Maternal 25-hydroxyvitamin d and preterm birth in twin gestations.
Maternal 25-hydroxyvitamin d and preterm birth in twin gestations.
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DOI：
10.1097/aog.0b013e3182941d9a
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发表时间：
2013-07
影响因子：
7.2
通讯作者：
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network
中科院分区：
文献类型：
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作者：
Bodnar LM;Rouse DJ;Momirova V;Peaceman AM;Sciscione A;Spong CY;Varner MW;Malone FD;Iams JD;Mercer BM;Thorp JM Jr;Sorokin Y;Carpenter MW;Lo J;Ramin SM;Harper M;Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network
在美国多中心双胎妊娠队列中，评估24-28周孕妇25-羟基维生素D浓度与早产之间是否存在独立关联。采用液相色谱-串联质谱法（n=211）对参加17 α-羟孕酮己酸预防双胎早产临床试验的母亲血清样本进行25-羟基维生素D检测。胎龄在妊娠早期通过严格的算法确定。早产被定义为在妊娠35周内分娩双胞胎中的第一个或双胞胎中的任何一个死亡。血清25-羟基维生素D平均值（标准差）为82.7(31.5)nmol/L；40.3%的女性25-羟基维生素低于75 nmol/L。25-羟基维生素D低于75 nmol/L的孕妇早产率为49.4%，而25-羟基维生素D高于75 nmol/L的孕妇早产率为26.2% （P< 0.001）。在调整了母亲的种族和民族、研究地点、胎次、孕前体重指数、季节、婚姻状况、受教育程度、采血时的胎龄、吸烟状况和17 α-羟孕酮己酸治疗等因素后，与小于75 nmol/L的孕妇相比，母亲25-羟维生素D≥75 nmol/L与早产几率降低60%相关（校正优势比[or] 0.4, 95%可信区间[CI] 0.2-0.8）。在研究小于32周的早产（OR 0.2, 95% CI 0.1-0.6）和混杂校正后，也观察到类似的保护性关联。在该双胎妊娠队列中，妊娠中期晚期母亲25-羟基维生素D低于75 nmol/L与早产风险增加有关。
To assess whether there was an independent association between maternal 25-hydroxyvitamin D concentrations at 24–28 weeks of gestation and preterm birth in a multicenter U.S. cohort of twin pregnancies. Serum samples from mothers who participated in a clinical trial of 17 α-hydroxyprogesterone caproate for the prevention of preterm birth in twin gestations (2004–2006) were assayed for 25-hydroxyvitamin D using liquid-chromatography-tandem mass spectrometry (n=211). Gestational age was determined early in pregnancy using a rigorous algorithm. Preterm birth was defined as delivery of the first twin or death of either twin at less than 35 weeks of gestation. The mean (standard deviation) serum 25-hydroxyvitamin D was 82.7(31.5) nmol/L; 40.3% of women had 25-hydroxyvitamin Dless than 75 nmol/L. Preterm birth less than 35 weeks occurred in 49.4% of mothers with 25-hydroxyvitamin D less than 75 nmol/L compared with 26.2% among those with 25-hydroxyvitamin D 75 nmol/L or more (P<.001). After adjustment for maternal race and ethnicity, study site, parity, prepregnancy body mass index, season, marital status, education, gestational age at blood sampling, smoking status and 17 α-hydroxyprogesterone caproate treatment, maternal 25-hydroxyvitamin D 75 nmol/L or more was associated with a 60% reduction in the odds of preterm birth compared with less than 75 nmol/L (adjusted odds ratio[OR] 0.4, 95% confidence interval [CI] 0.2–0.8). A similar protective association was observed when studying preterm birth less than 32 weeks (OR 0.2, 95% CI 0.1–0.6) and after confounder adjustment. Late second trimester maternal 25-hydroxyvitamin D less than 75 nmol/L is associated with an increase in the risk of preterm birth in this cohort of twin pregnancies.