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孕妇哮喘患者血清 25 羟维生素 D 水平:与母体特征及不良母婴结局的关系。

Serum 25 Hydroxyvitamin D Levels During Pregnancy in Women with Asthma: Associations with Maternal Characteristics and Adverse Maternal and Neonatal Outcomes.

机构信息

Priority Research Centre Grow Up Well, Hunter Medical Research Institute and University of Newcastle, New Lambton Heights, NSW 2305, Australia.

Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA 02114, USA.

出版信息

Nutrients. 2020 Sep 29;12(10):2978. doi: 10.3390/nu12102978.

Abstract

Low 25-hydroxyvitamin D (25(OH)D) levels are common in pregnancy and associated with adverse maternal/neonatal outcomes. In pregnant women with asthma, this study examined the association of lifestyle- and asthma-related factors on 25(OH)D levels and maternal/neonatal outcomes by vitamin D status. Serum 25(OH)D was measured at 16 and 35 weeks gestation in women with asthma ( = 103). Body mass index (BMI), gestational weight gain (GWG), smoking status, inhaled corticosteroid (ICS) use, asthma control, airway inflammation, and exacerbations, and maternal/neonatal outcomes were collected. Baseline and change (Δ) in 25(OH)D were modelled separately using backward stepwise regression, adjusted for season and ethnicity. Maternal/neonatal outcomes were compared between low (25(OH)D < 75 nmol/L at both time points) and high (≥75 nmol/L at one or both time points) vitamin D status. Fifty-six percent of women had low vitamin D status. Obesity was significantly associated with lower baseline 25(OH)D (Adj-R = 0.126, = 0.008); ICS and airway inflammation were not. Excess GWG and season of baseline sample collection were significantly associated with Δ25(OH)D (Adj-R = 0.405, < 0.0001); asthma-related variables were excluded ( > 0.2). Preeclampsia was more common in the low (8.6%) vs. high (0%) vitamin D group ( < 0.05). Obesity and excess GWG may be associated with gestational 25(OH)D levels, highlighting the importance of antenatal weight management.

摘要

低 25-羟维生素 D(25(OH)D)水平在妊娠中很常见,与不良的母婴/新生儿结局相关。在患有哮喘的孕妇中,本研究通过维生素 D 状态检查了生活方式和哮喘相关因素对 25(OH)D 水平和母婴/新生儿结局的关联。在哮喘孕妇中(n=103),在妊娠 16 周和 35 周时测量血清 25(OH)D。收集体重指数(BMI)、妊娠体重增加(GWG)、吸烟状况、吸入皮质类固醇(ICS)使用、哮喘控制、气道炎症和加重、母婴/新生儿结局等数据。使用逐步向后回归模型分别对 25(OH)D 的基线和变化(Δ)进行建模,调整季节和种族因素。比较低(两个时间点的 25(OH)D<75nmol/L)和高(一个或两个时间点的 25(OH)D≥75nmol/L)维生素 D 状态之间的母婴/新生儿结局。56%的女性维生素 D 状态较低。肥胖与较低的基线 25(OH)D 显著相关(调整后 R=0.126,=0.008);ICS 和气道炎症则无相关性。GWG 过量和基线样本采集季节与 Δ25(OH)D 显著相关(调整后 R=0.405,<0.0001);排除与哮喘相关的变量(>0.2)。低维生素 D 组(8.6%)子痫前期的发生率明显高于高维生素 D 组(0%)(<0.05)。肥胖和 GWG 过量可能与妊娠期 25(OH)D 水平相关,突出了产前体重管理的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d42d/7600161/937ea6db9c87/nutrients-12-02978-g001.jpg

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