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母亲孕早期维生素 D 状况与胎儿和新生儿生长的关系:多民族阿姆斯特丹出生儿童及其发育队列研究结果。

Maternal early pregnancy vitamin D status in relation to fetal and neonatal growth: results of the multi-ethnic Amsterdam Born Children and their Development cohort.

机构信息

Institute of Health Sciences, VU University Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands.

出版信息

Br J Nutr. 2010 Jul;104(1):108-17. doi: 10.1017/S000711451000022X. Epub 2010 Mar 2.

DOI:10.1017/S000711451000022X
PMID:20193097
Abstract

Low vitamin D levels during pregnancy may account for reduced fetal growth and for altered neonatal development. The present study explored the association between maternal vitamin D status measured early in pregnancy and birth weight, prevalence of small-for-gestational-age (SGA) infants and postnatal growth (weight and length), as well as the potential role of vitamin D status in explaining ethnic disparities in these outcomes. Data were derived from a large multi-ethnic cohort in The Netherlands (Amsterdam Born Children and their Development (ABCD) cohort), and included 3730 women with live-born singleton term deliveries. Maternal serum vitamin D was measured during early pregnancy (median 13 weeks, interquartile range: 12-14), and was labelled 'deficient' ( <or= 29.9 nmol/l), 'insufficient' (30-49.9 nmol/l) or 'adequate' ( >or= 50 nmol/l). Six ethnic groups were distinguished: Dutch, Surinamese, Turkish, Moroccan, other non-Western and other Western. Associations with neonatal outcomes were analysed using multivariate regression analyses. Results showed that compared with women with adequate vitamin D levels, women with deficient vitamin D levels had infants with lower birth weights ( - 114.4 g, 95 % CI - 151.2, - 77.6) and a higher risk of SGA (OR 2.4, 95 % CI 1.9, 3.2). Neonates born to mothers with a deficient vitamin D status showed accelerated growth in weight and length during the first year of life. Although a deficient vitamin D status influenced birth weight, SGA risk and neonatal growth, it played a limited role in explaining ethnic differences. Although vitamin D supplementation might be beneficial to those at risk of a deficient vitamin D status, more research is needed before a nationwide policy on the subject can be justified.

摘要

孕期维生素 D 水平较低可能导致胎儿生长受限和新生儿发育改变。本研究探讨了妊娠早期测量的母体维生素 D 状况与出生体重、小于胎龄儿(SGA)发生率和产后生长(体重和身长)的关系,以及维生素 D 状况在解释这些结局的种族差异中的潜在作用。数据来自荷兰的一个大型多民族队列(阿姆斯特丹出生儿童及其发育(ABCD)队列),包括 3730 名足月单胎活产妇女。在妊娠早期(中位数 13 周,四分位间距:12-14)测量了母体血清维生素 D,并将其标记为“不足”( <or= 29.9 nmol/L)、“不足”(30-49.9 nmol/L)或“充足”( >or= 50 nmol/L)。区分了 6 个族裔群体:荷兰人、苏里南人、土耳其人、摩洛哥人、其他非西方人和其他西方人。使用多变量回归分析来分析与新生儿结局的关系。结果表明,与维生素 D 水平充足的妇女相比,维生素 D 水平不足的妇女所生婴儿的出生体重较低( - 114.4 g,95 % CI - 151.2,- 77.6),SGA 风险较高(OR 2.4,95 % CI 1.9,3.2)。母亲维生素 D 状态不足的新生儿在生命的第一年体重和身长增长加速。尽管维生素 D 状态不足会影响出生体重、SGA 风险和新生儿生长,但它在解释种族差异方面作用有限。尽管维生素 D 补充可能对那些有维生素 D 状态不足风险的人有益,但在制定全国性政策之前,还需要更多的研究。

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