Jan Mohamed Hamid Jan, Rowan Angela, Fong Bertram, Loy See-Ling
Nutrition Program, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
Fonterra Co-operative Group Ltd, Palmerston North, New Zealand.
PLoS One. 2014 Jul 3;9(7):e100705. doi: 10.1371/journal.pone.0100705. eCollection 2014.
Vitamin D deficiency has become a global health issue in pregnant women. This study aimed to assess the adequacy of maternal vitamin D status by measuring maternal serum and breast milk 25-hydroxyvitamin D [25(OH)D] levels and to determine the association between maternal serum and milk 25(OH)D levels.
Data was obtained from the Universiti Sains Malaysia Pregnancy Cohort Study. This study was conducted from April 2010 to December 2012 in the state of Kelantan, Malaysia. Blood samples from pregnant women aged 19 to 40 years were drawn in the second and third trimesters of pregnancy, while breast milk samples at delivery, 2, 6 and 12 months postpartum were collected to analyze for 25(OH)D levels. A total of 102 pregnant women were included in the analysis.
Vitamin D deficiency [25(OH)D <50 nmol/L] was detected in 60% and 37% of women in the second and third trimesters of pregnancy, respectively. There were 6% and 23% of women who reached normal level of vitamin D status in the second trimester and the third trimester, respectively. Multivitamin intakes during pregnancy were significantly associated with higher serum 25(OH)D levels in the second trimester (β = 9.16, p = 0.005) and the third trimester (β = 13.65, p = 0.003). 25(OH)D levels in breast milk during the first year of lactation ranged from 1.01 to 1.26 nmol/L. Higher maternal serum 25(OH)D level in the second trimester of pregnancy was associated with an elevated level of 25(OH)D in breast milk at delivery (β = 0.002, p = 0.026).
This study shows that high proportions of Malay pregnant women are at risk of vitamin D deficiency. Maternal vitamin D status in the second trimester of pregnancy was found to influence vitamin D level in breast milk at delivery.
维生素D缺乏已成为全球孕妇面临的健康问题。本研究旨在通过测量孕妇血清和母乳中25-羟维生素D[25(OH)D]水平来评估孕妇维生素D状态的充足程度，并确定孕妇血清和母乳中25(OH)D水平之间的关联。
数据来自马来西亚理科大学孕妇队列研究。本研究于2010年4月至2012年12月在马来西亚吉兰丹州进行。采集19至40岁孕妇在妊娠中期和晚期的血样，同时在分娩时、产后2个月、6个月和12个月采集母乳样本来分析25(OH)D水平。共有102名孕妇纳入分析。
妊娠中期和晚期分别有60%和37%的女性检测出维生素D缺乏[25(OH)D<50 nmol/L]。妊娠中期和晚期分别有6%和23%的女性维生素D状态达到正常水平。孕期服用多种维生素与妊娠中期（β=9.16，p=0.005）和晚期（β=13.65，p=0.003）较高的血清25(OH)D水平显著相关。哺乳期第一年母乳中的25(OH)D水平在1.01至1.26 nmol/L之间。妊娠中期孕妇较高的血清25(OH)D水平与分娩时母乳中升高的25(OH)D水平相关（β=0.002，p=0.026）。
本研究表明，高比例的马来孕妇有维生素D缺乏风险。发现妊娠中期孕妇的维生素D状态会影响分娩时母乳中的维生素D水平。
