Vitamin D in pregnancy: current concepts.
Vitamin D in pregnancy: current concepts.
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DOI：
10.1097/gco.0b013e3283505ab3
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发表时间：
2012-03
影响因子：
2.1
通讯作者：
Thorp JM
中科院分区：
文献类型：
--
作者：
Urrutia RP;Thorp JM
维生素D（VD）是一种复杂的类固醇激素系统的一部分，长期以来一直被认为参与骨代谢。近年来，血管性痴呆已涉及多种生理过程，如血管健康、免疫功能、代谢和胎盘功能。本文综述了VD在围产期健康中的作用的现有证据。使用VD和妊娠的关键词对2010年5月至2011年10月期间在PubMed上发表的文章进行了系统综述。共审查了78项研究。关于VD在生殖结局中的作用的生物学证据是强有力的，VD缺乏症在孕妇中的发生率可能很高。然而，关于怀孕期间的最佳VD水平或VD缺乏的标准测量方法尚未达成共识。建立VD水平与不良妊娠结局（如先兆子痫、妊娠期糖尿病、低出生体重、早产、剖宫产和感染性疾病）之间相关性的临床研究结果相互矛盾。这可能是由于缺乏随机试验，研究人群的异质性，以及样本量低，观察性研究之间的混杂调整不良。进一步的研究应集中在确定最佳的25（OH）D水平在怀孕期间以及人口的各个亚群。需要进行随机试验来确定VD补充剂是否可以改善妊娠结局。目前，ACOG和IOM建议在怀孕期间每天补充600 IU VD，以支持母亲和胎儿的骨代谢。
Vitamin D (VD) is part of a complex steroid hormone system long known to be involved in bone metabolism. Recently, VD has been implicated physiologic processes as diverse as vascular health, immune function, metabolism and placental function. This review summarizes the current evidence for the role of VD in perinatal health. A systematic review of articles published in PubMed between May 2010 and October 2011 was undertaken using key words for VD and pregnancy. Seventy-eight studies were reviewed. The biologic evidence regarding a role for VD in reproductive outcomes is strong, and rates of VD deficiency may be high among pregnant women. However, no consensus exists regarding optimum VD levels in pregnancy or standard measurement of VD deficiency. Clinical studies establishing an association between VD levels and adverse pregnancy outcomes such as preeclampsia, gestational diabetes, low birthweight, preterm labor, cesarean delivery and infectious diseases have conflicting results. This is likely due to a paucity of randomized trials, heterogeneity of populations studied, and low sample size with poor adjustment for confounding among observational studies. Further research should focus on defining optimum 25(OH)D levels in pregnancy as well as among various subgroups of the population. Randomized trials are needed to determine if VD supplementation can improve pregnancy outcomes. Currently, ACOG and IOM recommend 600 IU of daily VD supplementation during pregnancy to support maternal and fetal bone metabolism.