无锡市足月新生儿维生素D水平及适宜补充剂量的研究

Study on vitamin D level and appropriate supplementary dose of full-term neonates in Wuxi

目的分析无锡市新生儿维生素D(VD)的营养状况及其影响因素,为制定适合本地区的新生儿VD补充方案提供科学依据。方法选取2015年3月-2018年3月入住无锡市人民医院新生儿科的足月、母乳喂养、日龄≤7 d的新生儿347例,检测其血清25-(OH)D基础水平,其中血清25-(OH)D≤50 nmol/L的新生儿随机分为两组,分别给予400 U/d或800 U/d VD口服,6周后复查。同时对其母亲一般信息及孕期补充VD情况等展开问卷调查。结果VD缺乏、VD不足和VD充足的比例分别为91.07%、8.07%和0.86%。夏秋季出生的患儿血清25-(OH)D水平较冬春季出生的患儿高(t=-3.467,P<0.05)。6周后复查发现,总体患儿血清25-(OH)D平均值较前上升,VD缺乏者比例下降(χ2=118.235、163.196,P<0.05)。新生儿血清25-(OH)D水平与母亲孕期是否补充充足的钙剂、VD存在一定的相关性(r=0.116,P=0.043)。结论无锡地区足月新生儿VD普遍缺乏,建议根据母亲孕期VD补充情况,可以将早期足月新生儿VD补充剂量调整为400~800 U/d,持续6周。

Objective To investigate the nutritional status and influencing factors of neonatal vitamin D(VD)in Wuxi,in order to provide scientific basis for formulating the supplementation program suitable for neonates in this region.Methods A total of 347 full-term infants who were breastfed and aged≤7 days were selected in Wuxi Children's Hospital from March 2015 to March 2018.The serum 25-(OH)D level of the infants was tested,and those whose serum 25-(OH)D level≤50 nmol/L were divided into 400 U/d supplementation group and 800 U/d supplementation group.After six-week supplementation,25-(OH)D level of infants was retested.Mothers were investigated about their general situations and vitamin D intake in pregnancy by questionnaire.Results The proportions of vitamin D deficiency,insufficiency and sufficiency were 91.07%,8.07%and 0.86%,respectively.The serum levels of 25-(OH)D in neonates born in summer and autumn were significantly higher than those born in winter and spring(t=-3.467,P<0.05).Six weeks later,it was found that the overall level of serum 25-(OH)D increased,the proportion of vitamin D deficiency decreased(χ2=118.235,163.196,P<0.05).There was some correlation between the levels of calcium and vitamin D supplementation in mothers and 25-(OH)D level in infants(r=0.116,P=0.043).Conclusion s The vitamin D level of full-term newborns in Wuxi is generally deficient.In order to improve the situation,it is suggested to adjust the vitamin D supplementation dose of early-term newborns to 400-800 U/d for 6 weeks according to the supplementation of mothers during pregnancy.