Thomson Katherine, Morley Ruth, Grover Sonia R, Zacharin Margaret R
Royal Children's Hospital, Parkville, VIC, Australia.
Med J Aust. 2004 Nov 1;181(9):486-8. doi: 10.5694/j.1326-5377.2004.tb06405.x.
To determine the postnatal vitamin D status and bone health of women identified as vitamin D-deficient in pregnancy, and of their infants.
Retrospective audit conducted between 27 August and 5 November 2003. The study included women delivering between August and October 2002 at the Royal Women's Hospital, Melbourne, who had had a 25-hydroxyvitamin D (25-[OH]D) level < 30 nmol/L in pregnancy, and their infants at age 4-10 months.
The outpatient clinic at the Royal Children's Hospital, Melbourne.
Maternal and infant serum levels of vitamin D, total alkaline phosphatase (tALP), parathyroid hormone (PTH), calcium and phosphorus; x-ray results in children with clinical or laboratory findings suggestive of rickets.
Of 69 mother-infant pairs invited to participate, 47 (68%) attended. All 47 women had 25-(OH)D levels < 50 nmol/L, and 39 (83%) had levels < 30 nmol/L. Vitamin D supplements had been prescribed in pregnancy for 35 women (74%), and 19/35 reported having taken them as prescribed. None had continued to take supplements postnatally, but one had recently started taking them again. Among 45 infants from whom blood samples were successfully obtained, 18 (40%) had 25-(OH)D levels < 50 nmol/L, and 14 (31%) had levels < 30 nmol/L. Twelve of 16 breastfed infants had 25-(OH)D levels < 30 nmol/L, compared with 2/29 fed formula milk (P = 0.001).
Most mothers who had been vitamin D-deficient in pregnancy were also deficient postnatally, indicating that treatment offered, counselling and/or treatment compliance were inadequate. Their infants, especially if breastfed, were at high risk of vitamin D deficiency and increased bone formation. Breastfed infants of mothers at high risk of vitamin D deficiency should receive vitamin D supplements.
确定孕期被认定为维生素D缺乏的女性及其婴儿出生后的维生素D状况和骨骼健康情况。
2003年8月27日至11月5日进行的回顾性审计。该研究纳入了2002年8月至10月在墨尔本皇家妇女医院分娩、孕期25-羟维生素D（25-[OH]D）水平<30 nmol/L的女性及其4至10个月大的婴儿。
墨尔本皇家儿童医院门诊。
母婴血清维生素D、总碱性磷酸酶（tALP）、甲状旁腺激素（PTH）、钙和磷水平；有临床或实验室检查结果提示佝偻病的儿童的X线检查结果。
受邀参与的69对母婴中，47对（68%）前来就诊。所有47名女性的25-(OH)D水平<50 nmol/L，39名（83%）<30 nmol/L。孕期有35名女性（74%）被开了维生素D补充剂，其中19/35报告按医嘱服用。产后无人继续服用补充剂，但有一人最近又开始服用。在成功采集血样的45名婴儿中，18名（40%）的25-(OH)D水平<50 nmol/L，14名（31%）<30 nmol/L。16名母乳喂养婴儿中有12名25-(OH)D水平<30 nmol/L，而人工喂养的29名婴儿中只有2名（P = 0.001）。
大多数孕期维生素D缺乏的母亲产后仍缺乏，这表明所提供的治疗、咨询和/或治疗依从性不足。她们的婴儿，尤其是母乳喂养的婴儿，维生素D缺乏和骨形成增加的风险很高。维生素D缺乏高危母亲的母乳喂养婴儿应补充维生素D。
