Vitamin D activity of breast milk in women randomly assigned to vitamin D3 supplementation during pregnancy.
Vitamin D activity of breast milk in women randomly assigned to vitamin D3 supplementation during pregnancy.
复制标题
DOI：
10.3945/ajcn.115.114603
复制
发表时间：
2016-02
期刊：
影响因子：
--
通讯作者：
C. Wall;A. Stewart;C. Camargo;R. Scragg;E. Mitchell;A. Ekeroma;J. Crane;Tania Milne;Judy Rowden;R. Horst;C. Grant
中科院分区：
文献类型：
--
作者：
C. Wall;A. Stewart;C. Camargo;R. Scragg;E. Mitchell;A. Ekeroma;J. Crane;Tania Milne;Judy Rowden;R. Horst;C. Grant
背景人乳中维生素D活性（VDA）通常较低。据我们所知，母亲在怀孕期间补充维生素D是否可以增加出生时母乳中的维生素D含量，目前还没有报道。目的：我们研究了妊娠期补充维生素D对哺乳期前2个月母乳VDA的影响。母乳样本来自于一项随机、双盲、安慰剂对照的孕期补充维生素D的试验。孕妇在妊娠27周时入组，并随机分配到以下3组：安慰剂组、每日口服维生素D3（1000 IU）一次的组或每日口服维生素D3（2000 IU）两次的组。血清25-羟维生素D [25（OH）D]在登记时，在妊娠36周，并在出生时在脐带血中进行了测量。在产后2周和2个月，邀请母乳喂养的研究参与者提供母乳样本用于VDA测量[维生素D2、维生素D3、25（OH）D2和25（OH）D3浓度]。使用线性混合模型比较3个研究组之间的母乳VDA。结果：共有75名妇女提供母乳样本（44名妇女在产后2周和2个月提供母乳样本）。2周龄时的平均（95% CI）VDA为52 IU/L（12，217 IU/L），安慰剂组51 IU/L 1000-IU组为17、151 IU/L，74 IU/L（25，221 IU/L）; 2月龄时，平均（95% CI）VDA分别为45 IU/L（16，124 IU/L）、43 IU/L（18，103 IU/L）和58 IU/L（15，224 IU/L）。样本采集时间和治疗之间的VDA无显著相互作用（P = 0.61），但低剂量和高剂量治疗组之间存在差异（P = 0.04）。结论孕妇孕期补充维生素D 2000 IU/d（与1000 IU/d和安慰剂相比）可导致产后≥2 mo母乳VDA升高。本试验在澳大利亚新西兰临床试验注册中心注册为ACTRN 12610000483055。
BACKGROUND Human milk is typically low in vitamin D activity (VDA). Whether the vitamin D content of breast milk at birth can be increased by supplementing the mother during pregnancy has not been reported to the best of our knowledge. OBJECTIVE We examined the effect of vitamin D supplementation during pregnancy on breast-milk VDA in the first 2 mo of lactation. DESIGN Breast-milk samples were obtained from women who were enrolled in a randomized, double-blinded, placebo-controlled trial of vitamin D supplementation during pregnancy. Pregnant women were enrolled at 27 wk of gestation and randomly assigned to the following 3 groups: a placebo group, a group who received one dosage of daily oral vitamin D3 (1000 IU), or a group who received 2 dosages of daily oral vitamin D3 (2000 IU). Serum 25-hydroxyvitamin D [25(OH)D] was measured at enrollment, at 36 wk of gestation, and in cord blood at birth. Study participants who were breastfeeding were invited to provide breast-milk samples for VDA measurement [concentration of vitamin D2, vitamin D3, 25(OH)D2, and 25(OH)D3] at 2 wk and 2 mo postpartum. A linear mixed model was used to compare breast-milk VDA between the 3 study groups. RESULTS A total of 75 women provided breast-milk samples (44 women provided breast-milk samples at both 2 wk and 2 mo postpartum). The mean (95% CI) VDA at age 2 wk was 52 IU/L (12, 217 IU/L) in the placebo group, 51 IU/L (17, 151 IU/L) in the 1000-IU group, and 74 IU/L (25, 221 IU/L) in the 2000-IU group; and at age 2 mo, the mean (95% CI) VDA was 45 IU/L (16, 124 IU/L), 43 IU/L (18, 103 IU/L), and 58 IU/L (15, 224 IU/L), respectively. There was no significant interaction in VDA between the sample-collection time and treatment (P = 0.61), but there was a difference between lower- and higher-dosage treatment groups (P = 0.04). CONCLUSION Maternal vitamin D supplementation during pregnancy of 2000 IU/d (compared with 1000 IU/d and with a placebo) results in a higher VDA of breast milk ≥2 mo postpartum. This trial was registered at the Australian New Zealand Clinical Trials Registry as ACTRN12610000483055.