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孕期及脐带血维生素 D 状况的大型前瞻性法国队列研究。

Vitamin D status during pregnancy and in cord blood in a large prospective French cohort.

机构信息

Department of Physiology, Georges Pompidou European Hospital, AP-HP, Université Paris Descartes, INSERM U1151-CNRS UMR8253, Paris, France.

Department of Physiology, Necker-Enfants Malades Hospital, AP-HP, Paris, France.

出版信息

Clin Nutr. 2019 Oct;38(5):2136-2144. doi: 10.1016/j.clnu.2018.08.035. Epub 2018 Aug 31.

Abstract

BACKGROUND & AIMS: Vitamin D status during pregnancy and in newborns has never been studied in France. This study aims at determining the vitamin D status during the first and third trimesters of pregnancy (T1, T3) and in cord blood (CB) in the middle-north of France.

METHODS

We conducted a prospective cohort study in five French centers (latitude 47.22 to 48.86°N). Serum 25(OH)-vitamin D (25(OH)D) concentrations were measured using a radioimmunoassay during T1, T3 and in CB. According to the French guidelines, pregnant women received cholecalciferol, 100,000 IU, in the seventh month.

RESULTS

Between April 2012 and July 2014, 2832 women were included, of whom 2803 were analyzed (mean ± SD age: 31.5 ± 5.0 years; phototypes 5-6: 21.8%). Three and 88.6% of participants received supplementation during the month before inclusion and in the seventh month, respectively. At T1, T3, and CB, mean 25(OH)D concentrations were 21.9 ± 10.4, 31.8 ± 11.5, and 17.0 ± 7.2 ng/mL, respectively, and 25(OH)D was <20 ng/mL in 46.5%, 14.0%, and 68.5%, respectively. At T1, body mass index ≥25 kg/m, dark phototypes, sampling outside summer, and no supplementation before inclusion were independently associated with vitamin D insufficiency (25(OH)D < 20 ng/mL). Women who received cholecalciferol supplementation in month 7 had higher 25(OH)D at T3 than non-supplemented women (32.5 ± 11.4 versus 25.8 ± 11.4 ng/mL, p = <0.001) and marginally higher 25(OH)D in CB (17.2 ± 7.2 versus 15.5 ± 7.1 ng/mL, p = 0.004).

CONCLUSIONS

Despite the recommended supplementation, vitamin D insufficiency is frequent during pregnancy and in newborns in France.

摘要

背景与目的

法国从未对孕妇和新生儿的维生素 D 状况进行过研究。本研究旨在确定法国中北部孕妇在妊娠第一和第三期(T1、T3)及脐血(CB)中的维生素 D 状况。

方法

我们在五个法国中心(纬度 47.22 至 48.86°N)进行了一项前瞻性队列研究。在 T1、T3 和 CB 时使用放射免疫法测量血清 25-羟维生素 D(25(OH)D)浓度。根据法国指南,孕妇在第七个月接受 10 万 IU 胆钙化醇。

结果

2012 年 4 月至 2014 年 7 月期间,共纳入 2832 名女性,其中 2803 名进行了分析(平均年龄±标准差:31.5±5.0 岁;肤色 5-6:21.8%)。分别有 3%和 88.6%的参与者在纳入前一个月和第七个月接受了补充。T1、T3 和 CB 时,25(OH)D 浓度分别为 21.9±10.4、31.8±11.5 和 17.0±7.2ng/ml,分别有 46.5%、14.0%和 68.5%的患者 25(OH)D<20ng/ml。T1 时,体质指数≥25kg/m2、深色肤色、夏季以外采样和纳入前未补充均与维生素 D 不足(25(OH)D<20ng/ml)独立相关。在第七个月接受胆钙化醇补充的女性在 T3 时的 25(OH)D 高于未补充的女性(32.5±11.4 与 25.8±11.4ng/ml,p<0.001),在 CB 时的 25(OH)D 也略有升高(17.2±7.2 与 15.5±7.1ng/ml,p=0.004)。

结论

尽管建议补充,但法国孕妇和新生儿仍普遍存在维生素 D 不足。

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