Current Recommended Vitamin D Prenatal Supplementation and Fetal Growth: Results From the China-Anhui Birth Cohort Study
Current Recommended Vitamin D Prenatal Supplementation and Fetal Growth: Results From the China-Anhui Birth Cohort Study
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目前推荐的维生素 D 产前补充和胎儿生长：中国-安徽出生队列研究的结果
DOI：
10.1210/jc.2017-00850
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发表时间：
2018-01-01
影响因子：
5.8
通讯作者：
Zhu, Peng
中科院分区：
文献类型：
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作者：
Tao, Rui-xue;Meng, Deng-hon;Zhu, Peng
背景：母亲维生素 D 不足与胎儿生长受限有关。然而，母亲补充维生素 D 对胎儿生长的影响尚未得到证实。 目的：评估妊娠期医学研究所 (IOM) 推荐的母亲补充维生素 D 对新生儿维生素 D 状况和小于胎龄儿 (SGA) 风险的影响。 设计和参与者：作为中国-安徽出生队列研究的一部分，研究母亲的社会人口学特征、食物 前瞻性收集摄入量、生活方式、维生素 D 补充信息和出生结果。对于参与者，通常建议在怀孕期间每天服用 600 IU 的维生素 D3。测量了 1491 名新生儿的脐带血中 25-羟基维生素 D [25(OH) D]、钙和磷水平，根据母亲在怀孕期间补充维生素 D 的持续时间将这些新生儿分为三组。 结果：新生儿中 25(OH) D 的平均脐带血浓度高出 3.5 nmol/L [95% 置信区间 (CI)，0.8，6.2]（中位数， 与母亲未服用任何补充剂的母亲（中位数，34.3 nmol/L）相比，母亲在怀孕期间补充维生素 D 超过 2 个月的患者（中位数为 37.9 nmol/L）。无论出生季节如何，脐带血 25(OH)D 浓度的显着差异都会发生。补充维生素 D 超过 2 个月的孕妇的 SGA 调整后风险显着低于未补充任何维生素 D 的女性（11.8% vs 6.9%；调整后优势比 = 0.53；95% CI，0.32，0.87）。结论：来自中国的研究结果表明，IOM 推荐的母亲补充维生素 D 会导致胎儿的 SGA 水平略有但显着升高。 25(OH)D 并促进胎儿生长。
Context: Maternal vitamin D insufficiency has been associated with fetal growth restriction. However, the effect of maternal vitamin D supplementation on fetal growth has not been confirmed.Objective: To assess the effect of maternal vitamin D supplementation recommended by the Institute of Medicine (IOM) during pregnancy on the neonatal vitamin D status and the risk of small for gestational age (SGA).Design and Participants: As part of the China-Anhui Birth Cohort study, maternal sociodemographic characteristics, food intake, lifestyle, information on vitamin D supplementation, and birth outcomes were prospectively collected. For participants, 600 IU/d of vitamin D3 was routinely advised to take during pregnancy. Cord blood levels of 25-hydroxyvitamin D [25(OH) D], calcium, and phosphorus were measured in 1491 neonates who were divided into three groups based on the duration of maternal vitamin D supplementation during pregnancy.Results: Mean cord blood concentrations of 25(OH) D were 3.5 nmol/L higher [95% confidence interval (CI), 0.8, 6.2] in neonates (median, 37.9 nmol/L) whose mother took vitamin D supplementation for >2 months during pregnancy compared with those (median, 34.3 nmol/L) whose mother did not take any supplement. These significant differences on cord blood concentrations of 25(OH) D occurred regardless of the season of birth. The adjusted risk of SGA in pregnant women with vitamin D supplementation for >2 months was significantly decreased than that in women without any vitamin D supplementation (11.8% vs 6.9%; adjusted odds ratio = 0.53; 95% CI, 0.32, 0.87).Conclusions: The findings from China suggest that maternal vitamin D supplementation recommended by the IOM results in a slight but significantly higher fetal level of 25(OH) D and improves fetal growth.