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维生素D缺乏新生儿两种维生素D补充方案的比较。

Comparison of two regimens of vitamin D supplementation for vitamin D-deficient neonates.

作者信息

Shakiba Mehrdad, Pahloosye Ali, Mirouliaei Mehrdad, Islami Zia

机构信息

Department of Pediatrics, Shahid Sadoughi University of Medical Science, Avicenna Street, Yazd, Iran.

出版信息

Singapore Med J. 2014 May;55(5):266-70. doi: 10.11622/smedj.2014070.

Abstract

INTRODUCTION

Vitamin D deficiency is common in pregnant women, and supplementation of vitamin D is necessary for the infants of these women. This study explored the efficacy of an alternative way of vitamin D supplementation in an area with a high prevalence of vitamin D deficiency in mothers.

METHODS

This was a non-randomised clinical trial conducted in 2010 in Yazd, Iran. Full-term healthy infants born to vitamin D-deficient mothers (n = 82) were divided into the high-dose regimen (HDR; single oral bolus 30,000 IU vitamin D3, n = 34) and the standard-dose regimen (SDR; 400 IU/day vitamin D3 within two weeks of life, n = 48) groups. 25-hydroxyvitamin D (25OHD) was measured using chemiluminescent immunoassays, and 25OHD level > 20 ng/mL was deemed sufficient.

RESULTS

Over 90% of infants in the HDR group attained vitamin D sufficiency within one month, while comparable sufficiency was reached in the SDR group only after four months. At two months, the proportion of infants attaining 25OHD > 30 ng/mL was 93.3% and 27.9% in the HDR and SDR groups, respectively (p = 0.003). None of our infants achieved 25OHD levels > 100 ng/mL.

CONCLUSION

For infants born to vitamin D-deficient mothers, oral supplementation of 30,000 IU vitamin D3 during the first month of life, followed by a routine recommended dose of 400 IU/day, should be considered. The four-month lag for attaining vitamin D sufficiency in 90% of infants in the SDR group may have clinical implications and should be further investigated.

摘要

引言

维生素D缺乏在孕妇中很常见,这些孕妇的婴儿有必要补充维生素D。本研究在母亲维生素D缺乏患病率较高的地区探索了一种替代维生素D补充方式的效果。

方法

这是一项于2010年在伊朗亚兹德进行的非随机临床试验。维生素D缺乏母亲所生的足月健康婴儿(n = 82)被分为高剂量方案组(HDR;单次口服30,000 IU维生素D3,n = 34)和标准剂量方案组(SDR;出生后两周内每天400 IU维生素D3,n = 48)。使用化学发光免疫分析法测量25-羟维生素D(25OHD),25OHD水平> 20 ng/mL被视为充足。

结果

HDR组超过90%的婴儿在一个月内达到维生素D充足,而SDR组仅在四个月后才达到类似的充足水平。在两个月时,HDR组和SDR组中25OHD> 30 ng/mL的婴儿比例分别为93.3%和27.9%(p = 0.003)。我们的婴儿中没有一个达到25OHD水平> 100 ng/mL。

结论

对于维生素D缺乏母亲所生的婴儿,应考虑在出生后第一个月口服30,000 IU维生素D3,随后按常规推荐剂量每天400 IU。SDR组90%的婴儿达到维生素D充足的四个月延迟可能具有临床意义,应进一步研究。

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