Wang Chen, Gao Jinsong, Liu Ning, Yu Songlin, Qiu Ling, Wang Danhua
Department of Pediatrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
Department of Gynaecology and Obstetrics, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
J Pediatr Endocrinol Metab. 2019 Feb 25;32(2):167-172. doi: 10.1515/jpem-2018-0422.
Background An adequate maternal vitamin D (vitD) intake is rarely achieved in actual practice. The aim of this study was to assess maternal factors associated with neonatal vitD deficiency. Methods This is a single-institution prospective case-control study. Consecutive single-birth neonates admitted between September 2014 and February 2015 were prospectively enrolled. Serum 25-hydroxyvitamin D (25(OH)D) concentrations were measured by spectrometry. The associations between neonatal vitD deficiency (defined as 25(OH)D <15 ng/mL) and several maternal characteristics, including body mass index (BMI) at delivery, education, health insurance status, birth season, sun exposure time, egg consumption, and vitD supplementation during pregnancy, were examined using multivariable logistic regression and their respective odds ratios (ORs) reported. Results A total of 125 mother-infant dyads were enrolled, with a gestational age of 36.8±2.7 weeks. Fifty-six percent (70/125) of the neonates had vitD deficiency. Maternal factors that were significantly associated with vitD deficiency included winter birth, insufficient sun exposure time, high maternal BMI at delivery, insufficient egg consumption, insufficient vitD supplementation during pregnancy, and disadvantaged health insurance. Disadvantaged insurance status and insufficient vitD supplementation during pregnancy were the two most influential factors of neonatal vitD deficiency, with an OR of 7.5 (95% confidence interval [CI], 2.0-37.6) and 7.0 (95% CI, 2.7-20.7), respectively. Conclusions Neonatal vitD deficiency is very rampant. An individualized vitD supplementation strategy may be developed by taking into consideration pregnant women's socioeconomic status and lifestyles.
背景 在实际临床实践中，孕妇很少能摄入足够的维生素D（vitD）。本研究旨在评估与新生儿vitD缺乏相关的母体因素。方法 这是一项单机构前瞻性病例对照研究。前瞻性纳入了2014年9月至2015年2月期间收治的连续单胎新生儿。采用光谱法测定血清25-羟维生素D（25(OH)D）浓度。使用多变量逻辑回归分析新生儿vitD缺乏（定义为25(OH)D<15 ng/mL）与多种母体特征之间的关联，包括分娩时的体重指数（BMI）、教育程度、健康保险状况、出生季节、日照时间、鸡蛋摄入量以及孕期vitD补充情况，并报告各自的比值比（OR）。结果 共纳入125对母婴，孕周为36.8±2.7周。56%（70/125）的新生儿存在vitD缺乏。与vitD缺乏显著相关的母体因素包括冬季出生、日照时间不足、分娩时母体BMI高（超重）、鸡蛋摄入量不足、孕期vitD补充不足以及健康保险状况不佳。健康保险状况不佳和孕期vitD补充不足是新生儿vitD缺乏的两个最具影响力的因素，OR分别为7.5（95%置信区间[CI]，2.0 - 37.6）和7.0（95%CI，2.7 - 20.7）。结论 新生儿vitD缺乏非常普遍。可考虑孕妇的社会经济状况和生活方式制定个性化的vitD补充策略。
