Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226 014, India.
Br J Nutr. 2012 Sep 28;108(6):1052-8. doi: 10.1017/S0007114511006246. Epub 2012 Jan 3.
Hypovitaminosis D is common in India. In the present prospective partially randomised study of vitamin D (D₃) supplementation during pregnancy, subjects were randomised in the second trimester to receive either one oral dose of 1500 μg vitamin D₃ (group 1, n 48) or two doses of 3000 μg vitamin D₃ each in the second and third trimesters (group 2, n 49). Maternal 25-hydroxyvitamin D (25(OH)D) at term, cord blood (CB) alkaline phosphatase (ALP), neonatal serum Ca and anthropometry were measured in these subjects and in forty-three non-supplemented mother-infant pairs (usual care). Median maternal 25(OH)D at term was higher in group 2 (58·7, interquartile range (IQR) 38·4-89·4 nmol/l) v. group 1 (26·2, IQR 17·7-57·7 nmol/l) and usual-care group (39·2, IQR 21·2-73·4 nmol/l) (P = 0·000). CB ALP was increased (>8.02 μkat/l or >480 IU/l) in 66·7 % of the usual-care group v. 41·9 % of group 1 and 38·9 % of group 2 (P = 0·03). Neonatal Ca and CB 25(OH)D did not differ significantly in the three groups. Birth weight, length and head circumference were greater and the anterior fontanelle was smaller in groups 1 and 2 (3·08 and 3·03 kg, 50·3 and 50·1 cm, 34·5 and 34·4 cm, 2·6 and 2·5 cm, respectively) v. usual care (2·77 kg, 49·4, 33·6, 3·3 cm; P = 0·000 for length, head circumference and fontanelle and P = 0·003 for weight). These differences were still evident at 9 months. We conclude that both 1500 μg and two doses of 3000 μg vitamin D₃ had a beneficial effect on infant anthropometry, the larger dose also improving CB ALP and maternal 25(OH)D.
印度普遍存在维生素 D 缺乏症。在这项针对妊娠期间维生素 D（D₃）补充的前瞻性部分随机研究中，受试者在妊娠中期随机分为两组，一组接受一次口服 1500μg 维生素 D₃（组 1，n=48），另一组在妊娠第二和第三期各接受两次 3000μg 维生素 D₃（组 2，n=49）。这些受试者以及 43 对未接受补充的母婴对（常规护理）在分娩时测量了母体 25-羟维生素 D（25（OH）D）、脐血（CB）碱性磷酸酶（ALP）、新生儿血清 Ca 和人体测量学指标。与组 1（26.2，IQR 17.7-57.7 nmol/L）和常规护理组（39.2，IQR 21.2-73.4 nmol/L）相比，组 2 产妇在分娩时的 25（OH）D 中位数更高（58.7，IQR 38.4-89.4 nmol/L）（P=0.000）。常规护理组中有 66.7%的婴儿 CB ALP 升高（>8.02 μkat/L 或>480 IU/L），而组 1 为 41.9%，组 2 为 38.9%（P=0.03）。三组新生儿血清 Ca 和 CB 25（OH）D 无显著差异。组 1 和组 2 的新生儿体重、身长和头围较大，前囟门较小（分别为 3.08 和 3.03kg、50.3 和 50.1cm、34.5 和 34.4cm、2.6 和 2.5cm），而常规护理组为 2.77kg、49.4cm、33.6cm、3.3cm（身长、头围和前囟门，P=0.000；体重，P=0.003）。这些差异在 9 个月时仍然存在。我们得出结论，1500μg 和两次 3000μg 维生素 D₃ 剂量均对婴儿人体测量学有有益影响，较大剂量还可改善 CB ALP 和母体 25（OH）D。
