Perampalam Sumathy, Ganda Kirtan, Chow Kerri-Anne, Opie Nicole, Hickman Peter E, Shadbolt Bruce, Hennessy Annemarie, Grunstein Harry, Nolan Christopher J
Department of Endocrinology and Diabetes, The Canberra Hospital, Australian National University Medical School, Canberra, ACT, Australia.
Aust N Z J Obstet Gynaecol. 2011 Aug;51(4):353-9. doi: 10.1111/j.1479-828X.2011.01313.x. Epub 2011 May 18.
High prevalence rates of suboptimal vitamin D levels have been observed in women who are not considered 'at risk'. The effect of behavioural factors such as sun exposure, attire, sunscreen use and vitamin D supplementation on vitamin D levels in pregnancy is unknown.
To determine prevalence and predictive factors of suboptimal vitamin D levels in 2 antenatal clinics in Australia--Campbelltown, NSW and Canberra, ACT.
A cross-sectional study of pregnant women was performed with a survey of demographic and behavioural factors and a mid-pregnancy determination of maternal vitamin D levels.
The prevalence of vitamin D deficiency (≤25 nmol/L) and insufficiency (26-50 nmol/L) was 35% in Canberra (n=100) and 25.7% in Campbelltown (n=101). The majority of participants with suboptimal D levels had vitamin D insufficiency. Among the vitamin D-deficient women, 38% were Caucasian. Skin exposure was the main behavioural determinant of vitamin D level in pregnancy in univariate analysis. Using pooled data ethnicity, season, BMI and use of vitamin D supplements were the main predictive factors of suboptimal vitamin D. Vitamin D supplementation at 500 IU/day was inadequate to prevent insufficiency.
Behavioural factors were not as predictive as ethnicity, season and BMI. As most participants had one of the predictive risk factors for suboptimal vitamin D, a case could be made for universal supplementation with a higher dose of vitamin D in pregnancy and continued targeted screening of the women at highest risk of vitamin D deficiency.
在未被视为“高危”的女性中，维生素D水平未达最佳状态的患病率较高。阳光照射、着装、防晒用品使用及维生素D补充等行为因素对孕期维生素D水平的影响尚不清楚。
确定澳大利亚两个产前诊所（新南威尔士州坎贝尔敦市和澳大利亚首都直辖区堪培拉市）维生素D水平未达最佳状态的患病率及预测因素。
对孕妇进行横断面研究，调查人口统计学和行为因素，并在孕中期测定孕妇维生素D水平。
堪培拉市（n = 100）维生素D缺乏（≤25 nmol/L）和不足（26 - 50 nmol/L）的患病率为35%，坎贝尔敦市（n = 101）为25.7%。维生素D水平未达最佳状态的大多数参与者存在维生素D不足。在维生素D缺乏的女性中，38%为白种人。单因素分析中，皮肤暴露是孕期维生素D水平的主要行为决定因素。综合数据显示，种族、季节、体重指数和维生素D补充剂的使用是维生素D水平未达最佳状态的主要预测因素。每天补充500国际单位的维生素D不足以预防不足。
行为因素的预测性不如种族、季节和体重指数。由于大多数参与者存在维生素D水平未达最佳状态的预测风险因素之一，因此有理由在孕期普遍补充更高剂量的维生素D，并继续对维生素D缺乏风险最高的女性进行针对性筛查。
