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母亲的维生素D水平会影响早产新生儿的维生素D水平吗?

Do Maternal Vitamin D Levels Influence Vitamin D Levels in Preterm Neonates?

作者信息

Panda M, McIntosh J, Chaudhari T, Kent A L

机构信息

Dept of Neonatology, Centenary Hospital for Women and Children, Canberra Hospital, Woden, ACT, Australia.

Dept of Neonatology, John Hunter Hospital, Newcastle, NSW, Australia.

出版信息

Int J Pediatr. 2019 Jan 1;2019:8613414. doi: 10.1155/2019/8613414. eCollection 2019.

Abstract

OBJECTIVE

To determine the prevalence of Vitamin D (VitD) deficiency/insufficiency in mothers of preterm neonates less than or equal to 32 weeks of gestation and determine if the current level of VitD supplementation used for preterm neonates is appropriate.

DESIGN

Prospective study from 10 May 2015 to 1 November 2016.

SETTING

Neonatal Intensive Care Unit at the Canberra Hospital.

PATIENTS

Mothers and their preterm neonates born less than or equal to 32 weeks gestation.

INTERVENTIONS

Maternal VitD levels were obtained within 3-4 days following delivery. Neonatal VitD levels were obtained in the first 3-4 days of life, at 3-4 weeks of age, and at 6-8 weeks of age. Demographic data and data on VitD intake from parenteral nutrition, enteral feeds, and vitamin supplementation agents were collected.

RESULTS

70 neonates were enrolled into the study. Median gestation was 29 (27-30) weeks and median birth weight 1197 (971.2-1512.5) grams. Median maternal VitD level was 54.5 (36-70.7) nmol/L, median neonatal Vit D level at birth was 57 (42-70) nmol/L. Median Vit D level at 3 weeks and 6 weeks were 63.5 nmol/L (53-80.2) nmol/L and 103 (71.5-144) nmol/L respectively. 22/55 (40%) mothers were VitD deficient/insufficient. 25/70 (36%) neonates were VitD deficient/insufficient at birth. Of those neonates who were VitD deficient/insufficient at birth 5/25(10%) were deficient/insufficient at 6 weeks. The median intake of VitD at 6 weeks was 826.5 (577.5-939.5) IU/day.

CONCLUSIONS

VitD deficiency/insufficiency in mothers of preterm neonates and in preterm neonates at birth is common. Routine screening of maternal VitD and their preterm neonates along with individualized supplementation regimens in mothers and preterm infants may optimize VitD status and reduce risk of ongoing VitD deficiency/insufficiency.

摘要

目的

确定孕周小于或等于32周的早产儿母亲维生素D(VitD)缺乏/不足的患病率,并确定目前用于早产儿的VitD补充水平是否合适。

设计

2015年5月10日至2016年11月1日的前瞻性研究。

地点

堪培拉医院新生儿重症监护室。

患者

孕周小于或等于32周的早产儿及其母亲。

干预措施

产后3 - 4天内获取母亲的VitD水平。在出生后的前3 - 4天、3 - 4周龄和6 - 8周龄时获取新生儿的VitD水平。收集人口统计学数据以及来自肠外营养、肠内喂养和维生素补充剂的VitD摄入量数据。

结果

70名新生儿纳入研究。中位孕周为29(27 - 30)周,中位出生体重为1197(971.2 - 1512.5)克。母亲的VitD水平中位数为54.5(36 - 70.7)nmol/L,新生儿出生时的VitD水平中位数为57(42 - 70)nmol/L。3周龄和6周龄时的VitD水平中位数分别为63.5 nmol/L(53 - 80.2)nmol/L和103(71.5 - 144)nmol/L。22/55(40%)的母亲VitD缺乏/不足。25/70(36%)的新生儿出生时VitD缺乏/不足。在出生时VitD缺乏/不足的新生儿中,5/25(10%)在6周龄时仍缺乏/不足。6周龄时VitD的摄入量中位数为826.5(577.5 - 939.5)IU/天。

结论

早产儿母亲和早产儿出生时VitD缺乏/不足很常见。对母亲及其早产儿进行常规的VitD筛查,并为母亲和早产儿制定个性化的补充方案,可能会优化VitD状态并降低持续VitD缺乏/不足的风险。

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