Rodriguez Agueda, Santa Marina Loreto, Jimenez Ana María, Esplugues Ana, Ballester Ferran, Espada Mercedes, Sunyer Jordi, Morales Eva
Hospital de Sabadell, Corporació Sanitària Parc Taulí, Institut Universitari ParcTaulí-UAB, Sabadell, Spain.
Universitat Autònoma de Barcelona, Campus d'Excelència Internacional, Bellaterra, Spain.
Paediatr Perinat Epidemiol. 2016 May;30(3):217-28. doi: 10.1111/ppe.12281. Epub 2016 Feb 5.
Population-based data on vitamin D status in pregnancy in southern European countries are scarce. We assessed the prevalence and determinants of vitamin D insufficiency and deficiency in pregnancy in Spain.
Plasma 25-hydroxyvitamin D3 (25(OH)D3) concentration was measured at the first trimester of gestation in 2,036 pregnant women from several geographical areas of Spain (latitude 39-42°N). Uni- and multivariable regression models were conducted to identify predictors of circulating 25(OH)D3 concentration and vitamin D insufficiency (20-30 ng/mL) and deficiency (<20 ng/mL).
Thirty-one per cent and 18% of women were vitamin D insufficient and deficient, respectively. Season at blood collection, latitude, age, social class, tobacco smoking, physical activity and use of vitamin D supplements were identified as independent determinants of 25(OH)D3 concentration. Lower risk of vitamin D insufficiency and deficiency was associated with summer season at blood collection (RR for insufficiency = 0.34, confidence intervals (CI) 0.25, 0.48; and RR for deficiency = 0.07, 95% CI 0.04, 0.12), southern latitude (RR for insufficiency = 0.71, 95% CI 0.50, 1.02; RR for deficiency = 0.60, 95% CI 0.38, 0.94); use of vitamin D supplements (RR for insufficiency = 0.50, 95% CI 0.35, 0.71; RR for deficiency = 0.24, 95% CI 0.14, 0.41); and strong physical activity (RR for insufficiency = 0.80, 95% CI 0.58, 1.09; and RR for deficiency = 0.67, 95% CI 0.46, 1.03). Higher risk of vitamin D deficiency was related to lower social class (RR = 1.94, 95% CI 1.19, 3.16) and smoking (RR = 1.76, 95% CI 1.23, 2.54).
Vitamin D insufficiency and deficiency are highly prevalent in pregnancy. Recommendations and policies to detect and prevent hypovitaminosis D during pregnancy should be developed taking into account the associated factors.
欧洲南部国家关于孕期维生素D状况的基于人群的数据稀缺。我们评估了西班牙孕期维生素D不足和缺乏的患病率及其决定因素。
对来自西班牙几个地理区域（北纬39 - 42°）的2036名孕妇在妊娠早期测量血浆25 - 羟基维生素D3（25(OH)D3）浓度。采用单变量和多变量回归模型来确定循环25(OH)D3浓度以及维生素D不足（20 - 30 ng/mL）和缺乏（<20 ng/mL）的预测因素。
分别有31%和18%的女性存在维生素D不足和缺乏。采血季节、纬度、年龄、社会阶层、吸烟、身体活动以及维生素D补充剂的使用被确定为25(OH)D3浓度的独立决定因素。采血在夏季与维生素D不足和缺乏风险较低相关（不足的风险比（RR）= 0.34，置信区间（CI）0.25，0.48；缺乏的RR = 0.07，95% CI 0.04，0.12），南部纬度（不足的RR = 0.71，95% CI 0.50，1.02；缺乏的RR = 0.60，95% CI 0.38，0.94）；使用维生素D补充剂（不足的RR = 0.50，95% CI 0.35，0.71；缺乏的RR = 0.24，95% CI 0.14，0.41）；以及剧烈身体活动（不足的RR = 0.80，95% CI 0.58，1.09；缺乏的RR = 0.67，95% CI 0.46，1.03）。维生素D缺乏风险较高与较低社会阶层（RR = 1.94，95% CI 1.19，3.16）和吸烟（RR = 1.76，95% CI 1.23，2.54）有关。
孕期维生素D不足和缺乏非常普遍。应考虑相关因素制定在孕期检测和预防维生素D缺乏症的建议和政策。
