J Clin Endocrinol Metab:孕期维生素D水平影响胎儿发育
2013-01-21 J Clin Endocrinol Metab 国际糖尿病
美国的一项大型观察性队列研究显示,孕期维生素D水平是胎儿生长发育的独立标志物。研究发表于2013年1月出版的《临床内分泌代谢》杂志。 1959年~1965年从12个医学中心中入选了2146例参与围产期协作项目的孕妇,评估了孕期25-羟维生素D水平与出生体重及胎盘重量的相关性。 研究结果表明,校正混杂因素后,与孕期25-羟维生素D<37.5 nmol/L相比,孕期25羟维生
美国的一项大型观察性队列研究显示,孕期维生素D水平是胎儿生长发育的独立标志物。研究发表于2013年1月出版的《临床内分泌代谢》杂志。
1959年~1965年从12个医学中心中入选了2146例参与围产期协作项目的孕妇,评估了孕期25-羟维生素D水平与出生体重及胎盘重量的相关性。
研究结果表明,校正混杂因素后,与孕期25-羟维生素D<37.5 nmol/L相比,孕期25羟维生素D≥37.5 nmol/L可使新生儿出生体重增加46 g,头围增大0.13cm。在<37.5 nmol/L范围内,出生体重及头围会随着25-羟维生素D的水平增加而有所增长,随后趋于平稳。25羟维生素D水平与胎盘指数、胎盘重量以及胎盘重量/胎儿体重的比值均无显著相关性。
研究者指出,需进一步的随机对照试验验证孕期补充维生素D能够改善胎儿生长发育情况。
Context: Inconsistent associations between maternal vitamin D status and fetal size have been published in small studies.
Objective: Our objective was to examine the association between maternal 25-hydroxyvitamin D [25(OH)D] levels and measures of newborn and placental weight.
Design and Setting: We measured maternal 25(OH)D in mothers from the Collaborative Perinatal Project, an observational cohort conducted in 12 U.S. medical centers from 1959 to 1965.
Participants: Women delivering singleton, term, live births with 25(OH)D measured at a gestation of 26 wk or less (n = 2146).
Main Outcome Measures: Birth weight, ponderal index, placental weight, the placental to fetal weight ratio, and small for gestational age were measured. Hypotheses were formulated after data collection.
Results: After confounder adjustment, mothers with 25(OH)D of 37.5 nmol/liter or greater gave birth to newborns with 46 g [95% confidence interval (CI), 9–82 g] higher birth weights and 0.13 cm (0.01–0.25 cm) larger head circumferences compared with mothers with less than 37.5 nmol/liter. Birth weight and head circumference rose with increasing 25(OH)D up to 37.5 nmol/liter and then leveled off (P < 0.05). No association was observed between 25(OH)D and ponderal index, placental weight, or the placental to fetal weight ratio. Maternal 25(OH)D of 37.5 nmol/liter or greater vs. less than 37.5 nmol/liter in the first trimester was associated with half the risk of small for gestational age (adjusted odds ratio 0.5; 95% CI 0.3–0.9), but no second-trimester association was observed.
Conclusions: Maternal vitamin D status is independently associated with markers of physiological and pathological growth in term infants. Adequately powered randomized controlled trials are needed to test whether maternal vitamin D supplementation may improve fetal growth.
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