孕妇维生素D水平与婴幼儿神经发育影响的初步研究

Brief research of vitamin D level in pregnant women and its influence on infantile neurodevelopment

目的分析并研究孕妇维生素D水平对婴幼儿神经发育的影响,为妇幼公共卫生维生素D缺乏防治措施的制定提供依据。方法 160例孕检并分娩的孕妇及其分娩的足月健康新生儿,孕妇25-(OH)D<50 nmol/L维生素D缺乏为观察组(80例),25-(OH)D≥50 nmol/L为对照组(80例)。比较两组孕妇和新生儿脐血维生素D水平,观察其相关性;随访至生后6个月,比较两组新生儿Beylay婴幼儿发展量表(BSID)的智力发展指数(MDI)和精神运动发展指数(PDI)。结果观察组和对照组孕妇25-(OH)D水平分别为(30.83±9.88)、(56.78±5.26)nmol/L,观察组和对照组新生儿脐血25-(OH)D水平分别为(40.86±17.59)、(65.36±9.09)nmol/L,观察组孕妇和新生儿脐血25-(OH)D水平均明显低于对照组,差异有统计学意义(P<0.01)。新生儿脐血25-(OH)D水平与孕妇25-(OH)D水平呈显著正相关(r=0.866,P<0.05)。随访至生后6个月,观察组新生儿MDI、PDI指数明显低于对照组,差异有统计学意义(P<0.01)。结论孕妇维生素D缺乏可不同程度地影响婴幼儿神经发育和维生素D营养状况,因此建立规范的孕妇产前检测血清25-(OH)D项目十分必要,同时要加强对孕妇维生素D增补的宣教,对预防由于孕妇妊娠期维生素D缺乏导致的一系列危害婴幼儿健康的疾病和优生优育具有重要意义,提高我国婴幼儿的生存质量,具有较高的科学价值和社会效益。

Objective To analyze and research influence by vitamin D level in pregnant women on infantile neurodevelopment, and to provide reference for establishment of prevention and control measures for vitamin D deficiency in pregnant women and infants. Methods Among 160 pregnant women and their healthy full term infants, pregnant women with 25-（OH）D 〈50 nmol/L as vitamin D deficiency were taken as observation group（80 cases）, and others with 25-（OH）D ≥50 nmol/L were taken as control group（80 cases）. Comparison was made on vitamin D level in pregnant women and umbilical cord blood of newborn to observe their correlation. After follow-up to postnatal 6 months, comparison was made on mental development index（MDI） and psychomotor development index（PDI） in Bayley scales of infant development（BSID） between the two groups. Results The observation group and the control group had 25-（OH）D level in pregnant women respectively as（30.83±9.88） and（56.78±5.26） nmol/L, and the two groups had 25-（OH）D level in umbilical cord blood of newborn respectively as（40.86±17.59） and（65.36±9.09） nmol/L. The observation group had obviously lower 25-（OH）D level in pregnant women and umbilical cord blood of newborn than the control group, and their difference had statistical significance（P〈0.01）. 25-（OH）D level in umbilical cord blood of newborn was positively correlated with 25-（OH）D level in pregnant women（r=0.866, P〈0.05）. After follow-up to postnatal 6 months, the observation group had obviously lower MDI and PDI indexes than the control group, and their difference had statistical significance（P〈0.01）. Conclusion Vitamin D deficiency in pregnant women shows influence with different degree on infantile neurodevelopment and vitamin D nutritional status. Thus, it is essential to establish prenatal serum 25-（OH）D detection, along with education on enhancing vitamin D supplement. This method contains important significance for preventing gestational vitamin D deficiency-induced infantile diseases and keeping high quality birth. It can also improve quality of life in infants, along with high scientific value and social benefit.