孕期维生素D缺乏与儿童湿疹相关性的Meta分析

Meta-analysis of the relationship between vitamin D deficiency during pregnancy and children's eczema

目的利用Meta分析方法系统评价孕妇血清或脐血中维生素D水平与儿童湿疹的关系，为儿童湿疹防治提供依据。方法按照PRIsMA指南，检索PubMed、Ebsco、webofScience、中国生物医学数据库（CBM）、中国知网（CNKI）、万方数据库、维普中文科技期刊数据库（VIP）等，检索时间均为1998年1月1日一2016年2月29日，中文文献检索以“湿疹”和“维生素D”为关键词，英文文献检索以“eczema”和“vitaminD”为主题词。按照预先设定的标准检索、筛选、纳入和分析文献。采用Revman5．3软件进行Meta分析，根据异质性结果选择相应的效应模型分析。结果共有11篇文献纳入分析，总样本量为5919人。孕期维生素D缺乏与儿童湿疹之间存在关联性，RR值为1．11（95％CI：1．04～1．19，P％0．01）；孕妇维生素D缺乏的暴露一反应关系合并效应值[RR值为1．12（95％CI：1．05～1．20）]高于脐血维生素D缺乏[RR值为1．08（95％CI：1．02～1．13）]；孕期维生素D缺乏，6月龄组、1岁组、2岁组儿童湿疹患病率分别增加16％、10％和10％（P〈0．01）。结论孕期维生素D缺乏是小年龄段儿童湿疹的危险因素，孕晚期规律补充维生素D能够降低婴幼儿湿疹的发病率。

Objective To systematically assess the relationship between vitamin D deficiency during pregnancy and children＇s eczema with Meta-analysis and to provide theoretic evidence for the prevention and therapy. Methods Accord- ing to the PRISMA guidelines, studies of the correlation between children＇s eczema and vitamin D were collected in PubMed, Ebsco,Web of Science,CBM,CNKI, WanFang and VIP Data, which were published from January 1998 to February 2016. Literatures were retrieved,filtered,accepted and analyzed according to the preset standard. Meta-analysls was conducted by using RevMan 5.3 software. Results Totally 11 reviews were included, the sample size was 5 919. Vitamin D deficiency during pregnancy was associated with children＇s eczema[RR： 1.11,95 ~ CI~ 1.04 ~ 1.19]. The combined response effect of vitamin D deficiency in pregnant women[RR： 1. 12,95 % CI：I. 05 ~ 1.20] was higher than that of vitamin D deficiency in cord blood[RR= 1.08,95 % CI： 1.020 1. 13]. If there was a lack of vitamin D during pregnancy, the prevalence rate of 6 months, 1 year and 2 years old children＇s eczema increased by 16%, 10 % and 10% respectively. Conclusion Vitamin D de- ficiency during pregnancy is a risk factor for young children＇s eczema, Vitamin D supplements in third trimester reduce the incidence of infant＇s eczema.