Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences.
The Irish Centre for Fetal and Neonatal Translational Research (INFANT).
J Nutr. 2018 Oct 1;148(10):1580-1586. doi: 10.1093/jn/nxy150.
Although animal studies show evidence for a role of vitamin D during brain development, data from human studies show conflicting signals.
We aimed to explore associations between maternal and neonatal vitamin D status with childhood neurodevelopmental outcomes.
Comprehensive clinical, demographic, and lifestyle data were collected prospectively in 734 maternal-infant dyads from the Cork BASELINE Birth Cohort Study. Serum 25-hydroxyvitamin D [25(OH)D] concentrations were quantified at 15 weeks of gestation and in umbilical cord sera at birth via a CDC-accredited liquid chromatography-tandem mass spectrometry method. Children were assessed at age 5 y through the use of the Kaufman Brief Intelligence Test (2nd Edition, KBIT-2) and the Child Behaviour Checklist (CBCL). Linear regression was used to explore associations between 25(OH)D and neurodevelopmental outcomes.
25(OH)D concentrations were <30 nmol/L in 15% of maternal and 45% of umbilical cord sera and <50 nmol/L in 42% of mothers and 80% of cords. At age 5 y, the mean ± SD KBIT-2 intelligence quotient (IQ) composite score was 104.6 ± 8.6; scores were 107.2 ± 10.0 in verbal and 99.8 ± 8.8 in nonverbal tasks. Developmental delay (scores <85) was seen in <3% of children across all domains. The mean ± SD CBCL total problem score was 21.3 ± 17.5; scores in the abnormal/clinical range for internal, external, and total problem scales were present in 12%, 4%, and 6% of participants, respectively. KBIT-2 and CBCL subscale scores at 5 y were not different between children exposed to low antenatal vitamin D status, either at 30 or 50 nmol/L 25(OH)D thresholds. Neither maternal nor cord 25(OH)D (per 10 nmol/L) were associated with KBIT-2 IQ composite scores [adjusted β (95% CI): maternal -0.01 (-0.03, 0.02); cord 0.01 (-0.03, 0.04] or CBCL total problem scores [maternal 0.01 (-0.04, 0.05); cord 0.01 (-0.07, 0.09)].
In this well-characterized prospective maternal-infant cohort, we found no evidence that antenatal 25(OH)D concentrations are associated with neurodevelopmental outcomes at 5 y. The BASELINE Study was registered at www.clinicaltrials.gov as NCT01498965; the SCOPE Study was registered at http://www.anzctr.org.au as ACTRN12607000551493.
尽管动物研究表明维生素 D 在大脑发育过程中具有作用，但来自人类研究的数据显示出相互矛盾的信号。
我们旨在探索母体和新生儿维生素 D 状态与儿童神经发育结局之间的关联。
前瞻性地在来自科克 BASELINE 出生队列研究的 734 对母婴二联体中收集全面的临床、人口统计学和生活方式数据。通过美国疾病控制与预防中心认可的液相色谱-串联质谱法在妊娠 15 周和脐带血清中定量测定血清 25-羟维生素 D [25(OH)D] 浓度。在 5 岁时，使用 Kaufman 简明智力测试（第 2 版，KBIT-2）和儿童行为检查表（CBCL）评估儿童。线性回归用于探索 25(OH)D 与神经发育结局之间的关系。
15%的母体和 45%的脐带血清中 25(OH)D 浓度<30 nmol/L，42%的母亲和 80%的脐带中<50 nmol/L。在 5 岁时，KBIT-2 智商（IQ）综合得分的平均值±标准差为 104.6±8.6；言语部分的平均得分±标准差为 107.2±10.0，非言语部分为 99.8±8.8。所有领域的儿童中，发育迟缓（评分<85）的比例均<3%。CBCL 总问题评分的平均值±标准差为 21.3±17.5；内部、外部和总问题量表的异常/临床评分分别存在于 12%、4%和 6%的参与者中。在 30 nmol/L 和 50 nmol/L 25(OH)D 阈值下，暴露于低产前维生素 D 状态的儿童在 5 岁时的 KBIT-2 和 CBCL 亚量表评分没有差异。母体和脐带 25(OH)D（每 10 nmol/L）与 KBIT-2 IQ 综合评分均无相关性[调整β（95%CI）：母体-0.01（-0.03，0.02）；脐带 0.01（-0.03，0.04]或 CBCL 总问题评分[母体 0.01（-0.04，0.05）；脐带 0.01（-0.07，0.09）]。
在这个特征明确的前瞻性母婴队列中，我们没有发现产前 25(OH)D 浓度与 5 岁时的神经发育结局有关的证据。BASELINE 研究在 www.clinicaltrials.gov 上注册为 NCT01498965；SCOPE 研究在 http://www.anzctr.org.au 上注册为 ACTRN12607000551493。
