孕妇、乳母及婴儿补充钙和维生素D对婴儿骨碱性磷酸酶的影响

Effects of calcium and vitamin D supplementation on bone specific alkaline during pregnancy lactation and infant

目的调查研究孕妇、乳母及婴儿补充钙和维生素D的状况与婴儿骨质发育的关系。方法对2006年10月～2008年1月在北京妇产医院儿科就诊的1176例健康母-婴进行面对面的回顾性问卷调查,了解在母亲孕期和哺乳期以及婴儿期补充钙和维生素D的状况,同时检测婴儿全血骨碱性磷酸酶(BAP)的活性,并测量婴儿前囟斜径。用卡方检验和logistic回归对调查结果进行统计分析。结果母亲孕期补钙对婴儿的BAP活性没有显著影响(P=0.154)。在188名纯母乳喂养儿中,母亲在哺乳期补充钙和维生素D,可显著降低婴儿全血BAP的活性(P=0.018)。用logistic回归分析婴儿的喂养方式和是否补充钙和维生素D对婴儿全血BAP活性的影响,结果表明仅婴儿补充钙和维生素D可显著降低全血BAP的活性(P=0.000),而喂养方式对BAP活性没有显著影响影响。对婴儿前囟门大小的分析,42天内婴儿的前囟门大小与BAP活性有明显负关联,但与母亲孕期是否补钙没有关联。结论母亲哺乳期和婴儿补充钙和维生素D可显著降低婴儿全血BAP的活性。婴儿前囟门大小不能作为是否缺钙的判断依据。

Objective To investigate the effect of calcium and vitamin D supplementation during pregnancy, lactation and infants on bone development of infant. Methods 1176 health infants aged 42-365 days and their mothers were recruited as subjects at Pediatric Department in Beijing Obstetrics and Gynecology Hospital during November 2006 to January 2008. Retrospective questionnaire was asked about calcium and vitamin D supplementation during pregnancy, lactation and infant. Blood bone-specific alkaline （BAD） and fontanel anterior （FA） of infant were measured. X2 test and logistic regression were used to analyze the research data. Results The X^2 test result showed that maternal supplementation with Ca and vitamin D during breasffeeding could decrease infant BAP significantly （ P = 0.018）, while supplementation during pregnancy could not （P = 0.154）. The logistic regression result showed that infant supplementation with Ca and Vitamin D could decrease infant BAP significantly （P = 0.000）, while infant feeding methods could not （P 〉 0.05）. The FA size of infants aged ~〈 42days had significant negative relationship with BAP （P = 0.017 ）, and no relationship with Ca and vitmin D supplementation during pregnancy. Conehtsion Supplementation with Ca and vitamin D of mother during lactation and infant could significantly decrease infant BAD. The FA size could not indicate the infant calcium status.