西安市城区孕妇维生素D缺乏对新生儿影响的调查研究

Effect of vitamin D deficiency among urban pregnant women on their neonates in Xi＇an

目的 调查西安市城区孕妇与新生儿维生素D营养状况,并进行相关因素分析,以了解孕妇与新生儿维生素D缺乏的流行现况及相关因素.方法 随机抽取冬春季和夏秋季两个时间段共182对在西安市第四医院产科分娩的孕妇及其新生儿为研究对象,采用问卷设计调查孕妇孕期维生素D的摄入情况.分娩当天抽取孕妇静脉血,分娩后采集新生儿脐血,检测血中25羟基维生素D、碱性磷酸酶、钙、磷的含量,对新生儿进行全面查体并记录.结果 新生儿脐血25羟基维生素D水平为（36.76±16.92）nmol/L,孕妇血清25羟基维生素D水平为（38.54±17.18）nmol/L,两者呈显著正相关（r=0.794,P〈0.001）;夏秋季组新生儿脐血25羟基维生素D[（39.23±17.11）]nmol/L明显高于冬春季组[（34.01±16.38）nmol/L],两组比较差异有统计学意义（t=2.08,P〈0.05）;如以血清25羟基维生素D〈50nmol/L判断为维生素D缺乏时,分别有88.46%的孕妇及91.20%的新生儿为维生素D缺乏者.结论 西安城区孕妇及新生儿维生素D缺乏发病率较高;孕母维生素D营养状况决定脐血维生素D水平;孕期应补充足量维生素D以改善孕妇及新生儿维生素D营养状况.

Objective To investigate the nutritional status of vitamin D of urban pregnant women in Xi＇ an and their neonates and analyze related factors, so as to study the prevalence and influencing factors of vitamin D deficiency in them. Methods From January to February and from August to September in 2011, 182 pregnant women and their neonates delivered in NO. 4 Hospital in Xi＇ an were enrolled in the study. Their basic information and the intake of vitamin D during pregnancy were obtained with questionnaires. Samples of maternal venous blood and cord blood were collected on the day of delivery, and the serum concentrations of 25 （OH） D, alkaline phosphatase, calcium and phosphorus were measured. A general check up was given to the neonates and the results were recorded. Results The concentration of 25（OH） D in cord blood and maternal serum was （36.76 ＋ 16.92） nmol/L and （38.54 -＋ 17.18） nmol/L, respectively, and there was a significant positive correlation between them （r = 0. 794, P 〈 0.001 ）. The concentration of 25 （OH） D in cord blood of neonates born in summer and autumn [ （39.23 _＋ 17.11 ） nmol/L] was significantly higher than that in winter and spring [ （ 34.01 ＋- 16.38 ） nmol/L ], and the difference was statistically significant （t = 2.08 ,P 〈 0.0）. If 25 （OH） D 〈 50nmol/L was regarded as vitamin D deficiency, 88.46% of pregnant women and 91.20% of neonates were involved. Conclusion The prevalence of vitamin D deficiency in pregnant women and neonates in Xi＇ an is relatively high, and nutritional status of vitamin D in urban pregnant women determines that of neonates. Vitamin D supplementation during pregnancy is needed to improve vitamin D nutritional status of both pregnant women and neonates.