بررسی ارتباط سطح ویتامین D با واژینوز باکتریایی در زنان باردار: یک مطالعه مرور نظام‌مند و متاآنالیز

نوع مقاله : مروری

نویسندگان

1 دانشجوی دکتری بهداشت باروری، کمیته تحقیقات و فناوری دانشجویی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

2 دکتری تخصصی بهداشت باروری، واحد توسعه تحقیقات بالینی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی کرمانشاه، کرمانشاه، ایران.

3 دکتری تخصصی بهداشت باروری، مرکز تحقیقات مامایی و بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

4 کارشناس ارشد مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

5 دانشجوی کارشناسی ارشد مامایی، کمیته تحقیقات و فناوری دانشجویی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

6 استادیار مرکز تحقیقات مامایی و بهداشت باروری، گروه مامایی و بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

7 استاد گروه مامایی و بهداشت باروری، مرکز تحقیقات مامایی و بهداشت باروری، دانشکدۀ پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

چکیده

مقدمه: واژینوز باکتریایی (BV) در بارداری با پیامدهای نامطلوبی همراه است. برخی از مطالعات، کمبود ویتامینD  را در بروز آن مؤثر و برخی دیگر آن را بی‌تأثیر دانسته‌اند. این مرور نظام‌مند با هدف تعیین ارتباط بین سطح ویتامین D و واژینوز باکتریایی در زنان باردار انجام شد.
روش‌کار: پایگاه­ های اطلاعاتی از جمله PubMed، Web of Science، Scopus، Embase با استفاده از کلیدواژه‌های "بارداری"، "ویتامین D" و "واژینوز باکتریایی" بدون محدودیت زمانی تا 12 مارس 2025 جستجو شدند. موتور جستجوی Google نیز بررسی شد. ارزیابی کیفیت مطالعات وارد شده نیز با استفاده از چک‌لیست تعدیل‌ شده نیوکاسل- اتاوا صورت گرفت. متاآنالیز با نرم‌افزار Stata، ارزیابی هتروژنیتی مطالعات با استفاده از شاخص I2 و آزمون کوکران و ارزیابی سوگیری انتشار مطالعات از طریق نمودار قیفی و آزمون­های Egger & Begg انجام شد.
یافته ­ها: از ۲۲۴ مطالعه اولیه، ۱۵ مطالعه با ۴۹۶۳ شرکت‌کننده وارد مرور شدند. ارتباط بین سطح ویتامین D و واژینوز باکتریایی بر اساس شاخص نسبت شانس تعدیل شده با مقدار نسبت شانس تعدیل‌ شده 98/0 (فاصله اطمینان 95%: 91/0 تا 05/1) نشان داد به‌علت عدم وجود رابطه آماری معنادار، کمبود ویتامین D با افزایش یا کاهش خطر ابتلاء به واژینوز باکتریایی همراه نبود.
نتیجه گیری: سطح سرمی ویتامین D ارتباط آماری معناداری با واژینوز باکتریایی در دوران بارداری نشان نداد. به‌نظر می‌رسد این رابطه تحت تأثیر عوامل مداخله‌گر متعددی قرار دارد و ویتامین D به‌تنهایی نمی‌تواند به‌عنوان یک عامل خطر مستقل در نظر گرفته شود.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

The Relationship between Vitamin D Levels and Bacterial Vaginosis in Pregnant Women: A Systematic Review and Meta-Analysis

نویسندگان [English]

  • Fatemeh Rashidi 1
  • Marzieh Bagherinia 2
  • Mehri Kalhor 3
  • Kimia Hosseinpour 4
  • Zahra Shirzadi 5
  • Zahra Kiani 6
  • Masoumeh Simbar 7
1 PhD Student of Reproductive Health, Student Research Committee, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 PhD of Reproductive Health, Clinical Research Development Center, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran.
3 PhD of Reproductive Health, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
4 M.Sc. of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
5 M.Sc. student of Midwifery, Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
6 Assistant professor, Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
7 Professor, Department of Midwifery and Reproductive Health, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
چکیده [English]

Introduction: Bacterial vaginosis (BV) during pregnancy is associated with adverse outcomes. Some studies have suggested that vitamin D deficiency may contribute to the development of BV, while others have found no association. This systematic review was conducted with aim to determine the relationship between serum vitamin D levels and bacterial vaginosis in pregnant women.
Methods: Electronic databases including PubMed, Web of Science, Scopus, and Embase were searched using the keywords of pregnancy, vitamin ", and bacterial vaginosis without time restrictions up to March 12, 2025. Google search engine was also reviewed. The quality of the included studies was assessed using the modified Newcastle–Ottawa Scale. Meta-analysis was performed using Stata software. Study heterogeneity was assessed using the I² index and Cochran’s Q test, and publication bias was evaluated using funnel plots and Egger’s and Begg’s tests.
Results: Of the initial 224 studies, 15 studies with 4963 participants were included in the review. The association between vitamin D levels and bacterial vaginosis, based on the adjusted odds ratio (AOR=0.98) (95% CI: 0.91–1.05), indicated that due to no statistically significant relationship, vitamin D deficiency was not associated with increased or decreased risk of BV.
Conclusion: Serum vitamin D levels showed no statistically significant association with bacterial vaginosis during pregnancy. It seems that this relationship is influenced by multiple intervening factors, and vitamin D alone cannot be considered an independent risk factor.

کلیدواژه‌ها [English]

  • Bacterial Vaginosis
  • Pregnant Women
  • Vaginal Infections
  • Vaginitis
  • Vitamin D

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مجله زنان، مامایی و نازایی ایران
دوره 28، شماره 11
بهمن 1404
صفحه 80-99

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