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加拿大魁北克一个出生队列中的脐血维生素D状况与新生儿结局

Cord blood vitamin D status and neonatal outcomes in a birth cohort in Quebec, Canada.

作者信息

Morgan Catherine, Dodds Linda, Langille Donald B, Weiler Hope A, Armson B Anthony, Forest Jean-Claude, Giguère Yves, Woolcott Christy G

机构信息

Department of Community Health and Epidemiology, Centre for Clinical Research, Dalhousie University, 5790 University Avenue, Halifax, NS, B3H 1V7, Canada.

Departments of Obstetrics and Gynaecology and Pediatrics, Dalhousie University, 5980 University Avenue, PO Box 9700, Halifax, NS, B3K 6R8, Canada.

出版信息

Arch Gynecol Obstet. 2016 Apr;293(4):731-8. doi: 10.1007/s00404-015-3899-3. Epub 2015 Sep 24.

Abstract

PURPOSE

Some evidence suggests that low maternal vitamin D status adversely affects perinatal health but few studies have examined cord blood vitamin D status. This project aimed to determine the association between the cord blood concentration of 25-hydroxyvitamin D [25(OH)D] and neonatal outcomes.

METHODS

A nested case-control study was conducted in Quebec City, Canada from 2005 to 2010. Included were 83 cases of low birthweight (LBW; <2500 g), 301 cases of small for gestational age (SGA; <10th percentile), 223 cases of preterm birth (PTB; <37 weeks' gestation), and 1027 controls. Levels of 25(OH)D were determined by chemiluminescence immunoassay. Adjusted odds ratios (OR) and 95 % confidence intervals (CI) were estimated with logistic regression.

RESULTS

Cord blood [25(OH)D] <50 nmol/L was associated with a lower risk of LBW compared to [25(OH)D] ≥75 nmol/L (OR 0.47 95 % CI 0.23-0.97). For 25(OH)D levels 50-75 nmol/L, a significant association was not demonstrated (OR 0.58, 95 % CI 0.34-1.01). No significant associations were observed between [25(OH)D] and either SGA or PTB after adjustment.

CONCLUSIONS

Although our findings suggest that [25(OH)D] <50 nmol/L is associated with reduced risk of having a LBW infant, prenatal vitamin D recommendations require an examination of the literature that considers the full spectrum of maternal and neonatal outcomes.

摘要

目的

一些证据表明,母亲维生素D水平低会对围产期健康产生不利影响,但很少有研究检测脐带血维生素D水平。本项目旨在确定脐带血25-羟基维生素D[25(OH)D]浓度与新生儿结局之间的关联。

方法

2005年至2010年在加拿大魁北克市进行了一项巢式病例对照研究。纳入了83例低出生体重儿(LBW;<2500g)、301例小于胎龄儿(SGA;<第10百分位数)、223例早产(PTB;<37周妊娠)和1027例对照。通过化学发光免疫分析法测定25(OH)D水平。采用逻辑回归估计调整后的优势比(OR)和95%置信区间(CI)。

结果

与[25(OH)D]≥75nmol/L相比,脐带血[25(OH)D]<50nmol/L与低出生体重风险较低相关(OR 0.47,95%CI 0.23-0.97)。对于25(OH)D水平为50-75nmol/L,未显示出显著关联(OR 0.58,95%CI 0.34-1.01)。调整后,未观察到[25(OH)D]与小于胎龄儿或早产之间存在显著关联。

结论

尽管我们的研究结果表明[25(OH)D]<50nmol/L与低出生体重儿风险降低相关,但产前维生素D建议需要对考虑了母亲和新生儿全部结局范围的文献进行审查。

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