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母体和新生儿维生素D水平与高胆红素血症:一项系统评价和荟萃分析。

Maternal and neonatal vitamin D levels and hyperbilirubinemia: A systematic review and meta-analysis.

作者信息

Ghavi Arezoo, Meert Kathleen L, Asghari-Jafarabadi Mohammad, Renirie Rebecca Hill, Mohammadi-Pirouz Zahra

机构信息

Department of Nursing, Fe.C., Islamic Azad University, Ferdows, Iran.

Department of Pediatrics, Children's Hospital of Michigan, Detroit, MI, USA; Central Michigan University, Mt. Pleasant, MI, USA.

出版信息

Clin Nutr ESPEN. 2025 Aug;68:715-726. doi: 10.1016/j.clnesp.2025.06.030. Epub 2025 Jun 13.

Abstract

BACKGROUND & AIMS: Vitamin D (Vit D) deficiency during pregnancy may have potential adverse effects on the health of mothers and neonates. The relationship between Vit D deficiency and neonatal hyperbilirubinemia is unknown. The aim of this study is to determine the relationship between Vit D levels in mothers and neonates and the occurrence of neonatal hyperbilirubinemia.

METHODS

This systematic review and meta-analysis were guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A literature search was conducted in electronic databases: PubMed, Cochrane, CINAHL, Scopus, Web of Science, Ovid MEDLINE, and MEDLINE Ultimate until the end of 2024 to find studies published in English that investigated Vit D levels in mothers or neonates and their associations with hyperbilirubinemia. The Newcastle Ottawa Scale (NOS) tool was used to assess the quality of the articles included. A random effects model was used for (subgroup) meta-analyses, assessing heterogeneity with I-squared, publication bias with funnel plot, Egger and Begg tests, and conducting meta-regression to explore heterogeneity sources.

RESULTS

Of the 29 studies included in this systematic review, 25 were eligible for meta-analysis. Despite the overall lack of significant results in some aspects of this meta-analysis, the random-effects model showed that Vit D levels were significantly lower during pregnancy in mothers of neonates with hyperbilirubinemia compared to mothers of neonates without hyperbilirubinemia (MD: -7.98 nmol/L, 95%CI: -11.02 to -4.94, I2: 49.82 %, p < 0.001). Additionally, Vit D levels were significantly lower in neonates with hyperbilirubinemia compared to neonates without hyperbilirubinemia (MD: -19.53 nmol/L, 95%CI: -25.42 to -13.64, I2: 93.76 %, p < 0.001).

CONCLUSIONS

This review suggests that higher maternal Vit D levels during pregnancy may lead to higher Vit D levels in neonates and ultimately a lower risk of neonatal hyperbilirubinemia.

摘要

背景与目的

孕期维生素D(Vit D)缺乏可能对母亲和新生儿的健康产生潜在不利影响。Vit D缺乏与新生儿高胆红素血症之间的关系尚不清楚。本研究的目的是确定母亲和新生儿的Vit D水平与新生儿高胆红素血症发生之间的关系。

方法

本系统评价和荟萃分析遵循系统评价和荟萃分析的首选报告项目(PRISMA)进行。在电子数据库中进行文献检索:PubMed、Cochrane、CINAHL、Scopus、Web of Science、Ovid MEDLINE和MEDLINE Ultimate,检索截至2024年底发表的英文研究,这些研究调查了母亲或新生儿的Vit D水平及其与高胆红素血症的关联。使用纽卡斯尔渥太华量表(NOS)工具评估纳入文章的质量。采用随机效应模型进行(亚组)荟萃分析,用I²评估异质性,用漏斗图、Egger检验和Begg检验评估发表偏倚,并进行meta回归以探索异质性来源。

结果

在本系统评价纳入的29项研究中,25项符合荟萃分析的条件。尽管该荟萃分析在某些方面总体缺乏显著结果,但随机效应模型显示,与无高胆红素血症新生儿的母亲相比,高胆红素血症新生儿的母亲在孕期的Vit D水平显著更低(MD:-7.98 nmol/L,95%CI:-11.02至-4.94,I²:49.82%,p<0.001)。此外,与无高胆红素血症的新生儿相比,高胆红素血症新生儿的Vit D水平显著更低(MD:-19.53 nmol/L,95%CI:-25.42至-13.64,I²:93.76%,p<0.001)。

结论

本综述表明,孕期母亲较高的Vit D水平可能导致新生儿较高的Vit D水平,并最终降低新生儿高胆红素血症的风险。

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