Effects of vitamin D deficiency on neurobehavioural outcomes in children: a systematic review

Abstract

Introduction: Vitamin D plays an important role in brain development in experimental studies; however, the effect of vitamin D deficiency on child development remains inadequately characterized. We aimed to estimate the effects of vitamin D deficiency on neurobehavioural outcomes in children up to 18 years of age. Methods: We searched PubMed, EMBASE, PsycINFO, Scopus, Cochrane Library, Web of Science and Open Grey for published studies up to 10th January 2020. We included all studies that assessed the effects of maternal or child vitamin D status or vitamin D supplementation on neurobehavioural outcomes in children. Study findings were synthesized qualitatively as the high level of heterogeneity in study populations and methodologies precluded a quantitative meta-analysis. Results: Our search identified 5,633 studies, of which 31 studies with 31,375 participants from 18 countries were included in the systematic review. Of the studies identified, one was a randomised controlled trial (RCT) of vitamin D supplementation in children, while 30 were observational. The RCT (n=55) reported a beneficial effect of supplementation with lower doses compared to higher doses of vitamin D on motor development. Twelve mother-child studies (n=17,136) and five studies in children (n=1,091) reported an association between low maternal or child 25-hydroxyvitamin D levels and impaired neurobehavioural outcomes in children, while 15 mother-child studies (n=20,778) and eight studies in children (n=7,496) reported no association. Conclusions: Although animal studies point to an effect of vitamin D deficiency on brain development, there are few studies on the effects of vitamin D deficiency on neurobehavioural outcomes in children and their findings are inconsistent. There is a need for well-conducted, adequately powered studies to further determine these effects in children. Registration: PROSPERO ID CRD42018087619; registered on 15 February 2018.

Assessment of vitamin D supply in children of Moscow and the Moscow Region

“…Во всем мире существует проблема низкой информированности родителей о роли витамина D в организме, источниках его поступления, последствиях дефицита и организации профилактического приема препаратов витамина D. При этом лишь каждый 4-й ребенок в возрасте до 2 лет получает профилактическую дозу холекальциферола [17]. Большинство взрослых также не осведомлены и не принимают витамин D [18][19][20][21].…”

“…В отношении подростков и детей старшего возраста нужно отметить, что частота тяжелого и умеренного дефицита 25(ОН)D 3 у них максимальная. Данные нарушения совпадают со временем ростового «скачка» и мощных гормональных изменений в организме ребенка, что может иметь различные негативные последствия, например увеличение риска реализации метаболического синдрома, сахарного диабета, увеличение риска канцерогенеза во взрослом возрасте и ряда других патологических состояний [1][2][3][4][5]19].…”

Effect of High-Dose vs Standard-Dose Vitamin D Supplementation on Neurodevelopment of Healthy Term Infants

“… 14 , 15 Associations between vitamin D concentrations and cognitive and motor functioning have not been systematically found. 16 However, previous evidence is based on observational studies, precluding causal inferences. Randomized clinical trials (RCTs), 17 , 18 , 19 , 20 as well as nonrandomized trials, 21 , 22 , 23 , 24 on vitamin D supplementation for children have been small, have typically focused on symptom severity among children with autism spectrum disorder or attention-deficit/hyperactivity disorder, and have reported mixed findings.…”

Prenatal maternal and cord blood vitamin D concentrations and negative affectivity in infancy

“…A recent meta-analysis found evidence for associations between maternal prenatal vitamin D status and child neurobehavioral outcomes to be mixed. [6] Some, but not all [7,8] previous studies have reported that low maternal vitamin D concentrations during pregnancy are associated with an increased risk of mental health problems in the offspring, including behavioral problems and diagnosis of attention deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and depression. [9][10][11][12][13][14][15] Lower cord blood 25(OH)D concentrations at birth have also been associated with poorer mental health outcomes [13,[16][17][18], however, these may be less predictive of child neurobehavioral outcomes, compared to early-and mid-pregnancy maternal measurements [6,11].…”