Ekeroma Alec J, Camargo Carlos A, Scragg Robert, Wall Clare, Stewart Alistair, Mitchell Ed, Crane Julian, Grant Cameron C
c/o Pacific Women's Health Research Unit, Department of Obstetrics and Gynaecology, Middlemore Hospital, University of Auckland, Private Bag 93311, Auckland, New Zealand.
N Z Med J. 2015 Sep 25;128(1422):24-34.
Newborn vitamin D status is largely determined by maternal vitamin D status during pregnancy. New Zealand has a sun avoidance health policy and minimal dietary vitamin D fortification. Vitamin D deficiency (serum 25-hydroxyvitamin D (25(OH)D) concentration <50 nmol/L) is present in 57% of a sample of newborns from Christchurch and Wellington. To inform vitamin D supplementation policy, our aim was to describe the frequency of, and factors associated with, vitamin D deficiency during pregnancy.
We enrolled an ethnically diverse sample of pregnant women from a community maternity clinic in South Auckland, New Zealand, with serum 25(OH)D concentration measured at 27 weeks gestation. We examined the associations of enrolment season, maternal demographics, health, sunlight exposure and vitamin D intake with vitamin D deficiency.
Vitamin D deficiency was present in 109/259 (42%). Enrolment season (P<0.001) and ethnicity (P=0.003) were independently associated with the odds of vitamin D deficiency, but not sunlight exposure or dietary vitamin D intake. Of those enrolled in winter (June-August)/spring (September-November), vitamin D deficiency was present in 43% of European, 67% of Māori, 80% of Pacific and 59% of women of other ethnic groups.
These findings suggest that New Zealand's targeted strategy for vitamin D supplementation may miss up to 42% of women with vitamin D deficiency in our population. Supplementation for all pregnant women during winter/spring could be an appropriate intervention for prevention of vitamin D deficiency during pregnancy in New Zealand.
新生儿的维生素D状况很大程度上取决于孕期母亲的维生素D状况。新西兰实行避免阳光照射的健康政策，且膳食中维生素D强化极少。在克赖斯特彻奇和惠灵顿的新生儿样本中，57%存在维生素D缺乏（血清25-羟维生素D（25(OH)D）浓度<50 nmol/L）。为了为维生素D补充政策提供依据，我们的目标是描述孕期维生素D缺乏的发生率及其相关因素。
我们从新西兰奥克兰南部一家社区产科诊所招募了种族多样的孕妇样本，在妊娠27周时测量其血清25(OH)D浓度。我们研究了入组季节、母亲人口统计学特征、健康状况、阳光照射情况和维生素D摄入量与维生素D缺乏之间的关联。
259名孕妇中有109名（42%）存在维生素D缺乏。入组季节（P<0.001）和种族（P=0.003）与维生素D缺乏的几率独立相关，但阳光照射或膳食维生素D摄入量与之无关。在冬季（6月至8月）/春季（9月至11月）入组的孕妇中，欧洲裔孕妇维生素D缺乏率为43%，毛利裔为67%，太平洋岛民裔为80%，其他种族女性为59%。
这些发现表明，新西兰有针对性的维生素D补充策略可能会遗漏我国高达42%的维生素D缺乏女性。在冬季/春季对所有孕妇进行补充可能是预防新西兰孕期维生素D缺乏的合适干预措施。
