Children's Hospital, University of Helsinki and Helsinki University Hospital, Tukholmankatu 8 C, Biomedicum Helsinki, P.O. Box 20, 00014, Helsinki, Finland.
Faculty of Agriculture and Forestry, University of Helsinki, Latokartanonkaari 7, P.O. Box 27, 00014, Helsinki, Finland.
Eur J Nutr. 2018 Jun;57(4):1369-1379. doi: 10.1007/s00394-017-1417-z. Epub 2017 Mar 2.
The objectives of this cross-sectional study were to define maternal and umbilical cord blood (UCB) 25-hydroxyvitamin D (25(OH)D) to characterize maternal factors modifying 25(OH)D during pregnancy and predict UCB 25(OH)D in two subgroups with Declined [Δ25(OH)D <0 nmol/l] and Increased [Δ25(OH)D >0 nmol/l] 25(OH)D concentration.
A complete dataset was available from 584 women. 25(OH)D was determined at gestational weeks 6-13 and in UCB. Baseline characteristics were collected retrospectively using questionnaires. Δ25(OH)D was calculated as UCB 25(OH)D-early pregnancy 25(OH)D. Dietary patterns were generated with principal component analysis. Multivariate regression models were applied.
Vitamin D deficiency was scarce, since only 1% had 25(OH)D concentration <50 nmol/l both in early pregnancy and in UCB. Shared positive predictors of UCB 25(OH)D in the subgroups of Declined and Increased, were early pregnancy 25(OH)D (P < 0.001) and supplemental vitamin D intake (P < 0.04). For the Increased subgroup summer season at delivery (P = 0.001) and "sandwich and dairy" dietary pattern characterized with frequent consumption of vitamin D fortified margarine and milk products (P = 0.009) were positive predictors of UCB 25(OH)D. Physical activity (P = 0.041) and maternal education (P = 0.004) were additional positive predictors in the Declined group CONCLUSIONS: Maternal and newborn vitamin D status was sufficient, thus public health policies in Finland have been successful. The key modifiable maternal determinants for 25(OH)D during pregnancy, and of the newborn, were supplemental vitamin D intake, frequent consumption of vitamin D fortified foods, and physical activity.
本横断面研究的目的是定义母体和脐血（UCB）25-羟维生素 D（25（OH）D），以描述怀孕期间影响 25（OH）D 的母体因素，并在 25（OH）D 浓度下降[Δ25（OH）D <0 nmol/l]和增加[Δ25（OH）D >0 nmol/l]的两个亚组中预测 UCB 25（OH）D。
共有 584 名女性的完整数据集可用。在妊娠 6-13 周时测定 25（OH）D，并在 UCB 中测定。使用问卷调查回顾性收集基线特征。Δ25（OH）D 计算为 UCB 25（OH）D-早期妊娠 25（OH）D。使用主成分分析生成膳食模式。应用多元回归模型。
维生素 D 缺乏很少见，因为只有 1%的女性在妊娠早期和 UCB 中 25（OH）D 浓度<50 nmol/l。下降和增加亚组 UCB 25（OH）D 的共同正预测因子是早期妊娠 25（OH）D（P<0.001）和补充维生素 D 摄入（P<0.04）。对于增加亚组，分娩时的夏季（P=0.001）和“三明治和乳制品”膳食模式，其特点是经常食用添加维生素 D 的人造黄油和乳制品（P=0.009），是 UCB 25（OH）D 的正预测因子。体力活动（P=0.041）和母亲教育（P=0.004）是下降亚组的额外正预测因子。
芬兰的公共卫生政策已经成功地使母体和新生儿的维生素 D 状况得到了充分满足。怀孕期间和新生儿 25（OH）D 的关键可改变母体决定因素是补充维生素 D 摄入、经常食用添加维生素 D 的食物和体力活动。
