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较高的25-羟基维生素D水平对预防早产儿呼吸窘迫综合征有效吗?

Is higher 25-hydroxyvitamin D level preventive for respiratory distress syndrome in preterm infants?

作者信息

Fettah Nurdan Dinlen, Zenciroğlu Ayşegül, Dilli Dilek, Beken Serdar, Okumuş Nurullah

机构信息

Neonatal Intensive Care Unit, Dr. Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Turkey.

出版信息

Am J Perinatol. 2015 Feb;32(3):247-50. doi: 10.1055/s-0034-1383849. Epub 2014 Sep 13.

Abstract

OBJECTIVE

The objective of this study was to investigate the relationship between cord blood 25-hydroxyvitamin D (25(OH)D) levels and respiratory distress syndrome (RDS) development in preterm infants.

STUDY DESIGN

Between January 2012 and January 2013, 81 preterm infants, gestational age below 32 weeks, were prospectively enrolled into the study. Cord bloods of these newborns were tested for 25(OH)D levels. Low level was defined as ≤ 15 ng/mL (Group 1) and normal level as > 15 ng/mL (Group 2). Patients in Group 1 were also divided further into two subgroups as severe deficiency (Group 1a, ≤ 5 ng/mL) and mild deficiency (Group 1b, 5-15 ng/mL).

RESULTS

In this study, 57 infants had low 25(OH)D levels (Group 1, median 8.0 ng/mL [interquartile range, IQR, 5-10]; Group 2, median 21 ng/mL [IQR, 19-24.7]). RDS rate was significantly higher in Group 1a (n = 18, 32.7%) and Group 1b (n = 34, 61.8%) compared with Group 2 (n = 3, 5.4%) (p = 0.001). There were no difference of having RDS between Group 1a (94.7%) and Group1b (89.5) (p = 0.512). Multivariate analysis showed that higher 25(OH)D level can be preventive for the development of RDS (odds ratio, 0.6; 95% confidence interval (0.5-0.8); p = 0.001).

CONCLUSION

Lower cord blood 25(OH)D levels might be associated with increased risk of RDS in preterm infants with very low birth weight.

摘要

目的

本研究旨在探讨脐带血25-羟基维生素D(25(OH)D)水平与早产儿呼吸窘迫综合征(RDS)发生之间的关系。

研究设计

在2012年1月至2013年1月期间,前瞻性纳入81例孕周小于32周的早产儿。检测这些新生儿脐带血中的25(OH)D水平。低水平定义为≤15 ng/mL(第1组),正常水平定义为>15 ng/mL(第2组)。第1组患者又进一步分为两个亚组,即严重缺乏组(第1a组,≤5 ng/mL)和轻度缺乏组(第1b组,5 - 15 ng/mL)。

结果

在本研究中,57例婴儿25(OH)D水平较低(第1组,中位数8.0 ng/mL[四分位间距,IQR,5 - 10];第2组,中位数21 ng/mL[IQR,19 - 24.7])。与第2组(n = 3,5.4%)相比,第1a组(n = 18,32.7%)和第1b组(n = 34,61.8%)的RDS发生率显著更高(p = 0.001)。第1a组(94.7%)和第1b组(89.5%)之间发生RDS的情况无差异(p = 0.512)。多因素分析表明,较高的25(OH)D水平可预防RDS的发生(比值比,0.6;95%置信区间(0.5 - 0.8);p = 0.001)。

结论

极低出生体重早产儿脐带血25(OH)D水平较低可能与RDS风险增加有关。

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