Hanieh Sarah, Ha Tran T, Simpson Julie A, Thuy Tran T, Khuong Nguyen C, Thoang Dang D, Tran Thach D, Tuan Tran, Fisher Jane, Biggs Beverley-Ann
Department of Medicine, Melbourne Academic Centre, University of Melbourne at the Doherty Institute, Parkville, Victoria, Australia.
Research and Training Centre for Community Development (RTCCD), Hanoi, Vietnam.
PLoS One. 2014 Jun 26;9(6):e99005. doi: 10.1371/journal.pone.0099005. eCollection 2014.
Vitamin D deficiency affects 1 billion people globally. It has an important role in bone homeostasis, brain development and modulation of the immune system and yet the impact of antenatal vitamin D deficiency on infant outcomes is poorly understood. We assessed the association of 25- hydroxyvitamin D levels (25-OHD) in late pregnancy and early infant growth and developmental outcomes in rural Vietnam.
A prospective cohort study of 960 women who had previously participated in a double-blind cluster randomized controlled trial of antenatal micronutrient supplementation in rural Vietnam was undertaken. Maternal 25-OHD concentration was measured at 32 weeks gestation, and infants were followed until 6 months of age. Main outcome measures were cognitive, motor, socio-emotional and language scores using the Bayley Scales of Infant Development, 3rd edition, and infant length-for-age z scores at 6 months of age.
60% (582/960) of women had 25-OHD levels <75 nmol/L at 32 weeks gestation. Infants born to women with 25-OHD deficiency (<37.5 nmol/L) had reduced developmental language scores compared to those born to women who were vitamin D replete (≥75 nmol/L) (Mean Difference (MD) -3.48, 95% Confidence Interval (CI) -5.67 to -1.28). For every 25 nmol increase in 25-OHD concentration in late pregnancy, infant length-for-age z scores at 6 months of age decreased by 0.08 (95% CI -0.15 to -0.02).
Low maternal 25- hydroxyvitamin D levels during late pregnancy are of concern in rural Vietnam, and are associated with reduced language developmental outcomes at 6 months of age. Our findings strengthen the evidence for giving vitamin D supplementation during pregnancy.
维生素D缺乏在全球影响着10亿人。它在骨骼稳态、大脑发育和免疫系统调节中发挥着重要作用，但产前维生素D缺乏对婴儿结局的影响却知之甚少。我们评估了越南农村地区妊娠晚期25-羟维生素D水平（25-OHD）与婴儿早期生长及发育结局之间的关联。
对960名曾参与越南农村地区产前微量营养素补充双盲整群随机对照试验的女性进行了一项前瞻性队列研究。在妊娠32周时测量母体25-OHD浓度，并对婴儿进行随访直至6个月龄。主要结局指标为使用贝利婴幼儿发展量表第三版得出的认知、运动、社会情感和语言得分，以及6个月龄时的婴儿年龄别身长Z评分。
60%（582/960）的女性在妊娠32周时25-OHD水平<75 nmol/L。与维生素D充足（≥75 nmol/L）的女性所生婴儿相比，25-OHD缺乏（<37.5 nmol/L）的女性所生婴儿的语言发育得分较低（平均差（MD）-3.48，95%置信区间（CI）-5.67至-1.28）。妊娠晚期25-OHD浓度每增加25 nmol，6个月龄婴儿的年龄别身长Z评分降低0.08（95% CI -0.15至-0.02）。
越南农村地区妊娠晚期母体25-羟维生素D水平较低令人担忧，且与6个月龄时语言发育结局降低有关。我们的研究结果强化了孕期补充维生素D的证据。
