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极低出生体重儿出生时维生素D水平与呼吸道疾病之间的关联。

Association between vitamin D level at birth and respiratory morbidities in very-low-birth-weight infants.

作者信息

Kim Ian, Kim Sung Shin, Song Jee In, Yoon Seock Hwa, Park Ga Young, Lee Yong-Wha

机构信息

Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.

Department of Laboratory Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.

出版信息

Korean J Pediatr. 2019 May;62(5):166-172. doi: 10.3345/kjp.2018.06632. Epub 2018 Oct 24.

Abstract

PURPOSE

This study aimed to evaluate vitamin D status at birth in very-low-birth-weight infants (VLBWIs: <1,500 g) and to determine the association between vitamin D level and respiratory morbidity.

METHODS

A retrospective study was conducted at Soonchunhyang University Bucheon Hospital between November 2013 and November 2017. We collected blood samples and data on respiratory morbidity from 230 VLBWIs on the first day of life. Patients who were transferred to other hospitals (n=19), died before 36 weeks of gestational age (n=18), or whose blood samples were not collected immediately after birth (n=5) were excluded. Finally, 188 patients were enrolled. VLBWIs with different vitamin D levels were compared with respect to demographic features, maternal diseases, respiratory morbidities, and other neonatal diseases.

RESULTS

The mean serum vitamin D level, as measured by 25-hydroxyvitamin D (25(OH)D), was 13.4± 9.3 ng/mL. The incidence of vitamin D deficiency (<20 ng/mL) was 79.8%, and 44.1% of preterm infants had severe vitamin D deficiency (<10 ng/mL). Logistic analysis shows that a low serum 25(OH)D level (<20 ng/mL) was a risk factor for respiratory distress syndrome (odds ratio [OR], 4.32; P=0.010) and bronchopulmonary dysplasia (OR, 4.11; P=0.035).

CONCLUSION

The results showed that 79.8% of preterm infants in this study had vitamin D deficiency at birth. Low vitamin D status was associated with respiratory morbidity, but the exact mechanism was unknown. Additional studies on the association between vitamin D level and neonatal morbidity are required.

摘要

目的

本研究旨在评估极低出生体重儿(VLBWIs:<1500克)出生时的维生素D状况,并确定维生素D水平与呼吸道疾病之间的关联。

方法

2013年11月至2017年11月在顺天乡大学富川医院进行了一项回顾性研究。我们收集了230例极低出生体重儿出生第一天的血样和呼吸道疾病数据。排除转至其他医院的患者(n = 19)、孕龄36周前死亡的患者(n = 18)或出生后未立即采集血样的患者(n = 5)。最终,纳入188例患者。比较了不同维生素D水平的极低出生体重儿在人口统计学特征、母亲疾病、呼吸道疾病和其他新生儿疾病方面的情况。

结果

通过25-羟基维生素D(25(OH)D)测定的平均血清维生素D水平为13.4±9.3 ng/mL。维生素D缺乏(<20 ng/mL)的发生率为79.8%,44.1%的早产儿存在严重维生素D缺乏(<10 ng/mL)。逻辑分析表明,血清25(OH)D水平低(<20 ng/mL)是呼吸窘迫综合征的危险因素(比值比[OR],4.32;P = 0.010)和支气管肺发育不良的危险因素(OR,4.11;P = 0.035)。

结论

结果显示,本研究中79.8%的早产儿出生时存在维生素D缺乏。低维生素D状况与呼吸道疾病有关,但确切机制尚不清楚。需要进一步研究维生素D水平与新生儿疾病之间的关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d61d/6528057/94b5eea94eed/kjp-2018-06632f1.jpg

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