1Division of Chronic Disease Epidemiology,Epidemiology, Biostatistics and Prevention Institute,University of Zurich,Hirschengraben 82,8001 Zurich,Switzerland.
2Gynecology and Obstetrics,Regional Hospital of Bellinzona,Carrale Morinascio 7A,6500 Bellinzona,Switzerland.
Br J Nutr. 2018 Feb;119(3):299-309. doi: 10.1017/S0007114517003634. Epub 2018 Jan 10.
Vitamin D deficiency during pregnancy is associated with negative health consequences for mothers and their infants. Data on the vitamin D status of pregnant women in Switzerland are scarce. A three-centre study was conducted in the obstetric departments of Zurich, Bellinzona and Samedan (Switzerland) to investigate the prevalence and determinants of vitamin D deficiency (serum 25-hydroxyvitamin D (25(OH)D)<50 nmol/l) in 3rd-trimester pregnant women living in Switzerland (n 305), and the correlation between 25(OH)D in pregnant women and their offspring at birth (n 278). Demographic and questionnaire data were used to explore the determinants of vitamin D deficiency. Median concentration of serum 25(OH)D in the third trimester of pregnancy was 46·0 nmol/l (1st-3rd quartiles: 30·5-68·5), representing a 53·4 % prevalence of vitamin D deficiency. 25(OH)D levels in the umbilcal cord blood (median: 50·0 nmol/l; 1st-3rd quartiles: 31·0-76·6) strongly correlated with mothers' serum 25(OH)D (Spearman's correlation ρ=0·79, P<0·001). Multivariable logistic regression analysis showed that significant determinants of vitamin D deficiency in pregnant women were centre of study, country of origin, season of delivery and vitamin D supplement intake. Near-term BMI, skin colour, use of sunscreen and mothers' education, although each not individually significant, collectively improved the ability of the model to explain vitamin D status. Low vitamin D levels were common in this sample of pregnant women and their newborns' cord blood. Vitamin D supplement intake was the most actionable determinant of vitamin D status, suggesting that vitamin D supplementation during pregnancy should receive more attention in clinical practice.
孕期维生素 D 缺乏与母婴健康不良后果有关。瑞士孕妇维生素 D 状况的数据稀缺。在苏黎世、贝林佐纳和萨梅丹（瑞士）的产科部门进行了一项三项中心研究，以调查生活在瑞士的孕晚期妇女（n=305）维生素 D 缺乏症（血清 25-羟维生素 D（25（OH）D）<50nmol/l）的患病率和决定因素，以及孕妇和其分娩时的新生儿（n=278）之间的 25（OH）D 相关性。使用人口统计学和问卷调查数据来探讨维生素 D 缺乏的决定因素。孕晚期血清 25（OH）D 的中位数浓度为 46.0nmol/l（1 四分位数-3 四分位数：30.5-68.5），代表 53.4%的维生素 D 缺乏患病率。脐带血中 25（OH）D 水平（中位数：50.0nmol/l；1 四分位数-3 四分位数：31.0-76.6）与母亲血清 25（OH）D 呈强相关性（Spearman 相关 ρ=0.79，P<0.001）。多变量逻辑回归分析显示，孕妇维生素 D 缺乏的显著决定因素是研究中心、原籍国、分娩季节和维生素 D 补充剂摄入。近期 BMI、肤色、使用防晒霜和母亲教育，尽管每个因素单独不显著，但总体上提高了模型解释维生素 D 状态的能力。该孕妇样本及其新生儿脐带血中维生素 D 水平低很常见。维生素 D 补充剂摄入是维生素 D 状态的最可操作决定因素，这表明在临床实践中应更加关注孕期维生素 D 补充。
