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维生素 D 缺乏与早产和子痫前期关联的证据:批判性评价。

Evidence of an Association Between Vitamin D Deficiency and Preterm Birth and Preeclampsia: A Critical Review.

机构信息

Texas Woman's University, Denton, Texas.

Parkland Memorial Hospital, Dallas, Texas.

出版信息

J Midwifery Womens Health. 2019 Sep;64(5):613-629. doi: 10.1111/jmwh.13014. Epub 2019 Aug 14.

Abstract

Vitamin D deficiency has been associated with adverse pregnancy and birth outcomes such as increased risk for preterm birth and preeclampsia. This state of the science review analyzed recently published meta-analyses and relevant studies that have evaluated the association between vitamin D deficiency and preeclampsia or preterm birth. The results suggest that a positive association between vitamin D deficiency and preterm birth exists. However, the findings of the relationship between vitamin D deficiency and preeclampsia were inconclusive, possibly because of the need for supplementation to occur prior to placentation. This may be because of a lack of studies with ethnic minority populations, who are more likely to experience vitamin D deficiency, and inadequate supplementation doses used for treatment of vitamin D deficiency. Health care providers should screen pregnant women at risk for vitamin D deficiency and supplement women accordingly based on their vitamin D status. Lastly, well-designed and standardized clinical trials need to include large cohorts of minority pregnant women to establish the impact of vitamin D supplementation on improving preterm birth and preeclampsia risk in pregnancy.

摘要

维生素 D 缺乏与不良妊娠和分娩结局有关,如早产和子痫前期的风险增加。本科学综述分析了最近发表的荟萃分析和相关研究,评估了维生素 D 缺乏与子痫前期或早产之间的关系。结果表明,维生素 D 缺乏与早产之间存在正相关关系。然而,维生素 D 缺乏与子痫前期之间的关系的研究结果尚无定论,这可能是因为需要在胎盘形成之前进行补充。这可能是由于缺乏对少数民族人群的研究,这些人群更有可能出现维生素 D 缺乏,以及治疗维生素 D 缺乏症时使用的补充剂量不足。医疗保健提供者应筛查有维生素 D 缺乏风险的孕妇,并根据其维生素 D 状况进行相应的补充。最后,需要进行精心设计和标准化的临床试验,纳入大量少数族裔孕妇,以确定维生素 D 补充对改善早产和子痫前期风险的影响。

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