Anusha Kaneshapillai, Hettiaratchi Usha, Gunasekera Dulani, Prathapan Shamini, Liyanage Guwani
Department of Biochemistry, Faculty of Medical Sciences, University of Sri Jayewardenepura, Sri Lanka.
Department of Paediatrics, Faculty of Medical Sciences, University of Sri Jayewardenepura, Sri Lanka.
Int J Endocrinol. 2019 Jul 9;2019:9017951. doi: 10.1155/2019/9017951. eCollection 2019.
Epidemiologic studies from South Asian countries have reported vitamin D deficiency among all age groups. However, there is very little information on vitamin D levels, especially in the vulnerable populations (pregnant/breast feeding mother and infants) in Sri Lanka. More data on vitamin D status of such populations will be important for policy decisions to be made at a national level. Similarly, it will be valuable for healthcare programs in other countries (e.g., United States, Australia, Europe, and Canada) as Sri Lankans are a fast-growing migrant population to those countries. The purpose of this study was to investigate maternal vitamin D status and its effects on infants in a state sector tertiary care centre in Sri Lanka. This prospective cohort study was conducted on 140 healthy pregnant mothers in the third trimester (mean gestational age 39±1 weeks). Blood was collected for 25(OH)D and parathyroid hormone (PTH). Sun exposure and feeding patterns of the infants were recorded based on maternal reporting. Mean age of the infants at follow-up visit was 36±7 days. Vitamin D (25 (OH)D) deficiency (<25 nmol/L) was observed in 12% pregnant mothers, 5% lactating mothers, and 63% infants. Insufficiency (<50 nmol/L) was found in an additional 51% and 43% in pregnant and lactating mothers and 25% of infants. Mean 25(OH)D was higher in pregnant (46.4±17.5 nmol/L) and lactating (51.9±17.0 nmol/L) mothers than infants (28.1±13.7 nmol/L). Maternal vitamin D level during pregnancy was a significant risk factor (OR: 6.00, 95%CI: 1.522-23.655) for infant deficiency and insufficiency. Sun exposure of infants showed a significant positive correlation with vitamin D level (OR: 3.23, 95%CI: 1.19-8.68). In conclusion, the presence of Vitamin D deficiency/insufficiency is higher in infants compared to pregnant/lactating mothers. Low maternal 25(OH)D during pregnancy was a risk factor for deficiency in infants. Although majority of lactating mothers had sufficient vitamin D, most of their exclusively breastfed offspring were deficient.
南亚国家的流行病学研究报告称，所有年龄组中都存在维生素D缺乏的情况。然而，关于维生素D水平的信息非常少，尤其是斯里兰卡弱势群体（孕妇/哺乳期母亲和婴儿）的维生素D水平。关于这类人群维生素D状况的更多数据，对于国家层面制定政策决策至关重要。同样，对于其他国家（如美国、澳大利亚、欧洲和加拿大）的医疗保健项目也很有价值，因为斯里兰卡人是这些国家中快速增长的移民群体。本研究的目的是在斯里兰卡一家国立三级医疗中心调查母亲的维生素D状况及其对婴儿的影响。这项前瞻性队列研究对140名孕晚期（平均孕周39±1周）的健康孕妇进行。采集血液检测25(OH)D和甲状旁腺激素（PTH）。根据母亲的报告记录婴儿的日照情况和喂养方式。随访时婴儿的平均年龄为36±7天。12%的孕妇、5%的哺乳期母亲和63%的婴儿存在维生素D（25(OH)D）缺乏（<25 nmol/L）。另外，51%的孕妇和43%的哺乳期母亲以及25%的婴儿存在维生素D不足（<50 nmol/L）。孕妇（46.4±17.5 nmol/L）和哺乳期母亲（51.9±17.0 nmol/L）的平均25(OH)D水平高于婴儿（28.1±13.7 nmol/L）。孕期母亲的维生素D水平是婴儿缺乏和不足的一个显著危险因素（OR：6.00，95%CI：1.522 - 23.655）。婴儿的日照情况与维生素D水平呈显著正相关（OR：3.23，95%CI：1.19 - 8.68）。总之，与孕妇/哺乳期母亲相比，婴儿中维生素D缺乏/不足的情况更为普遍。孕期母亲25(OH)D水平低是婴儿缺乏维生素D的一个危险因素。尽管大多数哺乳期母亲的维生素D充足，但她们大多数纯母乳喂养的后代却缺乏维生素D。
