脐带血维生素D水平与新生儿生长指标的关系  

Vitamin D level in cord blood and neonatal outcomes in a birth cohort study in Shanghai

作　　者：叶秀霞[1] 宋沅谨 姜艳蕊[2] 林建华[2] 张宇 贝斐 江帆[1] 

机构地区：[1]上海交通大学医学院附属上海儿童医学中心,上海200127 [2]上海交通大学医学院附属仁济医院产科,上海200127

出　　处：《临床儿科杂志》2017年第6期430-434,共5页Journal of Clinical Pediatrics

基　　金：国家自然科学基金资助项目(No.81422040;81172685);教育部新世纪优秀人才项目(No.NCET-13-0362);科技部973培育项目(No.2010 CB 535000);卫生部行业科研专项基金(No.201002006);上海市科委项目及启明星追踪项目(No.12411950405;No.13QH1401800);上海市教委曙光计划(No.11 SG 19)

摘　　要：目的了解新生儿脐带血维生素D水平现况,探讨脐带血维生素D水平与新生儿生长指标的相关性。方法共纳入223对足月单胎母子。问卷法收集母亲孕期信息;测量新生儿出生体质量、头围和身长指标;采用酶联免疫法测定新生儿脐带血和母亲孕晚期血25(OH)D浓度。结果脐带血25(OH)D平均浓度为20.7 nmol/L,维生素D缺乏率达82.1%,其中严重缺乏率为12.1%(<10 nmol/L)。子代与母亲孕晚期25(OH)D浓度基本一致。脐带血不同25(OH)D浓度新生儿的出生季节分布差异有统计学意义(P<0.05),<10 nmol/L组冬春季节所占比例较高。脐带血25(OH)D浓度与低出生体质量(LBW)和小于胎龄(SGA)新生儿的发生率均无显著相关(P>0.05)。控制性别、胎龄、出生季节等变量后,脐带血不同25(OH)D浓度组间的出生体质量和头围差异有统计学意义(P<0.05)。结论足月新生儿脐带血25(OH)D浓度普遍低,维生素D缺乏状态与其母亲孕晚期维生素D状况基本一致。脐带血25(OH)D浓度与新生儿出生体质量和头围存在一定相关性,其具体规律尚有待进一步扩大样本验证。ObjectivesTo detect the cord blood vitamin D level in neonates and to determine the association between the cord blood vitamin D level and neonatal outcomes. MethodsA total of 223 eligible mother-and-singleton-offspring pairs were recruited. The information of mothers’ pregnancy was collected by questionnaires. The weight, length, and head circumference of neonates were measured. The levels of 25（OH）D in cord blood of neonates and in blood of late pregnancy mothers were determined by chemiluminescence immunoassay. ResultsThe median concentration of 25（OH）D in cord blood was 20.7 nmol/L, and 82.1% of neonate had vitamin D defciency, and 12.1% had severe vitamin D defciency （〈10 nmol/L）. The concentration of 25（OH）D in cord blood was consistent with that in blood of late pregnancy mother. The distribution of concentration of 25（OH）D in cord blood was signifcantly different in neonates in different seasons of birth （P〈0.05）. There were more cases 〈10 nmol/L in winter and spring. The concentration of 25（OH）D in cord blood had no signifcant associations with the incidences of low birth weight （LBW） and small for gestational age （SGA） （P〉0.05）. After the variables of sex, gestational age and birth season are controlled, the birth weight and head circumference were signifcantly different in neonates with different concentrations of 25（OH）D in cord blood （P〈0.05）. ConclusionsThe concentration of 25（OH）D in cord blood in term neonates was generally lower. The vitamin D status in neonates was consistet with that in their late pregnancy mothers. Cord blood 25（OH）D levels were associated with neonates’ birth weight and head circumference, but it should be confrmed by larger sample size in the future.

关 键 词：脐带血 25(OH)D 生长指标 新生儿 

分 类 号：R722.1[医药卫生—儿科]