Lancet Diabetes Endo：孕前充足的维生素D水平可提高出生几率

2018-06-16 生物探索赞赏生物探索

新的研究显示，有过妊娠失败史但没有不孕的女性，如果其维生素D的水平在孕前足够的话，则更有可能怀孕并生下一个活婴儿。同一分析还显示，怀孕前维生素D水平也影响了妊娠丢失的风险。相关研究结果于5月30日在The Lancet Diabetes&Endocrinology杂志上在线发表，来自美国国立卫生研究院（NIH）的Sunni L.Mumford博士为该论文的通讯作者。Mumford和他的同事

新的研究显示，有过妊娠失败史但没有不孕的女性，如果其维生素D的水平在孕前足够的话，则更有可能怀孕并生下一个活婴儿。同一分析还显示，怀孕前维生素D水平也影响了妊娠丢失的风险。

相关研究结果于5月30日在The Lancet Diabetes&Endocrinology杂志上在线发表，来自美国国立卫生研究院（NIH）的Sunni L.Mumford博士为该论文的通讯作者。

Mumford和他的同事认为，尽管先前对非体外受精人群的研究表明维生素D具有有益作用，但这些研究通常在早孕时招募妇女，因此记录和评估早孕流失的能力有限。此外，这些研究也没有考虑到早孕健康的重要性。

为此，他们对名为EAGeR（Effects of Aspirin in Gestation and Reproduction）的试验进行了二次分析。

EAGeR最初的目的是评估低剂量阿司匹林对先前有一到两次妊娠失败的妇女生殖结果的影响。受试者从2007年6月15日到2011年7月15日在美国的4个临床试验点被招募。参与者在尝试怀孕期间被随访6个月经周期，已经怀孕的参与者，随访则贯穿整个孕期。此外，科学家们分别在将参与者随机分配之前以及妊娠8周时采集了他们的血液样本，并测量25-羟基维生素D(25[OH]D)水平。

分析结果显示，共有1191名妇女具有可评估的孕前（preconception）25[OH]D水平，其中47%具有足够的浓度，定义为75 nmol/L或更高。其余53%不足75 nmol/L。

良好的孕前维生素D水平与更多活产有关

研究人员首先观察到，怀孕前维生素D浓度越高，怀孕的可能性越大；在调整后的模型中，怀孕前维生素D浓度充足的妇女也更有可能实现临床妊娠；同样，与维生素D浓度不足的妇女相比，维生素D浓度充足的妇女更有可能活产。

需要强调的是，尽管怀孕前维生素D水平充足和不足的妇女流产率没有显著差异，但研究者指出，“有妊娠失败史的妇女流产率低于没有失败史的妇女”，因此，每增加25 nmol/L的25[OH]D浓度，妊娠失败的风险就会降低。

研究人员还假设，鉴于25[OH]D和骨化三醇（calcitriol）这两种生物活性形式都具有免疫调节功能，因此这两种形式的维生素D都可能通过改善母体-胎儿免疫反应在妊娠中发挥有利作用。“这是由于胎儿的存活取决于母体的免疫耐受环境。”作者们解释道。

怀孕前维生素D水平对怀孕结果的影响

意义

“我们的数据显示了维生素D的潜在有益作用，其在促进怀孕方面的保护作用可能会对试图怀孕的育龄夫妇产生临床影响。”他们强调。

但就目前来说，美国妇产科学院并不建议医师定期评估想要怀孕的妇女体内的维生素D水平，因为还需要进一步研究，以确定维生素D对健康生殖结果的最佳摄入量。

作者之一Robert M Silver建议，下一步需要调查维生素D水平低的妇女在怀孕前补充维生素D是否有更好的妊娠结果。

原始出处：

Sunni L Mumford, et al. Association of preconception serum 25-hydroxyvitamin D concentrations with livebirth and pregnancy loss: a prospective cohort study. Lancet Diabetes & Endocrinology. May 2018.

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2019-05-24 ms5439512287675881

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level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Sat Jun 16 09:27:04 CST 2018, time=2018-06-16, status=1, ipAttribution=)]
2018-07-08 howi

#Lancet#

84 0
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createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Fri May 24 01:59:00 CST 2019, time=2019-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1829683, encodeId=233518296830d, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sun Jul 08 07:59:00 CST 2018, time=2018-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1638651, encodeId=e89b163865131, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Mon Oct 22 08:59:00 CST 2018, time=2018-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1659588, encodeId=900b16595881a, content=<a href='/topic/show?id=c42845239ef' target=_blank style='color:#2F92EE;'>#孕前#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45239, encryptionId=c42845239ef, topicName=孕前)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c8925003801, createdName=szhvet, createdTime=Sat Jan 19 17:59:00 CST 2019, time=2019-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324640, encodeId=9356324640df, content=一定要多晒太阳.任何阶段都需要, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Sat Jun 16 11:36:18 CST 2018, time=2018-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324625, encodeId=36ab324625dd, content=学习了.长知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Sat Jun 16 10:51:43 CST 2018, time=2018-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324619, encodeId=d2ad324619d6, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/fhZdOu27e88Voqh19n8eF8cLplo8L4nicKtH0WnE3KFELXns5XDu8rsiceK2HHDZc2SEStia5VV3Pia2QLMVqlWbHw/0, createdBy=6e012139475, createdName=神功盖世, createdTime=Sat Jun 16 10:18:35 CST 2018, time=2018-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324609, encodeId=ffa6324609ec, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Sat Jun 16 09:55:50 CST 2018, time=2018-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324599, encodeId=91bc3245993f, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Sat Jun 16 09:27:04 CST 2018, time=2018-06-16, status=1, ipAttribution=)]
2018-10-22 ms9608593228839890

#DIA#

66 0
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createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Fri May 24 01:59:00 CST 2019, time=2019-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1829683, encodeId=233518296830d, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sun Jul 08 07:59:00 CST 2018, time=2018-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1638651, encodeId=e89b163865131, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, 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likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Sat Jun 16 11:36:18 CST 2018, time=2018-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324625, encodeId=36ab324625dd, content=学习了.长知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Sat Jun 16 10:51:43 CST 2018, time=2018-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324619, encodeId=d2ad324619d6, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/fhZdOu27e88Voqh19n8eF8cLplo8L4nicKtH0WnE3KFELXns5XDu8rsiceK2HHDZc2SEStia5VV3Pia2QLMVqlWbHw/0, createdBy=6e012139475, createdName=神功盖世, createdTime=Sat Jun 16 10:18:35 CST 2018, time=2018-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324609, encodeId=ffa6324609ec, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Sat Jun 16 09:55:50 CST 2018, time=2018-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324599, encodeId=91bc3245993f, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Sat Jun 16 09:27:04 CST 2018, time=2018-06-16, status=1, ipAttribution=)]
2019-01-19 szhvet

#孕前#

71 0
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createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Fri May 24 01:59:00 CST 2019, time=2019-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1829683, encodeId=233518296830d, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sun Jul 08 07:59:00 CST 2018, time=2018-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1638651, encodeId=e89b163865131, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Mon Oct 22 08:59:00 CST 2018, time=2018-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1659588, encodeId=900b16595881a, content=<a href='/topic/show?id=c42845239ef' target=_blank style='color:#2F92EE;'>#孕前#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45239, encryptionId=c42845239ef, topicName=孕前)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2c8925003801, createdName=szhvet, createdTime=Sat Jan 19 17:59:00 CST 2019, time=2019-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324640, encodeId=9356324640df, content=一定要多晒太阳.任何阶段都需要, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Sat Jun 16 11:36:18 CST 2018, time=2018-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324625, encodeId=36ab324625dd, content=学习了.长知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Sat Jun 16 10:51:43 CST 2018, time=2018-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324619, encodeId=d2ad324619d6, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/fhZdOu27e88Voqh19n8eF8cLplo8L4nicKtH0WnE3KFELXns5XDu8rsiceK2HHDZc2SEStia5VV3Pia2QLMVqlWbHw/0, createdBy=6e012139475, createdName=神功盖世, createdTime=Sat Jun 16 10:18:35 CST 2018, time=2018-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324609, encodeId=ffa6324609ec, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Sat Jun 16 09:55:50 CST 2018, time=2018-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324599, encodeId=91bc3245993f, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Sat Jun 16 09:27:04 CST 2018, time=2018-06-16, status=1, ipAttribution=)]
2018-06-16 医者仁心5538

一定要多晒太阳.任何阶段都需要

90 0
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2018-06-16 1ddf0692m34(暂无匿称)

学习了.长知识

123 0
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2018-06-16 神功盖世

阅

118 0
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2018-06-16 龙胆草

学习谢谢分享

91 0
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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/fhZdOu27e88Voqh19n8eF8cLplo8L4nicKtH0WnE3KFELXns5XDu8rsiceK2HHDZc2SEStia5VV3Pia2QLMVqlWbHw/0, createdBy=6e012139475, createdName=神功盖世, createdTime=Sat Jun 16 10:18:35 CST 2018, time=2018-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324609, encodeId=ffa6324609ec, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Sat Jun 16 09:55:50 CST 2018, time=2018-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324599, encodeId=91bc3245993f, content=学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Sat Jun 16 09:27:04 CST 2018, time=2018-06-16, status=1, ipAttribution=)]
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