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In this review, we investigated the association between maternal 25-hydroxyvitamin D status during pregnancy and the risk of diagnosis and symptoms of ASD and ADHD in offspring in developmental age. Methods: We searched online databases up to February 13, 2026. We conducted a quantitative meta-analysis by comparing the exposure categories and using a dose-response approach across the entire exposure range. Results: We included 15 eligible studies: 8 related to ASD and ASD symptoms, 5 related to ADHD and ADHD symptoms, and 2 to both. Comparing high versus low maternal vitamin D status, we found an inverse association with both lower ASD risk (RR\u2009=\u20090.91; 95% CI 0.87\u20130.96) and ADHD risk (RR\u2009=\u20090.90; 95% CI 0.82\u20130.99). In the dose-response pooled analysis, ASD risk linearly decreased by 9% for every 10 nmol\/L increase in maternal serum vitamin D levels. Higher vitamin D levels were also inversely associated with ADHD symptoms, though estimates were statistically imprecise due to the limited number of studies. Conclusions: Higher vitamin D status during pregnancy appears to be linearly associated with a reduced risk of ASD and ADHD diagnoses and symptoms in offspring, with no evidence of thresholds across the investigated exposure range. These findings suggest the opportunity to assess vitamin D levels during pregnancy, and to consider its supplementation in deficiency cases, to support fetal brain development and promote neuroprotection.<\/jats:p>","DOI":"10.1007\/s00787-026-03059-7","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T08:45:28Z","timestamp":1780476328000},"page":"2083-2102","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The impact of maternal vitamin D levels during pregnancy and risk of autism spectrum disorder and attention deficit hyperactivity disorder diagnosis and symptoms in offspring: a systematic review and dose-response meta-analysis"],"prefix":"10.1007","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6679-7401","authenticated-orcid":false,"given":"Laura","family":"Bandini","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0105-2121","authenticated-orcid":false,"given":"Beatrice","family":"Vinceti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1490-5508","authenticated-orcid":false,"given":"Teresa","family":"Urbano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1051-0472","authenticated-orcid":false,"given":"Giuseppe","family":"Plazzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2100-0344","authenticated-orcid":false,"given":"Tommaso","family":"Filippini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0551-2473","authenticated-orcid":false,"given":"Marco","family":"Vinceti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,3]]},"reference":[{"key":"3059_CR1","doi-asserted-by":"publisher","first-page":"3","DOI":"10.24171\/j.phrp.2024.0286","volume":"16","author":"A Issac","year":"2025","unstructured":"Issac A, Halemani K, Shetty A, Thimmappa L, Vijay VR, Koni K, Mishra P, Kapoor V (2025) The global prevalence of autism spectrum disorder in children: a systematic review and meta-analysis. 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