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• Preeclampsia and prematurity rates are higher among vitamin D deficient women. • Studies varied with regards to covariates, design, location and outcome definition. • Fixed and random effect meta-analyses evidenced discordant results. • The significance of associations must be clarified through well-designed clinical trials. Vitamin D has important functions outside of bone metabolism. Deficiency has been associated with several adverse outcomes during pregnancy such as preeclampsia and prematurity. There is an increasing body of literature on this topic with studies performed to date having produced contradictory results. To synthesize the literature about vitamin D deficiency and its association with preeclampsia and prematurity in order to determine if maternal vitamin D insufficiency and/or deficiency during pregnancy is associated with the prevalence of preeclampsia and prematurity. A systematic review and meta-analysis of observational and interventional studies. Two independent researchers reviewed the included studies according to PRISMA reporting guidelines. A protocol for this review was registered in PROSPERO with the registration number: "CRD42019136318". Three electronic databases (PubMed, ScienceDirect and Web of Science); were searched in order to identify eligible studies. Observational and interventional studies were selected which had been published in the last 6 years, and analysed the association between maternal vitamin D concentrations during pregnancy and the development of preeclampsia and/or preterm birth. Data were extracted and presented in tables and figures. Fixed and random-effects meta-analyses were performed on the studies which provided enough sample data to calculate odds ratios. Results from both statistical methods were compared. Meta-analysis cut-off points for vitamin D insufficiency and deficiency were defined as <75nmol/L and <50nmol/L, respectively. Fifty-five studies met the inclusion criteria. Fixed-effects meta-analysis of the interventional studies indicated that vitamin D supplementation acts as a prevention factor for preeclampsia and prematurity. Fixed-effects meta-analysis of observational studies concluded that vitamin D insufficiency and deficiency are associated with a higher risk of developing preeclampsia. However, prematurity and vitamin D were only associated when maternal vitamin D concentrations was <75 nmol/L. Random-effects meta-analysis found no significant association between vitamin D, preeclampsia and prematurity in either observational or interventional studies. Higher vitamin D concentrations during pregnancy could be associated with a decreased risk of preeclampsia and prematurity but statistical significance of associations depends on the study design used. Well-designed clinical trials with vitamin D supplementation are needed in order to better define associations. [ABSTRACT FROM AUTHOR]

Introduction Sleep is a physiological state of self-regulation. The international classification of sleep disorders now includes as a new category those occurring during pregnancy. Regular physical activity is known to improve the quality of life, one aspect of which is sleep quality. During pregnancy, physical activity is decreased but should not be eliminated, as studies have reported a high correlation between sleep disorders and the absence of physical activity. Regular physical exercise during pregnancy, whether performed in water or out of it, provides greater control of gestational weight gain. Furthermore, the reduced weight gain during pregnancy, as a result of physical exercise, is associated with greater physical resistance to the demands of childbirth, combats the fatigue caused by pregnancy and reduces back pain. All of these outcomes tend to enhance sleep quality, among other beneficial effects. Objective To determine whether, in pregnant women, there is an association between moderate-intensity physical activity in an aquatic environment and sleep quality. Material and methods A randomised clinical trial was conducted with a sample of 140 pregnant women aged 21–43 years, divided into two groups; Intervention Group and Control Group. The women were recruited in the twelfth week of gestation and took part in the [Study of] Water Exercise in Pregnancy programme from week 20 to week 37. Sleep quality was evaluated in the first and third trimesters of pregnancy, using the Pittsburgh Sleep Quality Index questionnaire. Results The Mann–Whitney U test showed that the results obtained were statistically significant (p < 0.05). In the Intervention Group, 44 of the women (65.67%) were classified as “poor sleepers” versus 62 women (92.54%) in the Control Group. Conclusions The [Study of] Water Exercise in Pregnancy method improves the quality of sleep in pregnant women, both subjectively and in terms of latency, duration and efficiency. [ABSTRACT FROM AUTHOR]