{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T14:15:19Z","timestamp":1792592119565,"version":"4.5.0"},"reference-count":66,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Fetal Growth Restriction (FGR) and Small-for-Gestational-Age (SGA) are major contributors to perinatal morbidity and mortality. Maternal vitamin D deficiency has been proposed to impair placental development and fetal growth through mechanisms involving angiogenesis, immune regulation, and oxidative stress. Increasing evidence suggests that maternal 25-hydroxyvitamin D [25(OH)D] status may play a significant role in the pathogenesis of impaired fetal growth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To synthesize evidence on the association between maternal 25-hydroxyvitamin D [25(OH)D] concentrations and the risk of FGR and SGA, and to evaluate the impact of vitamin D supplementation on fetal growth outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search of PubMed, Cochrane Library, Springer, ScienceDirect, and DOAJ was performed following PRISMA 2020 guidelines. Observational studies and randomized controlled trials examining maternal vitamin D status and fetal growth outcomes were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The 48 included studies showed consistent evidence linking low maternal 25(OH)D concentrations with increased risk of FGR and SGA, with several analyses demonstrating dose\u2013response patterns at lower vitamin D thresholds. Associations with preterm birth were directionally similar but less consistent. Findings from intervention trials assessing vitamin D supplementation were heterogeneous, influenced by variations in dosage, timing of initiation, baseline vitamin D status, adherence, and co-nutrient exposures. Experimental and mechanistic studies further supported biological plausibility, demonstrating vitamin D\u2013mediated effects on placental angiogenesis, immune modulation, endocrine signaling, and oxidative stress pathways.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Maternal vitamin D deficiency is consistently associated with impaired fetal growth, although findings from supplementation trials remain variable. Standardized dosing strategies, harmonized diagnostic cut-offs, and better-controlled interventions are needed to clarify the optimal role of vitamin D in preventing FGR and SGA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/prospero\/<\/jats:ext-link>\n                      , identifier CRD42024622395.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2025.1725177","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T15:48:07Z","timestamp":1768319287000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["The role of vitamin D deficiency in fetal growth restriction: a systematic review"],"prefix":"10.3389","volume":"12","author":[{"given":"Leony","family":"Octavia","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Hasanuddin University","place":["Makassar, Indonesia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Putri","family":"Nabila","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Pelita Harapan University","place":["Tangerang, Indonesia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dwi Andhika","family":"Panjarwanto","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Brawijaya University","place":["Malang, Indonesia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Putri Lenggo","family":"Geany","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Diponegoro University","place":["Semarang, Indonesia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosua Darmadi","family":"Kosen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Maranatha Christian University","place":["Bandung, Indonesia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aldo Aulia","family":"Rahman","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Sriwijaya University","place":["Palembang, Indonesia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vallexa Septina","family":"Yora","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Fatmawati Hospital","place":["Jakarta, Indonesia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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