Impact of Vitamin D during Pregnancy towards Postpartum Depression: A Meta-Analysis of Dose-Response Association and Intervention
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Abstract
Introduction: Serum vitamin D concentration has been associated with PPD in previous studies. However, whether there is a dose-response relationship and if its supplementation during pregnancy can improve symptoms after delivery remains unclear.
Objective: To evaluate the evidence on the association of vitamin D concentration during pregnancy towards PPD and whether its supplementation can improve symptoms
Methods: Five databases were searched on September 27, 2025. Cohort studies were included for dose-response meta-analysis (DRMA), while randomized controlled trials (RCTs) were included for meta-analysis (MA) of supplementation. The outcome for MA of supplementation was postpartum Edinburgh Postnatal Depression Scale (EPDS) score using the effect measure of mean difference (MD), while the outcome for DRMA was the odds ratio (OR) of PPD after delivery. Certainty was assessed using GRADE for MA of supplementation.
Results: Two prospective cohort studies were included for DRMA and two RCTs were included for MA of supplementation. There was a significant log linear dose-response relationship between vitamin D serum concentration and developing PPD with β = -0.0256 (95% CI = -0.0454 to -0.0057). Every 10 nmol/L increase was associated with OR = 0.77 (95% CI = 0.63 to 0.94). Meta-analysis of supplementation found a significant reduction in EPDS scores at 4 weeks after delivery (MD = -2.70; 95% CI = -3.68 to -1.71; low certainty).
Conclusion: Vitamin D serum concentration during pregnancy is log-linearly associated with developing PPD after delivery and its supplementation during pregnancy may improve PPD symptoms. Further larger and high quality studies with more diverse pregnant populations are needed to improve certainty and generalizability of evidence.
Keywords: Maternal health, Postpartum depression, Vitamin D
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