Vinkhuyzen Anna A E, Eyles Darryl W, Burne Thomas H, Blanken Laura M E, Kruithof Claudia J, Verhulst Frank, Jaddoe Vincent W, Tiemeier Henning, McGrath John J
Queensland Brain Institute, The University of Queensland, St Lucia, QLD 4072, Australia.
Queensland Brain Institute, The University of Queensland, St Lucia, QLD 4072, Australia; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD 4076, Australia.
J Steroid Biochem Mol Biol. 2016 Nov;164:161-167. doi: 10.1016/j.jsbmb.2015.09.018. Epub 2015 Sep 15.
Population-based studies have confirmed that the prevalence of vitamin D deficiency is substantial in many societies, and is of particular concern in pregnant women. Vitamin D deficiency during pregnancy is associated with a wide range of adverse maternal and offspring health outcomes. To date, studies of vitamin D deficiency during pregnancy have focused on measurements at one or two time points in isolation. We examined both midgestation and cord blood 25 hydroxyvitamin D (25OHD) concentration and explored the prevalence and correlates of vitamin D deficiency in a large ethnically diverse cohort of pregnant women and their infants in the Netherlands.
This study was embedded in the Generation R Study, a population-based prospective cohort from fetal life onwards in Rotterdam, The Netherlands. Using a highly sensitive tandem mass spectroscopy-based assay, we measured 25OHD in 7256 midgestation samples (mean gestation 20.6 weeks) and 5023 neonatal cord blood samples (mean gestation 40.0 weeks). Using a conservative threshold of less than 25nmol/L to define vitamin D deficiency, we examined the prevalence and socio-demographic correlates of vitamin D deficiency in mothers and infants. We also derived a measure of vitamin D deficiency based on the two time points in order to explore persistent vitamin D deficiency in mother-infant pairs.
The prevalence of vitamin D deficiency at midgestation was 26%, while in neonates 46% were deficient. 21% of the mother-infant pairs had persistent vitamin D deficiency (i.e., deficient in maternal and cord samples) and an additional 29% were vitamin D deficient in one of the two samples only. Persistent vitamin D deficiency was strongly associated with non-European ancestry and spring birth.
A sizeable proportion of women and their neonatal offspring in the Generation R cohort were vitamin D deficient. In light of the large body of evidence linking vitamin D deficiency with adverse health outcomes for pregnant women and their offspring, our findings indicate a large unmet need in this population. In particular, women and infants from non-European ethnic background are at high risk of vitamin D deficiency.
基于人群的研究已证实，维生素D缺乏在许多社会中普遍存在，在孕妇中尤为令人担忧。孕期维生素D缺乏与一系列不良的母婴健康结局相关。迄今为止，孕期维生素D缺乏的研究主要集中在孤立的一两个时间点的测量上。我们检测了孕中期和脐血中25羟维生素D（25OHD）的浓度，并在荷兰一个种族多样化的大型孕妇及其婴儿队列中探讨了维生素D缺乏的患病率及其相关因素。
本研究纳入了荷兰鹿特丹一项基于人群的前瞻性队列研究——R代研究，该研究从胎儿期开始。我们使用基于高灵敏度串联质谱的检测方法，对7256份孕中期样本（平均孕周20.6周）和5023份新生儿脐血样本（平均孕周40.0周）进行了25OHD检测。采用低于25nmol/L的保守阈值来定义维生素D缺乏，我们研究了母亲和婴儿中维生素D缺乏的患病率及其社会人口学相关因素。我们还基于这两个时间点得出了一个维生素D缺乏的指标，以探讨母婴对中持续性维生素D缺乏的情况。
孕中期维生素D缺乏的患病率为26%，而新生儿中这一比例为46%。21%的母婴对存在持续性维生素D缺乏（即母亲样本和脐血样本均缺乏），另外29%仅在两份样本中的一份中维生素D缺乏。持续性维生素D缺乏与非欧洲血统和春季出生密切相关。
R代队列中的相当一部分女性及其新生儿后代存在维生素D缺乏。鉴于大量证据表明维生素D缺乏与孕妇及其后代的不良健康结局有关，我们的研究结果表明该人群中存在大量未满足的需求。特别是，非欧洲种族背景的女性和婴儿维生素D缺乏风险很高。
