Vitamin D insufficiency is associated with increased risk of first-trimester miscarriage in the Odense Child Cohort
Vitamin D insufficiency is associated with increased risk of first-trimester miscarriage in the Odense Child Cohort
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DOI：
10.3945/ajcn.114.103655
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发表时间：
2015-09-01
影响因子：
7.1
通讯作者：
Christesen, Henrik T.
中科院分区：
文献类型：
--
作者：
Andersen, Louise B.;Jorgensen, Jan S.;Christesen, Henrik T.
工作背景：流产是妊娠最常见的负面结果，确定可改变的风险因素对公共卫生可能具有重要意义。妊娠期低维生素D浓度在世界范围内普遍存在，维生素D缺乏与母胎界面的免疫细胞调节和几种妊娠疾病有关。目的：我们研究了25-羟基维生素D血清浓度是否是早期流产的可改变的危险因素。设计：在一项前瞻性队列研究中，1683名孕妇在妊娠22周前捐献血清，我们调查了孕妇血清25-羟基维生素D [25（OH）D]浓度与随后流产风险之间的关系（n = 58）。25（OH）D浓度越高，调整后的妊娠早期流产风险越低（HR：0.98; 95% CI：0.96，0.99）。25（OH）D浓度使流产的校正HR增加2倍（HR：2.50; 95% CI：1.10，5.69）。25（OH）D浓度与孕中期流产的风险增加无关。结论：我们发现25（OH）D与孕早期流产之间存在关联，表明维生素D是流产的一个可改变的风险因素。为了验证这一假设，随机对照试验应该调查维生素D补充剂在怀孕早期或怀孕前增加25（OH）D浓度以降低流产风险的可能作用。
Background: Miscarriage is the most common negative outcome of pregnancy, and identification of modifiable risk factors is potentially of great importance for public health. Low vitamin D concentrations in pregnancy are widespread worldwide, and vitamin D deficiency is implicated in immune cell regulation at the feto-maternal interface and several diseases of pregnancy.Objective: We investigated whether 25-hydroxyvitamin D serum concentration was a modifiable risk factor for early miscarriage.Design: In a prospective cohort study of 1683 pregnant women donating serum before gestational week 22, we investigated the association between maternal serum concentrations of serum 25-hydroxyvitamin D [25(OH)D] and the risk of subsequent miscarriage (n = 58).Results: The adjusted hazard of first-trimester miscarriage was lower with higher 25(OH)D concentrations (HR: 0.98; 95% CI: 0.96, 0.99). Concentrations of 25(OH)D 2-fold increased adjusted HR for miscarriage (HR: 2.50; 95% CI: 1.10, 5.69). Concentrations of 25(OH)D were not associated with an increased risk of second-trimester miscarriage.Conclusions: We found an association between 25(OH)D and first-trimester miscarriages, suggesting vitamin D as a modifiable risk factor for miscarriage. To test this hypothesis, randomized controlled trials should investigate the possible effect of vitamin D supplementation to increase 25(OH)D concentrations in early pregnancy, or before conception, to decrease risk of miscarriage.