Department of Gynecology and Obstetrics, The Third Affiliated Hospital of Anhui Medical University, Hefei, China.
Hefei First People's Hospital, Hefei, China.
J Clin Endocrinol Metab. 2018 Jan 1;103(1):244-252. doi: 10.1210/jc.2017-00850.
Maternal vitamin D insufficiency has been associated with fetal growth restriction. However, the effect of maternal vitamin D supplementation on fetal growth has not been confirmed.
To assess the effect of maternal vitamin D supplementation recommended by the Institute of Medicine (IOM) during pregnancy on the neonatal vitamin D status and the risk of small for gestational age (SGA).
As part of the China-Anhui Birth Cohort study, maternal sociodemographic characteristics, food intake, lifestyle, information on vitamin D supplementation, and birth outcomes were prospectively collected. For participants, 600 IU/d of vitamin D3 was routinely advised to take during pregnancy. Cord blood levels of 25-hydroxyvitamin D [25(OH)D], calcium, and phosphorus were measured in 1491 neonates who were divided into three groups based on the duration of maternal vitamin D supplementation during pregnancy.
Mean cord blood concentrations of 25(OH)D were 3.5 nmol/L higher [95% confidence interval (CI), 0.8, 6.2] in neonates (median, 37.9 nmol/L) whose mother took vitamin D supplementation for >2 months during pregnancy compared with those (median, 34.3 nmol/L) whose mother did not take any supplement. These significant differences on cord blood concentrations of 25(OH)D occurred regardless of the season of birth. The adjusted risk of SGA in pregnant women with vitamin D supplementation for >2 months was significantly decreased than that in women without any vitamin D supplementation (11.8% vs 6.9%; adjusted odds ratio = 0.53; 95% CI, 0.32, 0.87).
The findings from China suggest that maternal vitamin D supplementation recommended by the IOM results in a slight but significantly higher fetal level of 25(OH)D and improves fetal growth.
母体维生素 D 不足与胎儿生长受限有关。然而，母体补充维生素 D 对胎儿生长的影响尚未得到证实。
评估美国医学研究所（IOM）建议的孕期母体维生素 D 补充对新生儿维生素 D 状态和小于胎龄儿（SGA）风险的影响。
作为中国-安徽出生队列研究的一部分，前瞻性收集了母体社会人口统计学特征、饮食、生活方式、维生素 D 补充信息和出生结局。建议参与者在孕期常规补充 600IU/d 的维生素 D3。在 1491 名新生儿中测量了脐带血中 25-羟维生素 D [25(OH)D]、钙和磷的水平，这些新生儿根据孕期母体维生素 D 补充的持续时间分为三组。
与未服用任何补充剂的新生儿（中位数 34.3 nmol/L）相比，母亲在孕期服用维生素 D 补充剂>2 个月的新生儿（中位数 37.9 nmol/L）脐带血中 25(OH)D 浓度平均高 3.5 nmol/L（95%置信区间，0.8，6.2）。这些关于脐带血 25(OH)D 浓度的显著差异与分娩季节无关。与未服用任何维生素 D 补充剂的孕妇相比，孕期服用>2 个月维生素 D 补充剂的孕妇 SGA 的调整风险显著降低（11.8%比 6.9%；调整后的优势比=0.53；95%置信区间，0.32，0.87）。
来自中国的研究结果表明，IOM 推荐的母体维生素 D 补充可导致胎儿 25(OH)D 水平略有升高且具有统计学意义，并改善胎儿生长。
