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前瞻性研究孕妇中期 25-羟维生素 D 水平与儿童早期呼吸道疾病的关系。

Prospective study of maternal mid-pregnancy 25-hydroxyvitamin D level and early childhood respiratory disorders.

机构信息

Department of Chronic Diseases, Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.

出版信息

Paediatr Perinat Epidemiol. 2013 Nov;27(6):532-41. doi: 10.1111/ppe.12080. Epub 2013 Aug 20.

Abstract

BACKGROUND

Studies suggest that prenatal vitamin D status may be inversely associated with lower respiratory tract infections (LRTIs) early in life. Studies of prenatal vitamin D status and development of asthma have inconsistent findings.

METHODS

We examined the associations of maternal mid-pregnancy 25-hydroxyvitamin D [25(OH)D] level with the frequency of LRTIs by 36 months and with current asthma at 36 months using the Norwegian Mother and Child Cohort Study. Maternal plasma 25(OH)D level was measured using liquid chromatography-tandem mass spectrometry. Respiratory disorders were evaluated by maternal report through questionnaires. LRTIs were analysed in a random sample of 1248 children. Asthma was analysed using a case-control design, including 489 cases and 1183 controls. Multivariable generalised linear models calculated adjusted measures of association.

RESULTS

The median gestational week of sample collection was 18 weeks (range 9, 35). The mean 25(OH)D level was 73.7 nmol/L (standard deviation 23.7). Higher maternal mid-pregnancy 25(OH)D level was associated with a reduced risk of three or more LRTIs by 36 months vs. none, adjusted risk ratio 0.74 [95% confidence interval (CI): 0.58, 0.93] per 20 nmol/L increase. Associations were similar when examining the frequency of LRTIs by 18 months, and the frequency of LRTIs between 18 and 36 months. Maternal mid-pregnancy 25(OH)D level was not significantly associated with current asthma at 36 months, adjusted odds ratio 0.91 [95% CI 0.81, 1.02] per 20 nmol/L increase.

CONCLUSIONS

Higher maternal mid-pregnancy 25(OH)D level was associated with a modestly reduced risk of recurrent LRTIs by 36 months, but was not associated with current asthma at 36 months.

摘要

背景

研究表明,产前维生素 D 状况可能与生命早期下呼吸道感染(LRTIs)呈负相关。关于产前维生素 D 状况与哮喘发展的研究结果不一致。

方法

我们利用挪威母婴队列研究,通过问卷调查评估了母亲妊娠中期 25-羟维生素 D [25(OH)D]水平与 36 个月时 LRTIs 频率以及与 36 个月时当前哮喘的相关性。采用液相色谱-串联质谱法测定母体外周血浆 25(OH)D 水平。通过母亲报告的问卷评估呼吸障碍。在 1248 名儿童的随机样本中分析 LRTIs。采用病例对照设计分析哮喘,包括 489 例病例和 1183 例对照。多变量广义线性模型计算调整后的关联度量。

结果

样本采集的中位妊娠周为 18 周(范围 9-35)。25(OH)D 平均水平为 73.7nmol/L(标准差 23.7)。与妊娠中期 25(OH)D 水平每增加 20nmol/L 相比,较高的 25(OH)D 水平与 36 个月时发生 3 次或以上 LRTIs 的风险降低相关,调整后的风险比为 0.74(95%置信区间:0.58,0.93)。当我们检查 18 个月时的 LRTIs 频率以及 18-36 个月之间的 LRTIs 频率时,观察到了类似的关联。妊娠中期 25(OH)D 水平与 36 个月时的当前哮喘无显著相关性,调整后的比值比为 0.91(95%置信区间:0.81,1.02),每增加 20nmol/L 风险比降低 10%。

结论

妊娠中期较高的 25(OH)D 水平与 36 个月时 LRTIs 复发的风险适度降低相关,但与 36 个月时的当前哮喘无关。

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