Maternal Vitamin D Status and Spontaneous Preterm Birth by Placental Histology in the US Collaborative Perinatal Project
Maternal Vitamin D Status and Spontaneous Preterm Birth by Placental Histology in the US Collaborative Perinatal Project
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DOI：
10.1093/aje/kwt237
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发表时间：
2014-01-15
影响因子：
5
通讯作者：
Simhan, Hyagriv N.
中科院分区：
文献类型：
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作者：
Bodnar, Lisa M.;Klebanoff, Mark A.;Simhan, Hyagriv N.
本研究的目的是确定母体25-羟基维生素D（25（OH）D）与妊娠35周前自发性早产（sPTB）风险之间的关系。从美国围产期合作项目（1959 - 1965）中随机抽取子队列（n 2，629），并增加妊娠35周前所有剩余的sPTB病例，共计767例。在妊娠26周或更早时采集的血清样本进行25（OH）D测定。血管组织学和炎症组织学的构建体由胎盘病理学检查开发。在白色女性中，25（OH）D与sPTB之间没有关系。在非白人母亲中，血清25（OH）D水平为3050、5075和75 nmol/L与每100例活产sPTB病例减少1.01.6例和sPTB风险减少2030例相关，与调整孕前体重指数后25（OH）D水平低于30 nmol/L相比（体重（kg）/身高（m）（2））、季节和其他混杂因素。这种关联是由炎症介导的sPTB病例和无胎盘病变的sPTB病例驱动的。对运动、鱼类摄入量和皮肤颜色的未测量混杂因素的敏感性分析表明，常规结果中存在一些偏离零值的偏差，但结论普遍得到支持。维生素DsPTB的关系应在现代队列中进行检查，并提供皮肤色素沉着和其他协变量的详细数据。
The objective of this study was to determine the association between maternal 25-hydroxyvitamin D (25(OH)D) and the risk of spontaneous preterm birth (sPTB) before 35 weeks gestation. A random subcohort from the US Collaborative Perinatal Project (19591965) was sampled (n 2,629) and augmented with all remaining cases of sPTB before 35 weeks gestation for a total of 767 cases. Banked serum samples collected at 26 weeks gestation or earlier were assayed for 25(OH)D. Constructs for vascular histology and inflammatory histology were developed from placental pathology examinations. There was no relationship between 25(OH)D and sPTB among white women. Among nonwhite mothers, serum 25(OH)D levels of 3050, 5075, and 75 nmol/L were associated with reductions of 1.01.6 cases of sPTB per 100 live births and 2030 reductions in risk of sPTB compared with 25(OH)D levels less than 30 nmol/L after adjustment for prepregnancy body mass index (weight (kg)/height (m)(2)), season, and other confounders. This association was driven by inflammation-mediated cases of sPTB and sPTB cases without placental lesions. A sensitivity analysis for unmeasured confounding by exercise, fish intake, and skin color suggested some bias away from the null in the conventional results, but conclusions were generally supported. The vitamin DsPTB relationship should be examined in modern cohorts with detailed data on skin pigmentation and other covariates.