Kiely Mairead, O'Donovan Sinead M, Kenny Louise C, Hourihane Jonathan O'B, Irvine Alan D, Murray Deirdre M
Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Ireland; Irish Centre for Fetal and Neonatal Translational Research [INFANT], University College Cork, Ireland.
Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Ireland; Irish Centre for Fetal and Neonatal Translational Research [INFANT], University College Cork, Ireland.
J Steroid Biochem Mol Biol. 2017 Mar;167:162-168. doi: 10.1016/j.jsbmb.2016.12.006. Epub 2016 Dec 19.
Vitamin D deficiency is widespread among mothers and neonates and quality clinical and analytical data are lacking. We used a CDC-accredited LC-MS/MS method to analyze vitamin D metabolites in cord sera from 1050 maternal-infant dyads in the prospective SCOPE Ireland Pregnancy and BASELINE Birth cohort studies, based in Cork, Ireland. The mean±SD total 25(OH)D was 34.9±18.1nmol/L; 35% of cords (50% during winter) had 25(OH)D <25nmol/L, 46% were <30nmol/L and 80% were <50nmol/L. In this predominantly white cohort, the main predictor of cord 25(OH)D [adj. mean difference in nmol/L (95% CI)] was summer delivery [19.2 (17.4, 20.9), P<0.0001]. Maternal smoking during pregnancy (9% prevalence) was negatively associated (P<0.002) with cord 25(OH)D [-4.83 (-7.9, -1.5) nmol/L]. There were no associations between cord 25(OH)D and birth weight or any anthropometric measures at birth. Despite the high prevalence of vitamin D deficiency at birth, there were no documented musculoskeletal complications during infancy, which was likely due to widespread supplementation with vitamin D. The mean±SD concentration of 3-epi-25(OH)D, detectable in 99.4% of cord samples, was 3.3±1.9nmol/L. The proportion of 25(OH)D as 3-epi-25(OH)D was 11.2%. Cord 3-epi-25(OH)D concentrations were positively predicted by cord 25(OH)D [0.101 (0.099, 0.103) nmol/L, P<0.0001] and negatively by gestational age [-0.104 (-0.131, -0.076) nmol/L, P<0.0001] and maternal age [-0.010 (-0.019, -0.001) nmol/L, P<0.05]. 25(OH)D was detected in 98% of cord sera (mean±SD; 2.2±1.9nmol/L) despite low antenatal consumption of vitamin D supplements. In conclusion, these first CDC-accredited data of vitamin D metabolites in umbilical cord blood emphasise the high risk of very low vitamin D status in infants born to un-supplemented mothers. Experimental data to define maternal vitamin D requirements for prevention of neonatal deficiency at high latitude are required.
维生素D缺乏在母亲和新生儿中普遍存在，且缺乏高质量的临床和分析数据。我们采用疾病控制与预防中心（CDC）认可的液相色谱-串联质谱法（LC-MS/MS），对爱尔兰科克市前瞻性爱尔兰孕期观察（SCOPE Ireland Pregnancy）和基线出生（BASELINE Birth）队列研究中1050对母婴的脐带血清中的维生素D代谢物进行了分析。总25(OH)D的平均值±标准差为34.9±18.1nmol/L；35%的脐带血（冬季为50%）25(OH)D<25nmol/L，46%<30nmol/L，80%<50nmol/L。在这个以白人为主的队列中，脐带血25(OH)D的主要预测因素[校正后平均差异，单位为nmol/L（95%置信区间）]是夏季分娩[19.2（17.4，20.9），P<0.0001]。孕期母亲吸烟（患病率9%）与脐带血25(OH)D呈负相关（P<0.002）[-4.83（-7.9，-1.5）nmol/L]。脐带血25(OH)D与出生体重或出生时的任何人体测量指标之间均无关联。尽管出生时维生素D缺乏的患病率很高，但婴儿期没有记录到肌肉骨骼并发症，这可能是由于广泛补充维生素D所致。99.4%的脐带血样本中可检测到3-表-25(OH)D，其平均值±标准差为3.3±1.9nmol/L。25(OH)D中3-表-25(OH)D的比例为11.2%。脐带血3-表-25(OH)D浓度与脐带血25(OH)D呈正相关[0.101（0.099，0.103）nmol/L，P<0.0001]，与胎龄呈负相关[-0.104（-0.131，-0.076）nmol/L，P<0.0001]，与母亲年龄呈负相关[-0.010（-0.019，-0.001）nmol/L，P<0.05]。尽管产前维生素D补充剂的摄入量较低，但98%的脐带血清中检测到了25(OH)D（平均值±标准差；2.2±1.9nmol/L）。总之，这些首批经CDC认可的脐带血中维生素D代谢物的数据强调了未补充维生素D的母亲所生婴儿维生素D水平极低的高风险。需要实验数据来确定高纬度地区预防新生儿维生素D缺乏所需的母亲维生素D需求量。
