Nutrition Research Division, Bureau of Nutritional Sciences, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada.
School of Human Nutrition, McGill University, Ste Anne de Bellevue, Québec, Canada.
J Nutr. 2022 Jan 11;152(1):255-268. doi: 10.1093/jn/nxab344.
Vitamin D status at birth is reliant on maternal-fetal transfer of vitamin D during gestation.
We aimed to examine the vitamin D status of newborn infants in a diverse population and to subsequently identify the modifiable correlates of vitamin D status.
In this cross-sectional study, healthy mother-infant dyads (n = 1035) were recruited within 36 h after term delivery (March 2016-March 2019). Demographic and lifestyle factors were surveyed. Newborn serum 25-hydroxyvitamin D [25(OH)D] was measured (standardized chemiluminescence immunoassay) and categorized as deficient [serum 25(OH)D <30 nmol/L] or adequate (≥40 nmol/L). Serum 25(OH)D was compared among categories of maternal characteristics using ANOVA; each characteristic was tested in a separate model. Subgroups (use of multivitamins preconception and continued in pregnancy compared with during pregnancy only) were matched (n = 352/group) for maternal factors (ancestry, age, income, education, parity, and prepregnancy BMI) using propensity scores; logistic regression models were generated for odds of deficiency or adequacy.
Infants' mean serum 25(OH)D was 45.9 nmol/L (95% CI: 44.7, 47.0 nmol/L) (n = 1035), with 20.8% (95% CI: 18.3%, 23.2%) deficient and 60.7% (95% CI: 55.2%, 66.2%) adequate. Deficiency prevalence ranged from 14.6% of white infants to 41.7% of black infants. Serum 25(OH)D was higher (P < 0.0001) in infants of mothers with higher income, BMI < 25 kg/m2, exercise and sun exposure in pregnancy, and use of multivitamins preconception. In the matched-subgroup analysis, multivitamin supplementation preconception plus during pregnancy relative to only during pregnancy was associated with lower odds for vitamin D deficiency (ORadj: 0.55; 95% CI: 0.36, 0.86) and higher odds for adequate vitamin D status (ORadj: 1.47; 95% CI: 1.04, 2.07).
In this study most newborn infants had adequate vitamin D status, yet one-fifth were vitamin D deficient with disparities between population groups. Guidelines for a healthy pregnancy recommend maternal use of multivitamins preconception and continuing in pregnancy. An emphasis on preconception use may help to achieve adequate neonatal vitamin D status.This trial was registered at clinicaltrials.gov as NCT02563015.
新生儿的维生素 D 状态取决于妊娠期间母体向胎儿的维生素 D 转移。
我们旨在检查不同人群中新生儿的维生素 D 状态，并随后确定维生素 D 状态的可改变相关因素。
在这项横断面研究中，在足月分娩后 36 小时内（2016 年 3 月至 2019 年 3 月）招募了健康的母婴二人组（n=1035）。调查了人口统计学和生活方式因素。测量了新生儿血清 25-羟维生素 D [25（OH）D]（标准化化学发光免疫测定），并将其分类为缺乏[血清 25（OH）D <30 nmol/L]或充足（≥40 nmol/L）。使用方差分析比较了母体特征类别之间的血清 25（OH）D；每个特征都在单独的模型中进行了测试。使用倾向评分（propensity scores）对使用多维维生素（孕前和怀孕期间使用，而不是仅在怀孕期间使用）的亚组（n=352/组）进行了匹配（n=1035），以匹配母体因素（祖籍、年龄、收入、教育程度、生育次数和孕前 BMI）；使用逻辑回归模型生成了缺乏或充足的可能性。
婴儿的平均血清 25（OH）D 为 45.9 nmol/L（95%CI：44.7，47.0 nmol/L）（n=1035），20.8%（95%CI：18.3%，23.2%）缺乏，60.7%（95%CI：55.2%，66.2%）充足。缺乏症的患病率从白人婴儿的 14.6%到黑人婴儿的 41.7%不等。血清 25（OH）D 在收入较高、BMI<25 kg/m2、怀孕期间运动和晒太阳以及孕前使用多维维生素的母亲的婴儿中较高（P<0.0001）。在匹配的亚组分析中，与仅在怀孕期间使用相比，孕前和怀孕期间使用多维维生素与维生素 D 缺乏症的几率降低（ORadj：0.55；95%CI：0.36，0.86）和维生素 D 充足的几率升高（ORadj：1.47；95%CI：1.04，2.07）相关。
在这项研究中，大多数新生儿的维生素 D 状态充足，但仍有五分之一的新生儿维生素 D 缺乏，人群之间存在差异。健康妊娠指南建议母亲在孕前和怀孕期间使用多维维生素。强调孕前使用可能有助于实现新生儿充足的维生素 D 状态。这项试验在 clinicaltrials.gov 上注册为 NCT02563015。
