Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, RJ, 21941-590, Brazil.
Postgraduate Program in Nutrition, Institute of Nutrition Josué de Castro, Rio de Janeiro Federal University, Rio de Janeiro, RJ, 21941-590, Brazil.
Eur J Clin Nutr. 2021 Mar;75(3):489-500. doi: 10.1038/s41430-020-00733-0. Epub 2020 Sep 2.
BACKGROUND/OBJECTIVES: Evidence is lacking on how variation in vitamin D concentrations during gestation affects perinatal outcomes. Therefore, we evaluated the association between vitamin D serum concentrations during pregnancy and neonatal outcomes.
A prospective cohort of 180 healthy Brazilian pregnant women was followed and plasma 25-hydroxyvitamin [25(OH)D, nmol/L] was measured at 5-13 (baseline), 20-26 and 30-36 gestational weeks. Birth weight (BW), birth length (BL), BW z-scores, BL z-scores, first minute Apgar, small for gestational age (SGA), large for gestational age (LGA) and preterm birth were the outcomes. Multiple linear and Poisson regression models were estimated. Best linear unbiased prediction of random coefficients model was used to determine the association between the mean rate of change in vitamin D during pregnancy concentrations and neonatal outcomes.
Mean (SD) BW was 3300 (600) g, BW z-score 0.34 (1.11), BL 49.3 (3.3) cm, BL z-score 0.44 (1.5), and first minute Apgar score 8.2 (1.4). Prevalence of SGA, LGA and preterm birth were 6%, 18% and 13%, respectively. 25(OH)D was directly associated with the risk of preterm birth at all trimesters. Incidence-rate ratios were 1.02, 1.05 and 1.04 for the 1st, 2nd and 3rd trimester, respectively. Mean rate of change during pregnancy in 25(OH)D was directly associated with BW z-score (β: 0.36, 95% CI 0.07; 0.65), LGA risk (IRR: 1.97, 95% CI 1.07; 3.63) and preterm birth (IRR: 7.35, 95% CI 2.99; 18.07).
Mean 25(OH)D rate of change during pregnancy was directly associated with BW z-scores, and increased LGA and preterm birth risk.
背景/目的：关于妊娠期间维生素 D 浓度变化如何影响围产期结局，目前证据不足。因此，我们评估了妊娠期间维生素 D 血清浓度与新生儿结局之间的关系。
前瞻性纳入 180 名健康的巴西孕妇进行随访，并在妊娠 5-13 周（基线）、20-26 周和 30-36 周时测量血浆 25-羟维生素 D [25(OH)D，nmol/L]。出生体重（BW）、出生长度（BL）、BW z 评分、BL z 评分、1 分钟 Apgar 评分、小于胎龄儿（SGA）、大于胎龄儿（LGA）和早产是结局。采用多元线性和泊松回归模型进行估计。最佳线性无偏预测随机系数模型用于确定妊娠期间维生素 D 浓度平均变化率与新生儿结局之间的关系。
平均（SD）BW 为 3300（600）g，BW z 评分 0.34（1.11），BL 为 49.3（3.3）cm，BL z 评分 0.44（1.5），1 分钟 Apgar 评分为 8.2（1.4）。SGA、LGA 和早产的患病率分别为 6%、18%和 13%。25(OH)D 与所有孕期早产风险呈直接相关。第 1、2 和 3 孕期的发生率比值分别为 1.02、1.05 和 1.04。妊娠期间 25(OH)D 的平均变化率与 BW z 评分呈直接相关（β：0.36，95%CI 0.07；0.65）、LGA 风险（IRR：1.97，95%CI 1.07；3.63）和早产（IRR：7.35，95%CI 2.99；18.07）。
妊娠期间 25(OH)D 的平均变化率与 BW z 评分直接相关，并增加了 LGA 和早产的风险。
