No^e	Unclear	N/A	Yes	Yes	Yes^j
Machado et al. (2013)⁴⁶46 Machado RH, Bonafe S, Castelo A, Patin RV. Vitamin profile of pregnant women living with HIV/AIDS. ESPEN J. 2013;8(03): e108-e112. Doi: 10.1016/j.clnme.2013.03.002 https://doi.org/10.1016/j.clnme.2013.03....	Yes	No^a	No^d	Yes	Yes	N/A	Yes	Yes	No^h
Martins et al. (2018)³⁷37 Martins MEP, Esmeraldo CUP, Sabiá JPD, Carvalho JHL, Suano- Souza FI, Sarni ROS. Vitamin D postpartum concentrations: relationship with nutritional condition and morbidities during pregnancy. J Pregnancy. 2018;2018:1070528. Doi: 10.1155/2018/1070528 https://doi.org/10.1155/2018/1070528...	Yes	No^b	No^d	Yes	Yes	N/A	Yes	Yes	Unclearⁱ
Medeiros et al. (2016)⁶⁴64 Medeiros M, Matos AC, Pereira SE, Saboya C, Ramalho A. Vitamin D and its relation with ionic calcium, parathyroid hormone, maternal and neonatal characteristics in pregnancy after roux-en-Y gastric bypass. Arch Gynecol Obstet. 2016;293(03):539-547. Doi: 10.1007/s00404-015-3861-4 https://doi.org/10.1007/s00404-015-3861-...	Yes	No^a	No^d	No^e	Unclear	N/A	Yes	Yes	No^h
Mendes et al. (2019)⁴⁷47 Mendes MM, Hart KH, Lanham-New SA, Botelho PB. Association between 25-Hydroxyvitamin D, parathyroid hormone, Vitamin D and calcium intake, and bone density in healthy adult women: a cross-sectional analysis fromthe D-SOL study. Nutrients. 2019;11 (06):1267. Doi: 10.3390/nu11061267 https://doi.org/10.3390/nu11061267...	Yes	No^a	No^d	No^e	Unclear	N/A	No^f	Yes	No^h
Menegati et al. (2016)¹⁷17 Menegati GC, de Oliveira LC, Santos AL, Cohen L, Mattos F, Mendonça LM, et al. Nutritional status, body composition, and bone health in women after bariatric surgery at a University Hospital in Rio de Janeiro. Obes Surg. 2016;26(07):1517-1524. Doi: 10.1007/s11695-015-1910-5 https://doi.org/10.1007/s11695-015-1910-...	Yes	No^a	No^d	No^e	Unclear	N/A	Yes	Yes	No^h
Pena et al. (2015)⁴⁸48 Pena HR, de Lima MC, Brandt KG, de Antunes MM, da Silva GA. Influence of preeclampsia and gestational obesity inmaternal and newborn levels of vitamin D. BMC Pregnancy Childbirth. 2015;15 (01):112. Doi: 10.1186/s12884-015-0547-7 https://doi.org/10.1186/s12884-015-0547-...	Yes	No^a	No^d	Yes	Yes	N/A	Yes	Yes	No^h
Pereira-Santos (2014)⁴⁹49 Pereira-Santos M. Determinantes socioambientais das concentrações séricas de vitamina D em gestantes [dissertação]. Salvador: Universidade Federal da Bahia; 2014 and Pereira-Santos et al. (2018)⁵⁰50 Pereira-Santos M, Queiroz Carvalho G, David Couto R, Barbosa Dos Santos D, Marlucia Oliveira A. Vitamin Ddeficiency and associated factors among pregnant women of a sunny city in Northeast of Brazil. Clin Nutr ESPEN. 2018;23:240-244. Doi: 10.1016/j.clnesp.2017.09.007 https://doi.org/10.1016/j.clnesp.2017.09...	Yes	No^a	No^d	No^e	Unclear	N/A	Yes	Yes	Unclearⁱ
Peters et al. (2009)⁵¹51 Peters BS, dos Santos LC, Fisberg M, Wood RJ, Martini LA. Prevalence of vitamin D insufficiency in Brazilian adolescents. Ann Nutr Metab. 2009;54(01):15-21. Doi: 10.1159/000199454 https://doi.org/10.1159/000199454...	Yes	No^a	No^d	No^e	Unclear	N/A	No^f	No^g	No^h
Santos et al. (2013)⁵²52 Santos BR, Mascarenhas LP, Boguszewski MC, Spritzer PM. Variations in the vitamin D-binding protein (DBP) gene are related to lower 25-hydroxyvitamin D levels in healthy girls: a cross-sectional study. Horm Res Paediatr. 2013;79(03):162-168. Doi: 10.1159/000348847 https://doi.org/10.1159/000348847...	Yes	No^a	No^c	No^e	Unclear	N/A	Yes	No^g	Unclearⁱ
Santos et al. (2017)⁵³53 Santos BR, Lecke SB, Spritzer PM. Genetic variant in vitamin Dbinding protein is associatedwithmetabolic syndrome and lower 25-hydroxyvitamin D levels in polycystic ovary syndrome: A cross-sectional study. PLoS One. 2017;12(03):e0173695. Doi: 10.1371/journal.pone.0173695 https://doi.org/10.1371/journal.pone.017...	Yes	No^a	No^d	Yes	Yes	N/A	Yes	No^g	No^h
Santos et al. (2019)⁵⁴54 Santos BR, Costa NC, Silva TR, Oppermann K, Magalhães JA, Casanova G, et al. Prevalence of vitamin D deficiency in women from southern Brazil and association with vitamin D-binding protein levels and GC-DBP gene polymorphisms. PLoS One. 2019; 14(12):e0226215. Doi: 10.1371/journal.pone.0226215 https://doi.org/10.1371/journal.pone.022...	Yes	No^a	No^d	Yes	Yes	N/A	Yes	Yes	No^h
Schtscherbyna et al. (2016)⁵⁵55 Schtscherbyna A, Gouveia C, Pinheiro MF, Luiz RR, Farias ML, Machado ES. Vitamin D status in a Brazilian cohort of adolescents and young adults with perinatally acquired human immunodeficiency virus infection. Mem Inst Oswaldo Cruz. 2016;111(02): 128-133. Doi: 10.1590/0074-02760150403 https://doi.org/10.1590/0074-02760150403...	Yes	No^a	No^d	Yes	Yes	N/A	Yes	Yes	No^h
Shinjo et al. (2011)⁵⁶56 Shinjo SK, Bonfá E, de Falco Caparbo V, Pereira RM. Low bone mass in juvenile onset sclerosis systemic: the possible role for 25- hydroxyvitamin D insufficiency. Rheumatol Int. 2011;31(08): 1075-1080. Doi: 10.1007/s00296-010-1421-6 https://doi.org/10.1007/s00296-010-1421-...	Yes	No^a	No^d	No^e	Unclear	N/A	Yes	Yes	No^h
Simões et al. (2016)⁵⁷57 Simões FF, Castro NP, Euclydes VV, Luzia LA, Paiva AA, Rondó PH. Maternal adiposity and maternal and cord blood concentrations of vitamin D. [25(OH)D3]Clin Nutr Exp. 2016;9:3-12. Doi: 10.1016/j.yclnex.2016.08.001 https://doi.org/10.1016/j.yclnex.2016.08...	Yes	No^a	No^d	No^e	Unclear	N/A	Yes	Yes	No^h
Weinert et al. (2014, 2016)⁶⁵65 Weinert LS, Reichelt AJ, Schmitt LR, Boff R, Oppermann ML, Camargo JL, et al. Serum vitamin D insufficiency is related to blood pressure in diabetic pregnancy. Am J Hypertens. 2014;27 (10):1316-1320. Doi: 10.1093/ajh/hpu043 https://doi.org/10.1093/ajh/hpu043... ⁶⁶66 Weinert LS, Reichelt AJ, Schmitt LR, Boff R, Oppermann ML, Camargo JL, et al. Vitamin D deficiency increases the risk of adverse neonatal outcomes in gestational diabetes. PLoS One. 2016;11(10):e0164999. Doi: 10.1371/journal.pone.0164999 https://doi.org/10.1371/journal.pone.016...	Yes	No^a	No^d	Yes	Yes	N/A	Yes	Yes	Unclearⁱ

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[1] Address for correspondence
Patricia de Carvalho Mastroianni, PhD, Department of Drugs and Medicines, School of Pharmaceutical Sciences, São Paulo State University (UNESP) Highway Jaú, Km 01 s/n, 14800-901, Campus Vile, Araraquara, SP, Brazil (e-mail: patricia.mastroianni@unesp.br).