Physiological Insights into Pregnancy-Associated Bone Metabolism: A Systematic Review of Vitamin D and Parathyroid Hormone Axis
DOI:
https://doi.org/10.36283/ziun-pjmd14-2/060Keywords:
Pregnancy, Vitamin D, Parathyroid Hormone, Pregnancy ComplicationsAbstract
Background: During pregnancy, bone metabolism requires a functional interaction between Vitamin D and the Parathyroid Hormone. This investigation examined the clinical and pathological nature of the Vitamin D-PTH pathway in pregnancy-related bone metabolic processes from a biological standpoint.
Methods: An assessment based on PRISMA 2020 guidelines was performed through a systematic review methodology that relied on PubMed, Scopus, and Web of Science databases from 2010 to 2025. The studies that focused on maternal nutrition, endocrine disorders, environmental factors, and inflammatory markers affecting maternal-fetal bone health were included, and studies that didn't measure Vitamin D-PTH axis activity, review papers without original data, non-pregnant subject studies, and those with inadequate sample sizes or methodological issues were excluded. Risk of bias assessment was done using the QUADAS-2 tool, and GRADE criteria evaluated the evidence quality.
Results: Out of 120 articles, 30 studies met the inclusion criteria, and 11 were included in a systematic review table, with a combined total of 50 to 3407 participants. Studies revealed hypovitaminosis D during prenatal periods creates high PTH activity that causes fetal bones to resorb while altering their growth patterns. Studies support maternal intake of vitamin D as a way to enhance bone development in maternal and fetal bodies.
Discussion: The review highlighted the importance of the Vitamin D-PTH axis in pregnancy-related bone metabolism. However, the evidence is limited by study risk of bias, particularly in observational studies, as well as inconsistencies in measurement methods and definitions of Vitamin D deficiency. Additionally, the imprecision of some data and variability in study designs restricts the ability to establish causality, suggesting a need for more controlled clinical trials and standardized protocols.
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