孕晚期增补维生素D与分娩前及新生儿血清25(OH)D水平的关联研究

Association between Vitamin D supplements during the third trimester and serum 25-hydroxyvitamin D levels of maternal and newborn

目的探讨孕晚期增补维生素D与分娩前及新生儿血清25（OH）D水平的关联。方法选取2014年6月-2015年2月在扬州市妇幼保健院产科就诊分娩的孕妇建立孕妇队列,通过问卷调查收集孕妇一般人口统计学特征,孕期服用维生素D状况等情况,共获得单胎活产儿及有效问卷4013份。采集孕妇分娩前以及新生儿血清使用酶联免疫法测定25（OH）D水平。数据资料采用χ～2检验和多因素Logistic回归进行分析。结果孕妇分娩前25（OH）D缺乏率为77.8%,新生儿25（OH）D缺乏率为85.8%,调整孕妇及丈夫年龄、孕妇及丈夫文化程度、户口、孕前体重指数（BMI）等因素后,孕晚期偶尔服用维生素D的孕妇发生分娩前血清25（OH）D水平缺乏的风险较高（RR=1.44,95%CI=1.184～1.741）,孕晚期未服用维生素D的孕妇发生分娩前及新生儿血清25（OH）D水平缺乏的风险均较高（RR=2.43,95%CI=2.015～2.938;RR=1.93,95%CI=1.530～2.429）。孕晚期偶尔服用维生素D导致新生儿血清25（OH）D水平缺乏并无明显影响（RR=1.54,95%CI=0.998～1.608）。结论孕晚期增补维生素D不足会导致孕妇及新生儿血清25（OH）D水平缺乏。

Objective To examine the association between Vitamin D supplements during the third trimester and serum 25-hydroxyvitamin D levels of maternal and newborn. Methods Pregnant women who received service in Yangzhou Maternal and Child Health Care Hospital,from Jun. 2014 to Feb. 2015 were selected as the target cohort population. All participants were asked to complete a questionnaire including demographic characteristics,Vitamin D supplements during the third trimester and so on. 4013 singleton live births and valid questionnaires were collected. ELISA was used to determine the serum 25（OH）D levels. Descriptive statistics and logistic regression models were used for data analysis. Results The prevalence of vitamin D deficiency was 77. 8% in women and 85. 8% in newborn. After adjustment for potential confounders,such as pregnant women and her husband＇s age,pregnant women and her husband＇s educational level,register and BMI before pregnant,results from the logistic regression showed that intake of Vitamin D occasionally during the third trimester significantly increased the risk of ante partum serum 25（OH） D deficiency（ RR =1.44,95% CI = 1.184-1.741）. No taking Vitamin D significantly increased the risk of serum 25（ OH） D deficiency in both ante partum and newborn（ RR = 2.43,95% CI = 2.015-2.938; RR = 1.93,95% CI = 1. 530-2.429）. However,intake of Vitamin D occasionally during the third trimester did not make obvious impact on neonatal serum 25（OH） D deficiency. Conclusion Insufficient supplement of Vitamin D during the third trimester could lead to ante partum and neonatal serum 25（OH） D deficiency.