新生儿脐带血25-羟维生素D水平调查

摘要

目的 了解新生儿维生素D的营养状况,为新生儿维生素D的合理补充提供依据.方法 选择2012年1月至2014年12月本院出生的新生儿脐带血25-羟维生素D[25-(OH)D]资料进行回顾性分析.25-(OH)D浓度采用酶联免疫测定法检测,<50.0 nmol/L为维生素D缺乏.分析新生儿胎龄、出生体重、出生季节与脐带血25-(OH)D的相关性.结果 共检测6420例新生儿,其中5358例(占83.5℅)脐带血25-(OH)D浓度<50.0 nmol/L;早期早产儿、中期早产儿、晚期早产儿、足月儿及过期产儿脐带血25-(OH)D浓度[M(Q1,Q3)]依次增高,各组间比较差异有统计学意义[29.0(22.5,38.9),33.4(26.3,41.6),35.1(26.9,43.3),35.7(28.1,45.0),43.3(33.5,52.8)nmol/L,P<0.001];极低出生体重儿、低出生体重儿、正常出生体重儿、巨大儿的25-(OH)D浓度[M(Q1,Q3)]依次增高,各组间比较差异有统计学意义[29.0(22.4,38.8),34.6(27.5,44.2),35.1(28.1,44.7),35.7(28.0,47.5),P<0.001].新生儿脐带血25-(OH)D浓度与出生胎龄、体重成正相关(r=0.619、0.180,P均<0.05).新生儿脐带血25-(OH)D浓度存在季节差异(P<0.001),春季最低[30.4(24.1,38.3)],秋季最高[39.3(31.6,50.9)].结论 新生儿特别是早产儿、低出生体重儿维生素D缺乏率偏高,应注重早产儿和低出生体重儿早期维生素D营养的补充,同时,应加强对孕妇和新生儿维生素D营养增补宣传,鼓励多晒太阳.%Objective To measure vitamin D levels in newborn cord blood inorder to ascertain appropriate supplementation regimes.Methods A total of 6420 newborn umbilical cord blood 25-hydroxyvitamin D [ 25-( OH ) D ] concentrations were measured by enzyme linked immunosorbent assay, and the correlation between 25-( OH ) D and gestational or birth weight or season was retrospectively analyzed.Results There were 5358(83.5℅)of the 6420,had umbilical cord blood concentrations of 25-(OH)D <50. 0 nmol/L. The 25-(OH)D levels M(Q1,Q3)increased from very preterm births, moderately preterm, later preterm, full-term infants to post-term infants [ 29. 0 ( 22. 5, 38.9),33.4(26.3,41.6),35.1(26.9,43.3),35.7(28.1,45.0),43.3(33.5,52.8)nmol/L, P <0. 001]. The 25-(OH) D levels M(Q1,Q3) increased from very low birth weight infants, low birth weight, normal birth weight infants to macrosomia [29. 0(22. 4,38. 8),34. 6(27. 5,44. 2),35. 1(28. 1, 44. 7),35. 7(28. 0,47. 5), P<0. 001]. The 25- (OH)D levels were positively correlated respectively in gestational ages and body weights ( r =0. 619 , 0. 180 , P <0. 05 ) . Newborn umbilical cord blood concentration of 25- ( OH ) D levels varied with season ( P all <0. 001 ) , the lowest in spring [ 30. 4 (24.1,38.3)]and highest in autumn[39.3(31.6,50.9)].Conclusions Premature and low birth weight infants are especially at high risk of vitamin D deficiency and should receive appropriate vitamin D supplementation. In addition, there should be an ongoing promotion of vitamin D supplements to pregnant women and the awareness of sun exposure to achieve vitamin D sufficiency.