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[母婴维生素D状况及相关因素]

[Maternal-neonatal vitamin D status and related factors].

作者信息

Zhuang Xue-ling, Zhu Zhi-wei, Zhu Dong-bo, Chen Li-qin, Zhao Zheng-yan, Shao Jie

机构信息

Department of Child Health Care, Zhejiang University School of Medicine, Hangzhou, China.

出版信息

Zhonghua Er Ke Za Zhi. 2012 Jul;50(7):498-503.

Abstract

OBJECTIVE

To determine the relationship between maternal and neonatal vitamin D status and related factors.

METHOD

Serum 25-(OH)D levels were measured by ELISA in 499 pregnant women at 30 - 37 weeks gestation and in cord blood of their infants born at term (37 - 42 wk gestation) in Southeastern China at 28.9°N latitude. One-way analysis of variance (ANOVA) was used to explore maternal and neonatal vitamin D levels by season. Pearson linear and linear regression of partial correlation was used to analyze the relationship between maternal and neonatal 25-(OH) D levels. The multiple factors related to maternal vitamin D status was assessed by binary logistic regression.

RESULT

The levels of serum 25-(OH)D were (33.0 ± 13.4) nmol/L in mothers and (31.0 ± 12.5) nmol/L in their newborns. Serum 25-(OH)D < 50 nmol/L was shown in 88.8% of mothers and 91.2% of their neonates. Both maternal and neonatal 25-(OH)D levels varied with season (Ps = 0.000). Vitamin D level was the lowest in spring, with the 25-(OH)D concentration < 50 nmol/L in 98.6% of mothers and 99.3% of their neonates. The highest vitamin D level was presented in fall, but there were still 64.0% of mothers and 75.0% of neonates with 25-(OH)D < 50 nmol/L. Except for season, calcium-vitamin D supplement and intake of egg ≥ 600 g per week during pregnancy benefited to improve maternal vitamin D level [25-(OH)D ≥ 50 nmol/L] [OR = 2.3 (95%CI:1.0, 5.3), 3.4 (95%CI:1.2, 9.9) respectively]. There was a positive correlation between maternal and neonatal 25-(OH)D measures in the sample as a whole (r = 0.45, P = 0.000, N = 499), the correlation was of no statistical significance when maternal serum 25-(OH)D was ≤ 25 nmol/L.

CONCLUSION

Hypovitaminosis D was common in late pregnant mothers and their newborns in southeastern China, especially in spring. Vitamin D supplement and intake of vitamin D-rich food were beneficial to improvement of maternal vitamin D level. There was a moderate and positive correlation between maternal and neonatal 25-(OH)D concentrations in this population. The correlation was lost when maternal serum 25-(OH)D ≤ 25 nmol/L.

摘要

目的

确定孕产妇和新生儿维生素D状态及其相关因素之间的关系。

方法

采用酶联免疫吸附测定法(ELISA)检测了中国东南部北纬28.9°地区499例妊娠30 - 37周孕妇及其足月(妊娠37 - 42周)分娩婴儿脐带血中的血清25 -(OH)D水平。采用单因素方差分析(ANOVA)按季节探讨孕产妇和新生儿的维生素D水平。采用Pearson线性相关和偏相关线性回归分析孕产妇和新生儿25 -(OH)D水平之间的关系。通过二元逻辑回归评估与孕产妇维生素D状态相关的多因素。

结果

母亲血清25 -(OH)D水平为(33.0±13.4)nmol/L,其新生儿为(31.0±12.5)nmol/L。88.8%的母亲和91.2%的新生儿血清25 -(OH)D<50 nmol/L。孕产妇和新生儿的25 -(OH)D水平均随季节变化(P值均为0.000)。春季维生素D水平最低,98.6%的母亲和99.3%的新生儿25 -(OH)D浓度<50 nmol/L。秋季维生素D水平最高,但仍有64.0%的母亲和75.0%的新生儿25 -(OH)D<50 nmol/L。除季节外,孕期补充钙 - 维生素D以及每周鸡蛋摄入量≥600 g有利于提高孕产妇维生素D水平[25 -(OH)D≥50 nmol/L][比值比分别为2.3(95%可信区间:1.0,5.3),3.4(95%可信区间:1.2,9.9)]。总体样本中孕产妇和新生儿的25 -(OH)D测量值呈正相关(r = 0.45,P = 0.000,N = 499),当孕产妇血清25 -(OH)D≤25 nmol/L时,相关性无统计学意义。

结论

维生素D缺乏症在中国东南部晚期妊娠母亲及其新生儿中很常见,尤其是在春季。补充维生素D和摄入富含维生素D的食物有利于提高孕产妇维生素D水平。该人群中孕产妇和新生儿25 -(OH)D浓度呈中度正相关。当孕产妇血清25 -(OH)D≤25 nmol/L时,相关性消失。

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