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目的了解北京协和医院(北纬39°)秋冬季出生新生儿的维生素D水平,并探讨其相关因素。方法选择2014年9月1日至2015年2月28日在我院出生后转入儿科的新生儿,除外重度窒息、贫血、先天遗传代谢性疾病患儿。调查母亲孕期日晒、膳食和维生素D补充情况,用同位素稀释超高效液相色谱串联质谱法检测新生儿生后48 h内静脉血清25(OH)D水平。结果 141例研究对象入选。新生儿血清25(OH)D水平(14.5±6.5)ng/ml,维生素D缺乏77例(54.6%),不足31例(22.0%)。孕末期3个月补充维生素D剂量≥600 IU/d母亲的64例新生儿中维生素D缺乏26例(40.6%),不足15例(23.4%)。不同胎龄、性别、胎数、小于胎龄儿(SGA)与适于胎龄儿(AGA)新生儿维生素D水平差异无统计学意义(P>0.05)。孕母体重指数(BMI)>27者新生儿血清25(OH)D水平低于BMI≤27者[(12.9±6.6)比(15.7±6.4)ng/ml,P=0.015],冬季出生新生儿血清25(OH)D水平低于秋季出生新生儿[(13.4±6.0)比(16.8±7.2)ng/ml,P=0.004],孕末期3个月补充维生素D剂量≥600 IU/d母亲的新生儿血清25(OH)D水平高于<600 IU/d者[(16.9±5.5)比(12.2±5.8)ng/ml,P<0.001]。出生季节(s)、母亲孕末期3个月补充维生素D剂量(d)均与新生儿血清25(OH)D水平(D)相关。直线回归方程为D=22.049+0.015d-3.924s(F=37.643,P<0.001)。结论北京协和医院(北纬39°)秋冬季出生新生儿维生素D缺乏发生率高。孕期补充维生素D 600 IU/d不足以有效预防新生儿维生素D缺乏。
Objective To investigate the vitamin D levels of newborns born in autumn and winter in Peking Union Medical College Hospital (latitude 39 °) and to explore the related factors. Methods From September 1, 2014 to February 28, 2015, newborns who were transferred to pediatrics after birth in our hospital except severe asphyxia, anemia and congenital metabolic diseases were selected. The mothers were exposed to sunburn, diet and vitamin D supplementation during pregnancy. Serum 25 (OH) D levels were measured within 48 hours after birth by isotope dilution ultra performance liquid chromatography-tandem mass spectrometry. Results 141 subjects were enrolled. Neonatal serum 25 (OH) D levels (14.5 ± 6.5) ng / ml, vitamin D deficiency in 77 cases (54.6%), less than 31 cases (22.0%). Sixty-four neonates with vitamin D Dose≥600 IU / d in the third trimester of pregnancy had a prevalence of vitamin D deficiency of 26 (40.6%) and less than 15 (23.4%). There was no significant difference in vitamin D levels between neonates with different gestational age, gender, number of fetuses, small gestational age (SGA) and gestational age (AGA) (P> 0.05). The serum 25 (OH) D level of neonates with BMI> 27 was lower than that of BMI≤27 (12.9 ± 6.6) vs (15.7 ± 6.4) ng / ml, P = 0.015] The serum 25 (OH) D level was lower than that of the newborns born in autumn [(13.4 ± 6.0) vs (16.8 ± 7.2) ng / ml, P = 0.004] Neonatal serum 25 (OH) D levels were higher than <600 IU / d [(16.9 ± 5.5) vs (12.2 ± 5.8) ng / ml, P <0.001]. Birth season (s), maternal vitamin D supplementation dose at 3 months of gestation (d) correlated with neonatal serum 25 (OH) D levels (D). The linear regression equation was D = 22.049 + 0.015d-3.924s (F = 37.643, P <0.001). Conclusions Beijing Union Medical College Hospital (39 ° N) has a high incidence of vitamin D deficiency in newborns in autumn and winter. Vitamin D 600 IU / d during pregnancy is not enough to effectively prevent neonatal vitamin D deficiency.