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孕母和新生儿维生素D水平及其相关因素的分析

Maternal-neonatal vitamin D status and related factors

摘要目的 了解孕母与新生儿维生素D水平及相关的影响因素.方法 采用酶联免疫法检测499名30 ~37周孕龄的母亲和配对新生儿脐血的血清25-羟维生素D[25-(OH)D]浓度,并采用直线相关和回归及二分类logistic回归进行关联性和相关影响因素的横断面分析.结果 孕母血清25-(OH)D水平为(33.0±13.4) nmol/L,新生儿为(31.0±12.5)nmoL/L,分别有88.8%的母亲及91.2%的新生儿血清25-(OH)D水平<50 nmol/L.孕母及新生儿25-(OH)D水平存在明显的季节差异(均P=0.000),春季最低,98.6%的孕母和99.3%的新生儿25-(OH)D水平<50 nmol/L;秋季最高,但仍有64.0%的孕母及75.O%的新生儿<50 nmol/L.除季节外,孕期钙维生素D合剂补充和蛋类摄入≥600 g/周有利于提高孕母维生素D水平[ 25-( OH) D≥50 nmol/L](OR值分别为2.3、3.4,均P =0.000).孕母-新生儿25-(OH)D水平呈正相关(r=0.45,P=0.000),当孕母25-(OH)D水平≤25 nmol/L时,则两者相关性无统计学意义(P>0.05).结论 孕母及其新生儿的维生素D水平普遍较低,以春季最低;含维生素D制剂及富含维生素D食物的摄入可改善维生素D营养状况;孕母-新生儿25-(OH)D水平呈中度正相关,当孕母25-(OH)D水平≤25 nmol/L时,则两者相关性不明显.

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abstractsObjective To determine the relationship between maternal and neonatal vitamin D status and related factors.Method Serum 25-( OH ) D levels were measured by ELISA in 499 pregnant women at 30-37 weeks gestation and in cord blood of their infants born at term (37-42 wk gestation ) in Southeastern China at 28.9° N latitude.One-way analysis of variance (ANOVA) was used to explore maternal and neonatal vitamin D levels by season.Pearson linear and linear regression of partial correlation was used to analyze the relationship between maternal and neonatal 25-( OH ) D levels.The multiple factors related to maternal vitamin D status was assessed by binary logistic regression.Result The levels of serum 25-(OH) D were ( 33.0 ± 13.4) nmol/L in mothers and (31.0 ± 12.5 ) nmol/L in their newborns.Serum 25-(OH) D < 50 nmol/L was shown in 88.8% of mothers and 91.2% of their neonates.Both maternal and neonatal 25- ( OH ) D levels varied with season ( Ps =0.000).Vitamin D level was the lowest in spring,with the 25-( OH ) D concentration < 50 nmol/L in 98.6% of mothers and 99.3% of their neonates.The highest vitamin D level was presented in fall,but there were still 64.0% of mothers and 75.0% of neonates with 25-(OH) D <50 nmol/L.Except for season,calcium-vitamin D supplement and intake of egg ≥600 g per week during pregnancy benefited to improve maternal vitamin D level [25-(OH) D ≥50 nmol/L] [ OR =2.3(95%CI:1.0,5.3),3.4(95%CI:1.2,9.9) respectively].There was a positive correlation between maternal and neonatal 25-( OH ) D measures in the sample as a whole ( r =0.45,P =0.000,N =499),the correlation was of no statistical significance when maternal serum 25-(OH) D was ≤25 nmol/L Conclusion Hypovitaminosis D was common in late pregnant motbers and their newborns in southeastern China,especially in spring.Vitamin D supplement and intake of vitamin D-rich food were beneficial to improvement of maternal vitamin D level.There was a moderate and positive correlation between maternal and neonatal 25-( OH )D concentrations in this population.The correlation was lost when maternal serum 25-( OH )D ≤25 nmol/L.

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中华儿科杂志

中华儿科杂志

2012年50卷7期

498-503页

MEDLINEISTICPKUCSCDCA

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