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中国无锡人群中母体维生素 D 状况与妊娠结局和后代生长的关系。

Association between maternal vitamin D status with pregnancy outcomes and offspring growth in a population of Wuxi, China.

机构信息

Department of Child Health Care, the Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University, Wuxi, Jiangsu, China.

Department of Epidemiology and Biostatics, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China.

出版信息

Asia Pac J Clin Nutr. 2021 Sep;30(3):464-476. doi: 10.6133/apjcn.202109_30(3).0013.

Abstract

BACKGROUND AND OBJECTIVES

The role of maternal vitamin D in infantile growth remains unclear.

METHODS AND STUDY DESIGN

Serum 25-hydroxyvitamin D [25(OH)D] concentrations were examined for pregnancies who visited the Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University from January 2016 to December 2017. Anthropometric measurements of corresponding offspring were performed from birth to 2 to 3 years old. Infantile body mass index (BMI) was transformed into age-, sex- and height- normalized z scores, and Latent Class Growth Mixture (LCGM) model was used to identify trajectories of BMI-Z.

RESULTS

Among the 329 included pregnancy women, 109 (33.13 %), 190 (57.75%) and 30 (9.12%) were defined as vitamin D deficiency [25(OH)D <30 nmol/L], insufficiency [30 nmol/L≤25(OH)D<50 nmol/L] and sufficiency [25(OH)D ≥50 nmol/L], respectively. When compared with vitamin D sufficiency, maternal vitamin D deficiency was not associated with preterm birth [odds ratio (OR)=2.69, 95% confidence interval (95% CI)=0.57-12.80], small for gestation age (OR=0.99, 95% CI=0.29-3.46), and low birth weight (OR=1.69, 95% CI=0.34-8.51). Similarly, no significant relationships were found between maternal vitamin D concentrations and anthropometric indices (such as weight, length, BMI) during 0 to 3 years old. Furthermore, LCGM model identified two patterns of offspring growth: stable moderate BMI-Z and early transient BMI-Z groups. Maternal vitamin D levels were higher in the former group than the latter (p=0.037); however, maternal vitamin D status appeared to be unrelated with offspring BMI-Z trajectories in multivariable logistic regression models.

CONCLUSIONS

Maternal vitamin D deficiency may not be related to adverse pregnancy outcomes as well as offspring growth.

摘要

背景与目的

母体维生素 D 对婴儿生长的作用尚不清楚。

方法和研究设计

检测了 2016 年 1 月至 2017 年 12 月期间在南京医科大学附属无锡妇幼保健院就诊的孕妇的血清 25-羟维生素 D [25(OH)D]浓度。对相应的后代进行出生至 2 至 3 岁的人体测量学测量。婴儿的体重指数(BMI)转换为年龄、性别和身高标准化 z 分数,使用潜在类别增长混合(LCGM)模型识别 BMI-Z 的轨迹。

结果

在 329 名纳入的妊娠妇女中,分别有 109 名(33.13%)、190 名(57.75%)和 30 名(9.12%)被定义为维生素 D 缺乏症[25(OH)D <30 nmol/L]、不足症[30 nmol/L≤25(OH)D<50 nmol/L]和充足症[25(OH)D ≥50 nmol/L]。与维生素 D 充足相比,母体维生素 D 缺乏与早产(比值比[OR]=2.69,95%置信区间[95%CI]=0.57-12.80)、小于胎龄儿(OR=0.99,95%CI=0.29-3.46)和低出生体重(OR=1.69,95%CI=0.34-8.51)无关。同样,母体维生素 D 浓度与 0 至 3 岁期间的人体测量学指标(如体重、长度、BMI)之间也没有显著关系。此外,LCGM 模型确定了后代生长的两种模式:稳定的中等 BMI-Z 和早期短暂的 BMI-Z 组。前者的母体维生素 D 水平高于后者(p=0.037);然而,在多变量逻辑回归模型中,母体维生素 D 状况与后代 BMI-Z 轨迹似乎无关。

结论

母体维生素 D 缺乏可能与不良妊娠结局以及后代生长无关。

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