Department of Chemical Pathology, University of Zimbabwe, College of Health Sciences, P.O. Box A178, Avondale, Harare, Zimbabwe.
Department of Immunology, University of Zimbabwe, College of Health Sciences, P.O. Box A178, Avondale, Harare, Zimbabwe.
BMC Pregnancy Childbirth. 2019 Jun 28;19(1):218. doi: 10.1186/s12884-019-2362-z.
The importance of vitamin D in bone health and calcium homeostasis has been well documented. However, emerging evidence supports the role of vitamin D beyond its recognised traditional roles. In pregnancy, vitamin D levels are crucial in sustaining both the maternal stores and optimal growth of the foetus. In Southern Africa, there is paucity of data on vitamin D in pregnancy and related outcomes. To expand this body of knowledge, we assessed vitamin D levels in late pregnancy and (if any) associated maternal determinants in Harare, Zimbabwe.
Study participants comprised of 138 pregnant Zimbabwean women in their third trimester. These were stratified by HIV status; sampling median (IQR) gestation for HIV negative study participants was 34 weeks (26-41) and 31 weeks (20-40) in the HIV positive participants. Maternal plasma 25 hydroxyvitamin (OH) Dlevels were measured using the ClinPrepHigh Pressure Liquid Chromatography (HPLC) kit. Statistical analysis was carried out using the STATA statistical package version 13. A p-value of < 0.05was considered to be statistically significant.
HIV infected participants had significantly higher mean 25 (OH) D concentration (112 ± 33.4 nmol/L) compared to the HIV uninfected (100 ± 27.1 nmol/L), p = 0.032.Participants whose samples were collected during summer had higher maternal 25 (OH) D levels than those cART duration and maternal 25 (OH) D levels (p = 0.031, Spearman correlation =0.28).
Our findings show high mean levels of maternal 25 (OH) D in late pregnancy in our setting and in the absence of vitamin D supplementation. Both HIV infection and season are significant determinants of maternal vitamin D levels. Summer season is associated with higher maternal plasma 25 (OH) D levels. HIV infection is associated with increased maternal vitamin D levels. Prolonged use of cART, Tenolam E is associated with improved maternal 25(OH) D levels.
维生素 D 在骨骼健康和钙平衡中的重要性已得到充分证实。然而，新出现的证据支持维生素 D 的作用超出了其公认的传统作用。在怀孕期间，维生素 D 水平对于维持母体储备和胎儿的最佳生长至关重要。在南非，关于怀孕期间维生素 D 及其相关结果的数据很少。为了扩展这方面的知识，我们评估了津巴布韦哈拉雷孕妇晚期的维生素 D 水平以及（如果有）相关的母体决定因素。
研究参与者包括 138 名处于妊娠晚期的津巴布韦孕妇。根据 HIV 状况对这些孕妇进行分层；HIV 阴性研究参与者的中位（IQR）妊娠时间为 34 周（26-41 周），HIV 阳性参与者为 31 周（20-40 周）。使用 ClinPrep 高压液相色谱（HPLC）试剂盒测量母体血浆 25 羟维生素（OH）D 水平。使用 STATA 统计软件包版本 13 进行统计分析。p 值<0.05 被认为具有统计学意义。
与 HIV 未感染者（100±27.1nmol/L）相比，HIV 感染者的平均 25（OH）D 浓度（112±33.4nmol/L）显著更高，p=0.032。与接受替诺福韦（Tenofovir）和恩曲他滨（Emtricitabine）（Tenolam E）持续时间较长和母体 25（OH）D 水平较低的参与者相比，采集样本在夏季的参与者具有更高的母体 25（OH）D 水平（p=0.031，Spearman 相关系数=0.28）。
我们的研究结果显示，在我们的研究环境中，孕妇在妊娠晚期的平均母体 25（OH）D 水平较高，且没有维生素 D 补充。HIV 感染和季节都是母体维生素 D 水平的重要决定因素。夏季与母体血浆 25（OH）D 水平升高有关。HIV 感染与母体维生素 D 水平升高有关。长期使用替诺福韦（Tenofovir）和恩曲他滨（Emtricitabine）（Tenolam E）与改善母体 25（OH）D 水平有关。
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