广元地区新生儿与孕母钙和维生素D营养状况的研究

Nutritional Status of Calcium and Vitamin D in Mother-Neonates Pairs in Guangyuan Region.

目的了解广元市妊娠晚期妇女钙(calcium,Ca)及维生素D摄入情况及新生儿维生素D营养状况及影响因素。方法选取2007年9月至11月在广元市妇幼保健院及广元市第一人民医院产科分娩的健康孕妇及其新生儿共计133对为研究对象。133例孕妇年龄,体重,孕、产次,分娩方式等比较,差异无显著意义(P>0.05)。133例新生儿出生体重、Apgar评分等比较,差异无显著意义(P>0.05)(本研究遵循的程序符合广元市妇幼保健院人体试验委员会所制定的伦理学标准,得到该委员会批准,征得受试对象的知情同意,并与之签署临床研究知情同意书)。通过膳食调查、了解妊娠晚期孕妇钙及维生素D摄入情况。测定孕妇血清及其新生儿脐血血清中,钙、磷(P)、碱性磷酸酶(alkaline phosphatase,ALP)、甲状旁腺激素(parathyroid hormone,PTH)、25羟维生素D[25-hydroxy vitamin D,25-(OH)D]水平。结果本地区孕妇妊娠晚期日均钙摄入量为(320±210)mg/d,维生素D摄入量为(162±66)IU/d。所有研究对象均未达到中国营养学会对妊娠晚期孕妇钙和维生素D的推荐摄入量(recommended nutrient intakes,RNIs)要求。孕母空腹血清25-羟维生素D水平为(19.2±7.0)nmol/L,与新生儿脐血血清25-羟维生素D水平[(25.1±8.6)nmol/L]呈正相关(r=0.94,P<0.01)。孕妇妊娠晚期日均钙摄入量与血清甲状旁腺激素水平呈负相关(r=-0.299,P<0.01)。结论广元地区孕妇妊娠晚期钙及维生素D摄入不足,孕母和新生儿钙及维生素D营养状况有待进一步改善。

Objective To assess vitamin D and calcium （Ca） intakes of late pregnant and vitamin D nutritional status of neonates and its influential factors in Guangyuan region. Methods From September to November 2007, 133 health pregnant women who delivered at the Guangyuan Maternal and Child Health Hospital and Guangyuan People＇s Hospital were included in the study. Informed consent was obtained from all participates. Diet was assessed by a 3-day-food record and food frequency questionnaires. Maternal serum and cord blood level of calcium, phosphor, 25-hydroxy vitamin D[25-（OH）D], alkaline phosphatase （ALP）, and parathyroid hormone （PTH） were measured. Results Mean maternal serum 25-hydroxy vitamin D was （19. 2 ± 7. 0） nmoi/L, and cord blood 25-hydroxy vitamin D was （25. 1 ±8.6） nmol/L. Calcium and vitamin D intakes were uniformly low, （320 ±210） mg/d and （162 ± 66） IU/d, respectively. Maternal serum 25-hydroxy vitamin D correlated positively with cord blood 25-hydroxy vitamin D（r= 0.94, P〈 0. 01 ）. Maternal serum parathyroid hormone correlated negatively with daily calcium intakes （r =0. 299, P〈0.01）. Conclusion A high prevalence of vitamin D and calcium deficiency of healthy late pregnancy and neonates are found in Guangyuan region. Supplementation is needed to improve pregnant women and neonates＇ vitamin D and calcium intakes.