University of Calgary Cumming School of Medicine, Community Health Sciences, Calgary, AB, Canada.
University of Calgary Cumming School of Medicine, Calgary, AB, Canada.
J Crohns Colitis. 2018 May 25;12(6):702-709. doi: 10.1093/ecco-jcc/jjy030.
Vitamin D insufficiency is prevalent in individuals with inflammatory bowel disease [IBD], as well as in pregnant women; however, the prevalence of vitamin D insufficiency in pregnant women with IBD is unknown. This study assessed the prevalence of vitamin D insufficiency in pregnant women with IBD and the adequacy of recommended supplementation.
A cross-sectional study was conducted in pregnant women with inflammatory bowel disease [Crohn's disease = 61, ulcerative colitis = 41] and without inflammatory bowel disease [n = 574]. Chi square tests and log binomial regression were used to examine the prevalence of vitamin D insufficiency. Covariates included ethnicity and season. Adequacy of vitamin D supplementation during pregnancy was also assessed.
The prevalence of vitamin D insufficiency [25-OHD ≤75 nmol/L] in those with Crohn's disease was 50.8% (95% confidence interval [CI]: 38.4%-63.2%) and 60.9% [95% CI: 45.3%-74.7%] with ulcerative colitis compared with 17.4% [95% CI: 14.6%-20.8%] without inflammatory bowel disease. Women with inflammatory bowel disease were more likely to be vitamin D insufficient after adjusting for ethnicity and season (Crohn's disease-adjusted relative risk [aRR] = 2.98,;: 2.19-4.04; ulcerative colitis-aRR = 3.61; 95% CI: 2.65-4.93). Despite vitamin D supplementation, 32.3% [95% CI: 17.8%-51.2%] of those with Crohn's disease, 58.3% [95% CI: 37.1%-76.9%] of those with with ulcerative colitis, and 10.8% [95% CI: 6.9%-16.6%] of those without inflammatory bowel disease were still vitamin D insufficient.
Pregnant women with inflammatory bowel disease are at increased risk of vitamin D insufficiency compared with those without inflammatory bowel disease. The current guidelines for vitamin D supplementation may be inadequate for pregnant women with inflammatory bowel disease.
维生素 D 不足在炎症性肠病[IBD]患者以及孕妇中较为常见，但患有 IBD 的孕妇中维生素 D 不足的发生率尚不清楚。本研究评估了患有 IBD 的孕妇中维生素 D 不足的发生率以及推荐补充的充足性。
对患有炎症性肠病（克罗恩病=61 例，溃疡性结肠炎=41 例）和无炎症性肠病的孕妇（n=574 例）进行了横断面研究。采用卡方检验和对数二项式回归分析来检测维生素 D 不足的发生率。协变量包括种族和季节。还评估了怀孕期间维生素 D 补充的充足性。
患有克罗恩病的患者维生素 D 不足的发生率（25-OHD≤75 nmol/L）为 50.8%（95%置信区间[CI]：38.4%-63.2%），溃疡性结肠炎为 60.9%（95% CI：45.3%-74.7%），而无炎症性肠病的患者为 17.4%（95% CI：14.6%-20.8%）。调整种族和季节后，患有 IBD 的女性发生维生素 D 不足的可能性更大（克罗恩病校正后的相对风险[aRR] = 2.98；95% CI：2.19-4.04；溃疡性结肠炎-aRR = 3.61；95% CI：2.65-4.93）。尽管进行了维生素 D 补充，但仍有 32.3%（95% CI：17.8%-51.2%）的克罗恩病患者、58.3%（95% CI：37.1%-76.9%）的溃疡性结肠炎患者和 10.8%（95% CI：6.9%-16.6%）的无炎症性肠病患者仍存在维生素 D 不足。
与无炎症性肠病的孕妇相比，患有炎症性肠病的孕妇发生维生素 D 不足的风险更高。目前针对炎症性肠病孕妇的维生素 D 补充指南可能不足。
