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口服避孕药可增加哺乳期妇女的循环 25-羟维生素 D 浓度。

Oral Contraceptive Pills Increase Circulating 25-Hydroxy-Vitamin D Concentrations in Women Who Are Lactating.

机构信息

Department of Pediatrics, Division of Neonatology, Medical University of South Carolina, Charleston, South Carolina.

Department of Pediatrics, Uniformed Services University, Bethesda, Maryland.

出版信息

Am J Perinatol. 2024 May;41(S 01):e2759-e2766. doi: 10.1055/s-0043-1775561. Epub 2023 Sep 19.

Abstract

OBJECTIVE

This article aims to determine the association between maternal 25-hydroxy-vitamin D [25(OH)D] status and intake of hormonal oral contraceptive pills (OCPs) in women who are lactating.

STUDY DESIGN

Women who were exclusively breastfeeding participated in a randomized controlled trial assessing vitamin D supplementation at 400, 2,400, or 6,400 international unit (IU)/d from 1 month through 7 months postpartum. This observational, secondary analysis assessed whether OCPs were associated with maternal 25(OH)D concentrations in women who are lactating. Multivariate regression models were used to predict 25(OH)D concentrations and create parameter estimates for each variable.

RESULTS

In a bivariate analysis, the use of OCPs at 4 months was associated with increased serum 25(OH)D ( = 0.02). OCPs' use at 7 months was associated with a higher trend in 25(OH)D, but this finding was not statistically significant ( = 0.1). In a multivariate regression model at 4 months, independent positive predictors of 25(OH)D concentrations were the use of OCPs ( = 0.03) and treatment with vitamin D at 6,400 IU/d ( ≤ 0.0001). Negative predictors were Black ( = 0.001) and Hispanic ( = 0.0001) race and ethnicity, and body mass index (BMI) greater than 30 ( = 0.0002). The same pattern occurred at 7 months, with more southern latitude as a positive independent predictor ( = 0.04) of 25(OH)D concentration.

CONCLUSION

The use of OCPs was associated with greater 25(OH)D in women who are lactating. Additionally, treatment with vitamin D at 6,400 IU/d and southern latitude was associated with greater 25(OH)D in women who are lactating. Black and Hispanic race and ethnicity, and BMI greater than 30, were independently associated with lower 25(OH)D in women who are lactating.

KEY POINTS

· The association of OCP with serum 25(OH)D concentrations during postpartum lactation is unknown.. · OCPs' use was associated with higher 25(OH)D concentrations in postpartum women who are lactating.. · Treatment with vitamin D and southern latitude was associated with greater 25(OH)D in women who are lactating.. · Black and Hispanic, and BMI > 30 were associated with lower 25(OH)D in women who are lactating.. · Practitioners can counsel women who are lactating on OCPs' use and the positive effects on their 25(OH)D status..

摘要

目的

本文旨在确定哺乳期妇女维生素 D 状态与激素口服避孕药(OCP)摄入之间的关系。

研究设计

仅母乳喂养的女性参加了一项随机对照试验,评估了从产后 1 个月到 7 个月期间每天补充 400、2400 或 6400 国际单位(IU)维生素 D 对维生素 D 补充的影响。这项观察性的二次分析评估了哺乳期妇女 OCP 的使用是否与母体 25-羟维生素 D(25(OH)D)浓度相关。使用多元回归模型预测 25(OH)D 浓度并为每个变量创建参数估计值。

结果

在单变量分析中,4 个月时使用 OCP 与血清 25(OH)D 增加有关(=0.02)。7 个月时 OCP 的使用与 25(OH)D 呈较高趋势相关,但无统计学意义(=0.1)。在 4 个月的多元回归模型中,25(OH)D 浓度的独立正预测因子是使用 OCP(=0.03)和维生素 D 治疗 6400IU/d(≤0.0001)。负预测因子是黑人和西班牙裔(=0.001)种族和民族,以及 BMI 大于 30(=0.0002)。7 个月时也出现了相同的模式,南部纬度作为 25(OH)D 浓度的独立正预测因子(=0.04)。

结论

OCP 的使用与哺乳期妇女 25(OH)D 增加有关。此外,6400IU/d 维生素 D 治疗和南部纬度与哺乳期妇女 25(OH)D 增加有关。黑人和西班牙裔种族和民族以及 BMI 大于 30 与哺乳期妇女 25(OH)D 降低有关。

重点

· 产后哺乳期妇女 OCP 与血清 25(OH)D 浓度之间的关系尚不清楚。· OCP 的使用与产后哺乳期妇女 25(OH)D 浓度升高有关。· 维生素 D 治疗和南部纬度与哺乳期妇女 25(OH)D 增加有关。· 黑人和西班牙裔以及 BMI>30 与哺乳期妇女 25(OH)D 降低有关。· 从业者可以为哺乳期妇女提供有关 OCP 使用及其对 25(OH)D 状态影响的咨询。

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