坦桑尼亚人类免疫缺陷病毒暴露儿童的母体维生素 D 状况与儿童发病率、贫血和生长情况。
Maternal vitamin D status and child morbidity, anemia, and growth in human immunodeficiency virus-exposed children in Tanzania.
机构信息
Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA.
出版信息
Pediatr Infect Dis J. 2012 Feb;31(2):171-5. doi: 10.1097/INF.0b013e318245636b.
BACKGROUND
Vitamin D may help prevent adverse pediatric outcomes, including infectious diseases and growth failure, based on its role in immune and metabolic functions. We examined the association of maternal vitamin D status and pediatric health outcomes in children born to human immunodeficiency virus (HIV)-infected women.
METHODS
Vitamin D status was determined in 884 HIV-infected pregnant women at 12 to 27 weeks of gestation in a trial of vitamin supplementation (not excluding vitamin D) in Tanzania. Information on child morbidities, anemia and hypochromic microcytosis, and anthropometry was recorded through monthly clinic visits. Generalized estimating equations and Cox proportional hazards models were used to assess the relationships of outcomes with maternal vitamin D status.
RESULTS
A total of 39% of women had low vitamin D levels (<32 ng/mL). Children born to women with low vitamin D status were 1.11 times more likely to report cough during follow-up (relative risk [RR], 1.11; 95% confidence interval [CI], 1.02-1.21). No significant associations were noted for other respiratory symptoms, diarrhea, or anemia outcomes. Low maternal vitamin D status was associated with significantly increased risk of stunting (height-for-age z score, <-2; RR, 1.29; 95% CI, 1.05-1.59) and being underweight (weight-for-age z score, <-2; RR, 1.33; 95% CI, 1.03-1.71).
CONCLUSIONS
Maternal vitamin D status may be important for preventing respiratory infections and ensuring optimal growth in HIV-exposed children.
背景
基于维生素 D 在免疫和代谢功能中的作用，其可能有助于预防儿科不良结局，包括传染病和生长发育迟缓。我们研究了人类免疫缺陷病毒（HIV）感染孕妇的维生素 D 状况与儿科健康结局的关系。
方法
在坦桑尼亚进行的一项维生素补充试验（不排除维生素 D）中，在妊娠 12-27 周时检测了 884 名 HIV 感染孕妇的维生素 D 状况。通过每月的临床访视记录儿童发病率、贫血和低色素性小细胞性贫血以及人体测量学的信息。使用广义估计方程和 Cox 比例风险模型评估结局与产妇维生素 D 状况的关系。
结果
共有 39%的女性维生素 D 水平较低（<32ng/ml）。与维生素 D 水平较低的女性所生的儿童在随访期间更有可能报告咳嗽（相对风险 [RR]，1.11；95%置信区间 [CI]，1.02-1.21）。对于其他呼吸道症状、腹泻或贫血结局，未观察到显著关联。母亲维生素 D 水平低与生长迟缓（身高年龄 z 评分，<-2；RR，1.29；95% CI，1.05-1.59）和体重不足（体重年龄 z 评分，<-2；RR，1.33；95% CI，1.03-1.71）的风险显著增加相关。
结论
产妇维生素 D 状况可能对预防呼吸道感染和确保 HIV 暴露儿童的最佳生长发育很重要。
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