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维生素 D 缺乏是否是呼吸窘迫综合征的一个危险因素?

Is vitamin d deficiency a risk factor for respiratory distress syndrome?

机构信息

Specialist, Ondokuz Mayıs University Medical Faculty, Division of Neonatology Department of Pediatrics, Samsun, Turkey.

Associate Professor, Ondokuz Mayıs University Medical Faculty, Division of Neonatology Department of Pediatrics, Samsun, Turkey.

出版信息

Int J Vitam Nutr Res. 2013;83(4):232-7. doi: 10.1024/0300-9831/a000165.

Abstract

BACKGROUND

Previous studies have shown the relationship between in utero lung development and vitamin D [25(OH)D], but there have been no studies to investigate whether vitamin D deficiency is a risk factor for respiratory distress syndrome (RDS) in preterm babies.

OBJECTIVES

In this study, we investigated if 25(OH)D deficiency is a risk factor for RDS.

METHODS

One hundred fifty-two preterm newborns, born at 29 - 35 weeks gestational age, were included in the study following informed consent from the parents. Peripheral blood samples were collected within the first 24 hours of life and 25(OH)D levels were measured by liquid chromatography-tandem mass spectrometry. Demographic characteristics of the babies and the diagnosis of RDS were recorded.

RESULTS

In 64 % of preterm infants, 25(OH)D levels were compatible with severe deficiency (≤ 10 ng/mL), 33 % with moderate deficiency (10 - 20 ng/mL), and 3 % with mild deficiency (20 - 30 ng/mL). In none of the babies was a normal 25(OH)D level observed. Serum 25(OH)D levels were not correlated with gestational age. Respiratory distress syndrome was more common in preterm babies with severe (28 %) compared to mild-moderate 25(OH)D deficiency (14 %) (p < 0.05).

CONCLUSIONS

None of the preterm infants in this study had normal vitamin D level, which underlined the burden of vitamin D deficiency in pregnant women and their offspring. RDS was more common in severely vitamin D-deficient preterms. Determination of vitamin D status of the mothers and appropriate supplementation might be a valuable strategy to reduce RDS, in addition to antenatal steroids. Besides, since vitamin D is a regulatory factor in many organs during fetal development, long-term effects of in utero vitamin D deficiency warrant further studies.

摘要

背景

先前的研究表明,子宫内肺发育与维生素 D[25(OH)D]之间存在关系,但尚无研究调查维生素 D 缺乏是否是早产儿呼吸窘迫综合征 (RDS) 的危险因素。

目的

本研究旨在探讨 25(OH)D 缺乏是否是 RDS 的危险因素。

方法

本研究共纳入 152 例胎龄 29-35 周的早产儿,均获得家长知情同意。于生后 24 小时内采集外周血样,采用液相色谱-串联质谱法检测 25(OH)D 水平。记录婴儿的一般特征和 RDS 诊断情况。

结果

64%的早产儿 25(OH)D 水平严重缺乏(≤10ng/mL),33%中度缺乏(10-20ng/mL),3%轻度缺乏(20-30ng/mL)。无一例婴儿 25(OH)D 水平正常。血清 25(OH)D 水平与胎龄无相关性。与轻-中度 25(OH)D 缺乏相比,严重缺乏的早产儿 RDS 更常见(28%比 14%)(p<0.05)。

结论

本研究中无 1 例早产儿维生素 D 水平正常,这突出了孕妇及其后代维生素 D 缺乏的负担。严重维生素 D 缺乏的早产儿 RDS 更常见。测定母亲的维生素 D 状态并进行适当补充,除了产前类固醇外,可能是减少 RDS 的一种有价值策略。此外,由于维生素 D 是胎儿发育过程中许多器官的调节因子,因此子宫内维生素 D 缺乏的长期影响值得进一步研究。

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