Department of Epidemiology, Harvard School of Public Health, Boston, MA.
Paediatr Perinat Epidemiol. 2014 Mar;28(2):166-76. doi: 10.1111/ppe.12103. Epub 2013 Dec 20.
Vitamin D deficiency during pregnancy has been associated with increased risk of complications and adverse perinatal outcomes. We evaluated seasonal variation of 25-hydroxyvitamin D [25(OH)D] among pregnant women, focusing on patterns and determinants of variation.
Data came from three cohort studies in the US that included 2583 non-Hispanic Black and White women having prenatal 25(OH)D concentrations determined. Fourier time series and generalised linear models were used to estimate the magnitude of 25(OH)D seasonality. We modelled seasonal variability using a stationary cosinor model to estimate the phase shift, peak-trough difference, and annual mean of 25(OH)D.
We observed a peak for 25(OH)D in summer, a nadir in winter, and a phase of 8 months, which resulted from fluctuations in 25(OH)D3 rather than 25(OH)D2. After adjustment for covariates, the annual mean concentrations and estimated peak-trough difference of 25(OH)D among Black women were 19.8 ng/mL [95% confidence interval (CI) 18.9, 20.5] and 5.8 ng/mL [95% CI 4.7, 6.7], and for non-Hispanic White women were 33.0 ng/mL [95% CI 32.6, 33.4] and 7.4 ng/mL [95% CI 6.0, 8.9].
Non-Hispanic Black women had lower average 25(OH)D concentrations throughout the year and smaller seasonal variation levels than non-Hispanic White women. This study's confirmation of 25(OH)D seasonality over a calendar year has the potential to enhance public health interventions targeted to improve maternal and perinatal outcomes.
孕妇维生素 D 缺乏与并发症风险增加和不良围产期结局有关。我们评估了孕妇 25-羟维生素 D [25(OH)D]的季节性变化,重点关注变化的模式和决定因素。
数据来自美国的三项队列研究,其中包括 2583 名非西班牙裔黑人和白人孕妇,检测了她们的产前 25(OH)D 浓度。傅里叶时间序列和广义线性模型用于估计 25(OH)D 的季节性幅度。我们使用固定余弦模型来模拟季节性变化,以估计 25(OH)D 的相位偏移、峰谷差和年平均值。
我们观察到 25(OH)D 在夏季达到峰值,在冬季达到谷值,相位为 8 个月,这是由于 25(OH)D3 的波动而不是 25(OH)D2 的波动。在调整了协变量后,黑人女性的 25(OH)D 年平均浓度和估计的峰谷差分别为 19.8ng/mL[95%置信区间(CI)18.9,20.5]和 5.8ng/mL[95%CI 4.7,6.7],而非西班牙裔白人女性分别为 33.0ng/mL[95%CI 32.6,33.4]和 7.4ng/mL[95%CI 6.0,8.9]。
非西班牙裔黑人女性全年的 25(OH)D 平均浓度较低,季节性变化水平也低于非西班牙裔白人女性。本研究在日历年证实了 25(OH)D 的季节性变化,有可能增强针对改善母婴和围产期结局的公共卫生干预措施。