Department of Obstetrics and Gynecology, University of Health Sciences, BursaYuksek Ihtisas Research and Training Hospital, Bursa, Turkey.
Şişli Kolan Hospital, Istanbul, Turkey.
J Obstet Gynaecol Res. 2024 Oct;50(10):1841-1847. doi: 10.1111/jog.16069. Epub 2024 Sep 3.
Although vitamin D deficiency in smokers has a greater risk of low birth weight than vitamin D deficiency or smoking alone, there is no study searching birth weight in vitamin D deficient passive smokers. We evaluated the effect of vitamin D deficiency on birth weight in active and passive smokers. Additionally, we aimed to determine the predictive role of vitamin D for low birth weight in smokers.
The study was designed as a retrospective case control study. A total of 210 participants were divided into three groups: active smoking (n = 34), passive smoking (n = 79), and non-smokers (n = 97). Then passive smokers were divided into two subgroups as vitamin D ≥ 20 ng/mL (n = 23) and vitamin D < 20 ng/mL (n = 56). Sociodemographic, laboratory, and perinatal characteristics were recorded and compared between groups.
Birth weight was higher in non-smokers as compared to active (p < 0.001) and passive (p = 0.001) smokers, and also in passive than active smokers (p = 0.023). In passive smokers, birth weight was lower in vitamin D < 20 ng/mL group (p < 0.001). Vitamin D were correlated with birth weight in all smokers (r = 0.653, p < 0.001), passive (r = 0.624, p < 0.001) and active smokers (r = 0.526, p = 0.001). Vitamin D ≤ 14 ng/mL predicted low birth weight with 100% sensitivity and 53.92% specificity in smokers (area under curve [AUC] = 0.773, p < 0.001), with 100% sensitivity and 63.5% specificity in passive smokers (AUC = 0.759, p < 0.001) while vitamin D ≤ 11 ng/mL predicted with 83.33% sensitivity and 71.43% specificity in active smokers (AUC = 0.774, p = 0.008).
Vitamin D deficiency in smokers is associated with low birth weight. Although vitamin D supplementation is not routinely recommended in pregnant women, we suggest that it could be an option in preventing low birth weight in smokers, even passive ones, who do not have adequate dietary intake and have insufficient exposure to daylight.
尽管与维生素 D 缺乏或单独吸烟相比，吸烟者的维生素 D 缺乏会使低出生体重的风险更大，但尚无研究搜索维生素 D 缺乏的被动吸烟者的出生体重。我们评估了维生素 D 缺乏对主动和被动吸烟者出生体重的影响。此外，我们旨在确定维生素 D 对吸烟者低出生体重的预测作用。
该研究设计为回顾性病例对照研究。共有 210 名参与者被分为三组：主动吸烟组（n=34）、被动吸烟组（n=79）和非吸烟组（n=97）。然后，将被动吸烟者分为两组：维生素 D≥20ng/ml（n=23）和维生素 D＜20ng/ml（n=56）。记录并比较了各组的社会人口学、实验室和围产期特征。
与主动吸烟者（p＜0.001）和被动吸烟者（p=0.001）相比，非吸烟者的出生体重更高，与主动吸烟者相比，被动吸烟者的出生体重也更高（p=0.023）。在维生素 D＜20ng/ml 的被动吸烟者中，出生体重较低（p＜0.001）。所有吸烟者（r=0.653，p＜0.001）、被动吸烟者（r=0.624，p＜0.001）和主动吸烟者（r=0.526，p=0.001）的维生素 D 与出生体重呈正相关。维生素 D≤14ng/ml 对吸烟者的低出生体重具有 100%的敏感性和 53.92%的特异性（曲线下面积[AUC]为 0.773，p＜0.001），对被动吸烟者的低出生体重具有 100%的敏感性和 63.5%的特异性（AUC=0.759，p＜0.001），而维生素 D≤11ng/ml 对主动吸烟者的低出生体重的预测具有 83.33%的敏感性和 71.43%的特异性（AUC=0.774，p=0.008）。
吸烟者的维生素 D 缺乏与低出生体重有关。尽管不常规建议孕妇补充维生素 D，但我们建议，即使是那些饮食摄入不足且日光照射不足的被动吸烟者，也可以选择补充维生素 D，以预防低出生体重。
