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妊娠晚期补充维生素 D3 对孟加拉国纵向随访研究中婴儿生长的影响。

Maternal vitamin D3 supplementation during the third trimester of pregnancy: effects on infant growth in a longitudinal follow-up study in Bangladesh.

机构信息

Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.

出版信息

J Pediatr. 2013 Dec;163(6):1605-1611.e3. doi: 10.1016/j.jpeds.2013.07.030. Epub 2013 Aug 30.

Abstract

OBJECTIVE

To estimate the effects of prenatal vitamin D supplementation on infant growth in Dhaka, Bangladesh.

STUDY DESIGN

Longitudinal follow-up of infants born at term or late preterm (≥34 weeks) to participants in a randomized double-blind trial of maternal third-trimester vitamin D3 (35 000 IU/wk; vitamin D ) vs placebo. Anthropometry was performed at birth, 1, 2, 4, 6, 9, and 12 months of age. The primary analysis (n = 145 overall; n = 134 at 1 year) was a comparison of mean length-for-age z-score (LAZ) based on World Health Organization standards.

RESULTS

LAZ was similar between groups at birth, but 0.44 (95% CI, 0.06-0.82) higher in vitamin D vs placebo at 1 year, corresponding to a sex-adjusted increase of 1.1 cm (95% CI, 0.06-2.0). Mean change in LAZ from birth to 1 month was significantly greater in vitamin D (0.53 per month) vs placebo (0.19 per month; P = .004); but there was no significant divergence thereafter. In longitudinal (repeated-measures) analysis, average LAZ during infancy was 0.41 higher in vitamin D vs placebo (95% CI, 0.11-0.71, P = .01). Stunting was less common in vitamin D (17% of infants were ever stunted) vs placebo (31%; P = .049). Other anthropometric indices were similar between groups.

CONCLUSIONS

Maternal vitamin D3 supplementation (35 000 IU/wk) during the third trimester of pregnancy enhanced early postnatal linear growth in a cohort of infants in Bangladesh.

摘要

目的

评估产前维生素 D 补充对孟加拉国达卡婴儿生长的影响。

研究设计

对一项随机、双盲、三 trimester 期维生素 D3(35000 IU/周;维生素 D)与安慰剂治疗母亲的临床试验中的足月或晚期早产儿(≥34 周)婴儿进行纵向随访。在出生、1、2、4、6、9 和 12 个月时进行人体测量。主要分析(总体 145 例;1 岁时 134 例)是根据世界卫生组织标准比较平均长度年龄 z 评分(LAZ)。

结果

出生时两组间 LAZ 相似,但 1 岁时维生素 D 组比安慰剂组高 0.44(95%CI,0.06-0.82),相当于调整性别后增加 1.1 厘米(95%CI,0.06-2.0)。维生素 D 组从出生到 1 个月的 LAZ 变化明显大于安慰剂组(每月增加 0.53 个月;P=0.004);但此后无明显差异。在纵向(重复测量)分析中,维生素 D 组婴儿期平均 LAZ 比安慰剂组高 0.41(95%CI,0.11-0.71,P=0.01)。维生素 D 组(17%的婴儿曾经发育迟缓)比安慰剂组(31%;P=0.049)发育迟缓的情况较少。两组间其他人体测量指标相似。

结论

在孟加拉国,妊娠晚期母亲补充维生素 D3(35000 IU/周)可增强婴儿早期的线性生长。

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