Ortigosa Gómez Sandra, García-Algar Oscar, Mur Sierra Antonio, Ferrer Costa Roser, Carrascosa Lezcano Antonio, Yeste Fernández Diego
Rev Esp Salud Publica. 2015 Jan-Feb;89(1):75-83. doi: 10.4321/S1135-57272015000100008.
Plasma 25(OH)D levels in the newborn are dependent on maternal stores, thus, neonates of vitamin D-deficient mothers present a greater risk of hypocalcaemia, rickets and infections the first year of life. Several studies showing a high prevalence of vitamin D deficiency in pregnant women have been published recently. The aim of the study is to analyze the levels of 25(OH)D in cord blood and determine whether there is a relation with nutritional, socioeconomic and clinical factors of pregnant women and their newborns.
Between March and May 2013, 99 pregnant women were recruited in Hospital del Mar (Barcelona), in whom plasma 25(OH)D and PTH levels were measured in cord blood at birth. Clinical history data were collected and a nutritional survey was made on maternal vitamin D and calcium intake and sun exposure. Statistical analysis was performed using SPSS. Comparisons were performed using Kruskal-Wallis and Mann-Whitney U tests, and correction for multiple comparisons using Bonferroni. P value <0.05 and <0.0083 for multiple comparisons were considered statistically significant.
Mean 25(OH)D value in cord blood was 10.4 ± 6 .1 ng/ml. 94% of pregnant women had 25(OH)D levels in cord blood <20 ng/ml. Vitamin D and calcium intake was considered adequate in 92% although sun exposure was deficient in 47%. A correlation between serum 25(OH)D and vitamin D (p 0.033) and calcium intake (p 0.005), sun exposure (p<0.001), ethnicity (p<0.001), skin phototype (p<0.001) and use of traditional clothing (p<0.001) was found.
There is a high prevalence of low levels of vitamin D after winter months in cord blood. The lowest 25(OH D levels were observed in Indo-Pakistani ethnicity, dark phototype and deficient sun exposure.
新生儿血浆25(OH)D水平取决于母体储备,因此,维生素D缺乏母亲的新生儿在出生后第一年出现低钙血症、佝偻病和感染的风险更高。最近发表的几项研究表明,孕妇维生素D缺乏的患病率很高。本研究的目的是分析脐血中25(OH)D的水平,并确定其与孕妇及其新生儿的营养、社会经济和临床因素之间是否存在关联。
2013年3月至5月期间,在巴塞罗那的德尔马医院招募了99名孕妇,在其出生时测量脐血中的血浆25(OH)D和甲状旁腺激素水平。收集临床病史数据,并对孕妇维生素D和钙的摄入量以及日照情况进行营养调查。使用SPSS进行统计分析。采用Kruskal-Wallis和Mann-Whitney U检验进行比较,并使用Bonferroni法进行多重比较校正。多重比较的P值<0.05和<0.0083被认为具有统计学意义。
脐血中25(OH)D的平均水平为10.4±6.1 ng/ml。94%的孕妇脐血中25(OH)D水平<20 ng/ml。92%的孕妇维生素D和钙的摄入量被认为充足,尽管47%的孕妇日照不足。发现血清25(OH)D与维生素D摄入量(p=0.033)、钙摄入量(p=0.005)、日照情况(p<0.001)、种族(p<0.001)、皮肤光型(p<0.001)和传统服装的穿着情况(p<0.001)之间存在相关性。
冬季过后,脐血中维生素D水平低的患病率很高。在印度-巴基斯坦种族、深色皮肤光型和日照不足的人群中观察到最低的25(OH)D水平。