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妊娠期维生素 D 缺乏——仍是公共卫生问题。

Vitamin D deficiency in pregnancy - still a public health issue.

机构信息

North West London Hospital NHS Trust, RNOH NHS Trust, Harrow, UK.

出版信息

Matern Child Nutr. 2013 Jan;9(1):23-30. doi: 10.1111/mcn.12014.

Abstract

The objectives of this study were to quantify the prevalence of vitamin D insufficiency and deficiency in pregnancy, explore associated risk factors and discuss the public health implications. The study used retrospective analysis of randomly selected data. This is the first report on serum vitamin D levels in an unselected multi-ethnic population of pregnant women collected between April 2008 and March 2009. Women with sufficient stored serum were randomly selected from among all women who delivered between April 2008 and March 2009. Serum vitamin D levels were determined using liquid chromatography coupled to tandem mass spectrometry. Vitamin D levels were analysed with respect to ethnicity (marking skin tone), calendar quartile, body mass index (BMI), trimester and parity. Deficiency was defined as <25 nmol L(-1) , insufficiency 25-75 nmol L(-1) and adequacy >75 nmol L(-1) . Three hundred and forty-six women were included and represented the total population regarding skin tone, quartile, BMI, gestation and parity. Overall, 18% [95% confidence interval (CI): 15-23%] of sample women had adequate vitamin D levels; 36% were deficient, 45% insufficient. Among women with dark skin, only 8% (95% CI: 5-12%) had adequate levels compared with 43% (95% CI: 33-53%) of those with light skin. Obese women were found have significantly lower vitamin D levels than non-obese women. Vitamin D deficiency and insufficiency are prevalent year-round among pregnant women in North West London, especially those with darker skin. Existing supplementation guidelines should be supported; however, other measures are required to improve status among all women.

摘要

本研究旨在量化妊娠期间维生素 D 不足和缺乏的流行率,探讨相关的危险因素,并讨论其公共卫生意义。本研究采用随机选择数据的回顾性分析。这是首次在 2008 年 4 月至 2009 年 3 月间收集的未选择的多民族孕妇人群中报告血清维生素 D 水平。从 2008 年 4 月至 2009 年 3 月间分娩的所有女性中随机选择具有足够储存血清的女性。采用液相色谱-串联质谱法测定血清维生素 D 水平。根据种族(标记肤色)、日历四分位数、体重指数(BMI)、孕期和产次分析维生素 D 水平。将缺乏定义为<25 nmol/L(-1),不足为 25-75 nmol/L(-1),充足为>75 nmol/L(-1)。共纳入 346 名女性,代表了肤色、四分位数、BMI、妊娠和产次方面的总人群。总体而言,18%[95%置信区间(CI):15-23%]的样本女性具有足够的维生素 D 水平;36%的女性缺乏维生素 D,45%的女性不足。在肤色较深的女性中,仅有 8%(95%CI:5-12%)具有足够的水平,而肤色较浅的女性中则有 43%(95%CI:33-53%)。肥胖女性的维生素 D 水平明显低于非肥胖女性。在伦敦西北部的孕妇中,维生素 D 缺乏和不足全年都很普遍,尤其是肤色较深的孕妇。应支持现有的补充指南;然而,还需要采取其他措施来改善所有女性的状况。

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