Gould Jacqueline F, Anderson Amanda J, Yelland Lisa N, Smithers Lisa G, Skeaff C Murray, Zhou Shao J, Gibson Robert A, Makrides Maria
Child Nutrition Research Centre, Women's and Children's Health Research Institute, Adelaide, South Australia, Australia.
Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.
J Paediatr Child Health. 2017 Jan;53(1):75-83. doi: 10.1111/jpc.13308. Epub 2016 Aug 27.
The association between fetal vitamin D [25-hydroxyvitamin D (25(OH)D)] exposure and early child growth and neurodevelopment is controversial. The aim of this study was to investigate the association between cord blood 25(OH)D and birth size, childhood growth and neurodevelopment.
Cord blood samples from 1040 Australian women enrolled in a randomised trial of docosahexaenoic acid (DHA) supplementation during pregnancy were analysed for 25(OH)D using mass spectroscopy. Infant length, weight and head circumference were measured at delivery. A sub-sample of 337 infants with cord blood samples were selected for growth and neurodevelopment assessment at 18 months and 4 years of age. Associations between standardised 25(OH)D and outcomes were assessed, taking into account DHA treatment, social and demographic variables.
Standardised 25(OH)D in cord blood was not associated with length, weight or head circumference at birth, 18 months or 4 years of age. 25(OH)D was not associated with cognitive, motor, social-emotional or adaptive behaviour scores at 18 months, or cognitive score at 4 years of age. A 10 nmol/L increase in cord blood 25(OH)D was associated with a modest increase in average Language scores of 0.60 points at 18 months (adjusted 95% CI 0.04-1.17, P = .04) and 0.68 points at 4 years (adjusted 95% CI 0.07-1.29, P = .03) of age.
Cord blood vitamin D was modestly, positively associated with language development in early childhood in our sample, although the magnitude of the association was small. Randomised controlled trials are needed to confirm a causal association and establish the potential clinical significance of the relationship between vitamin D status and language development.
胎儿维生素D[25-羟基维生素D(25(OH)D)]暴露与儿童早期生长及神经发育之间的关联存在争议。本研究旨在调查脐血25(OH)D与出生大小、儿童期生长及神经发育之间的关联。
对1040名参加孕期补充二十二碳六烯酸(DHA)随机试验的澳大利亚女性的脐血样本进行质谱分析,以测定25(OH)D。在分娩时测量婴儿的身长、体重和头围。选取337名有脐血样本的婴儿作为子样本,在18个月和4岁时进行生长及神经发育评估。评估标准化25(OH)D与各项结果之间的关联,并考虑DHA治疗、社会和人口统计学变量。
脐血中的标准化25(OH)D与出生时、18个月或4岁时的身长、体重或头围均无关联。25(OH)D与18个月时的认知、运动、社交情感或适应性行为评分,以及4岁时的认知评分均无关联。脐血25(OH)D每增加10 nmol/L,与18个月时平均语言评分适度增加0.60分(校正95%CI 0.04-1.17,P = 0.04)以及4岁时平均语言评分增加0.68分(校正95%CI 0.07-1.29,P = 0.03)相关。
在我们的样本中,脐血维生素D与幼儿期语言发育呈适度正相关,尽管这种关联程度较小。需要进行随机对照试验来证实因果关联,并确定维生素D状态与语言发育之间关系的潜在临床意义。