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妊娠期间维生素 D 状况与总孕期增重和产后体重滞留的关系:一项前瞻性队列研究。

Association between vitamin D status during pregnancy and total gestational weight gain and postpartum weight retention: a prospective cohort.

机构信息

Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, RJ, Brazil.

Graduate Program in Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, RJ, Brazil.

出版信息

Eur J Clin Nutr. 2020 Jan;74(1):126-134. doi: 10.1038/s41430-019-0465-2. Epub 2019 Jul 15.

Abstract

OBJECTIVES

To evaluate the association between vitamin D status during pregnancy and total gestational weight gain (GWG), GWG rates and postpartum weight retention.

METHODS

Prospective cohort of 163 women from Rio de Janeiro was followed at 5-13 (baseline), 20-26, 30-36 gestational weeks and at 30-62 days postpartum. Plasma 25-hydroxyvitamin D [25(OH)D] was evaluated during each trimester and was categorized as adequate (≥50 nmol/L) or inadequate (<50 nmol/L). GWG (kg) was calculated as the difference between the weight measured at baseline and 36-42 gestational weeks. GWG rates (kg/week) were calculated between each visit. Postpartum weight retention (kg) was analysed as the difference between weights measured at 30-62 days postpartum and 5-13 gestational weeks. Statistical analyses were performed using linear regression models that included interaction terms between vitamin D status and first trimester body mass index (BMI) (<25/≥25 kg/m). Confounders were selected based on a directed acyclic graph.

RESULTS

The prevalence of vitamin D inadequacy was 16.6%, 9.9% and 10.6% in the first, second and third trimesters, respectively. Overweight women with vitamin D inadequacy in the first (β = 3.70; 95% CI 0.09; 7.31, p-value = 0.045) and third trimester (β = 4.59, 95% CI 0.07; 9.10, p-value = 0.047) presented higher increases in total GWG than did women with vitamin D adequacy. This association was also observed between first trimester vitamin D status and GWG rates between visits 1 and 2 (β = 0.17; 95% CI 0.13; 0.36, p-value = 0.07).

CONCLUSIONS

There was an interaction effect of first trimester BMI (≥25 kg/m) on the association between first and third trimester vitamin D status and GWG.

摘要

目的

评估妊娠期间维生素 D 状况与总孕期体重增加(GWG)、GWG 率和产后体重滞留之间的关系。

方法

对来自里约热内卢的 163 名女性进行前瞻性队列研究,在 5-13 周(基线)、20-26 周、30-36 周妊娠和 30-62 天产后进行随访。在每个孕期末期评估血浆 25-羟维生素 D [25(OH)D],并将其分类为充足(≥50 nmol/L)或不足(<50 nmol/L)。GWG(kg)计算为基线测量体重与 36-42 周妊娠周之间的差值。GWG 率(kg/周)在每次就诊时计算。产后体重滞留(kg)分析为产后 30-62 天测量体重与 5-13 周妊娠之间的差值。使用线性回归模型进行统计分析,该模型包括维生素 D 状态和孕早期体重指数(BMI)(<25/≥25 kg/m)之间的交互项。根据有向无环图选择混杂因素。

结果

第一、二、三季度维生素 D 不足的发生率分别为 16.6%、9.9%和 10.6%。在第一和第三孕期维生素 D 不足的超重女性总 GWG 增加量高于维生素 D 充足的女性(β=3.70;95%CI 0.09;7.31,p 值=0.045)和第三孕期(β=4.59,95%CI 0.07;9.10,p 值=0.047)。在第一个孕期维生素 D 状况与就诊 1 和 2 之间的 GWG 率之间也观察到了这种关联(β=0.17;95%CI 0.13;0.36,p 值=0.07)。

结论

孕早期 BMI(≥25 kg/m)与第一和第三孕期维生素 D 状况与 GWG 之间的关系存在交互作用。

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