孕妇及其早产儿的维生素 D 血浆浓度。
Vitamin D plasma concentrations in pregnant women and their preterm newborns.
机构信息
Department of Pediatrics, Faculdade de Medicina do ABC, Avenida Lauro Gomes, 2000. Vila Sacadura Cabral, Santo André, São Paulo, 09060-870, Brazil.
Department of Pediatrics, Universidade Federal de São Paulo - Escola Paulista de Medicina, Rua Botucatu, 898, Vila Clementino, São Paulo, 04023-062, Brazil.
出版信息
BMC Pregnancy Childbirth. 2018 Oct 22;18(1):412. doi: 10.1186/s12884-018-2045-1.
BACKGROUND
Vitamin D deficiency is a global public health issue. More than half of pregnant women are affected by vitamin D insufficiency/deficiency. Studies suggest an association between low vitamin D concentrations during pregnancy with intrauterine growth restriction and prematurity. This study aimed to describe the concentrations of 25(OH)D (25-hydroxyvitamin D) of mothers who delivered preterm newborns compared to women with full-term pregnancy deliveries, as well as to relate 25(OH)D blood concentrations of mothers with those of their newborns.
METHOD
This cross-sectional study was conducted with 66 mothers who had given birth to preterm babies and their preterm newborns (PTNB, < 32 weeks), and 92 women who had given birth at the full-term of their pregnancy and their newborns (FTNB). Data were collected on the characteristics of mothers (gestational age, diseases, and habits) and newborns (anthropometry and adequacy for gestational age). Ten milliliters of blood were drawn from the mothers and the umbilical cord of newborns at birth to identify the 25(OH)D, parathyroid hormone, calcium, phosphorus, and alkaline phosphatase concentrations.
RESULTS
Mothers in the PTNB group had significantly lower mean 25(OH)D blood levels (21.7 ± 10.8 ng/mL vs. 26.2 ± 9.8 ng/mL; p = 0.011) and were three times more likely to have insufficiency when compared to mothers in the FTNB group (OR = 2.993; 95%CI 1.02-8.74). Newborns in the PTNB group also had lower 25(OH)D concentrations compared to FTNB group (25.9 ± 13.9 ng/dL vs. 31.9 ± 12.3 ng/dL; p = 0.009). There was a directly proportional correlation between mother and newborn umbilical cord 25(OH)D concentrations in PTNB (r = 0.596; p < 0.001) and FTNB (r = 0.765; p < 0.001).
CONCLUSION
Mothers who delivered preterm babies and their preterm newborns had lower 25(OH)D concentrations compared to women who had given birth at the full-term of their pregnancy. In both groups, 25(OH)D concentrations of the mothers correlated directly with those of the newborns, and this correlation was higher in the full-term birth group. Nevertheless, the recommended universal vitamin D supplementation in pregnant women to curb the risk of preterm birth is still incipient. More studies are required to clarify the particularities of vitamin D metabolism further and define the adequate 25(OH)D concentrations throughout pregnancy.
背景
维生素 D 缺乏是一个全球性的公共卫生问题。超过一半的孕妇都受到维生素 D 不足/缺乏的影响。研究表明,孕妇维生素 D 浓度低与宫内生长受限和早产有关。本研究旨在描述与足月分娩的母亲相比,早产儿母亲的 25(OH)D(25-羟维生素 D)浓度,并比较母亲和其新生儿的 25(OH)D 血液浓度。
方法
这是一项横断面研究,共纳入 66 名分娩早产儿的母亲及其早产儿(<32 周),以及 92 名足月分娩的母亲及其新生儿。收集母亲(孕龄、疾病和习惯)和新生儿(体格测量和胎龄适宜性)的特征数据。在出生时从母亲和新生儿的脐带中抽取 10 毫升血液,以确定 25(OH)D、甲状旁腺激素、钙、磷和碱性磷酸酶的浓度。
结果
PTNB 组母亲的平均 25(OH)D 血水平显著较低(21.7±10.8ng/mL 比 26.2±9.8ng/mL;p=0.011),与 FTNB 组相比,25(OH)D 不足的可能性高出三倍(OR=2.993;95%CI 1.02-8.74)。PTNB 组新生儿的 25(OH)D 浓度也低于 FTNB 组(25.9±13.9ng/dL 比 31.9±12.3ng/dL;p=0.009)。PTNB 组和 FTNB 组中,母亲和新生儿脐带 25(OH)D 浓度之间存在直接的比例关系(PTNB:r=0.596;p<0.001;FTNB:r=0.765;p<0.001)。
结论
与足月分娩的孕妇相比,分娩早产儿的母亲及其早产儿的 25(OH)D 浓度较低。在这两组中,母亲的 25(OH)D 浓度与新生儿的 25(OH)D 浓度直接相关,且在足月分娩组中这种相关性更高。然而,目前仍建议在孕妇中普遍补充维生素 D 以降低早产风险,但这一建议仍处于初步阶段。还需要更多的研究来进一步阐明维生素 D 代谢的特殊性,并确定整个孕期合适的 25(OH)D 浓度。