扬州地区新生儿维生素D水平及影响因素研究

目的 了解扬州地区新生儿血清中维生素D（Vitamin D，VD）水平及其影响因素。方法 选取孕早期在扬州市妇幼保健院建卡且于2014年5月~2015年5月在产科住院分娩的孕妇作为初始研究对象。按照纳入和排除标准选入3 913例健康单胎活产新生儿进入此次研究，并通过自制的问卷收集孕妇及新生儿相关信息。采用酶联免疫吸附法检测孕妇及新生儿血清中的VD浓度，描述并分析新生儿VD的分布特征及影响因素。结果 扬州地区新生儿VD水平为（28.79±8.37）nmol/L，其充足率、不足率、缺乏率分别为2.2%、11.7%、86.1%。多因素Logistic回归模型分析结果显示，孕妇孕中期VD缺乏（OR=3.16，95%CI:2.00~5.00，P<0.001）和不足（OR=1.67，95%CI:1.04~2.67，P=0.033），孕晚期VD缺乏（OR=8.64，95%CI:5.64~13.24，P<0.001）和不足（OR=1.63，95%CI:1.07~2.49，P=0.024），胎儿分娩季节为冬春季（OR=1.49，95%CI:1.13~1.97，P=0.004）均是新生儿VD缺乏的危险因素。结论 扬州地区新生儿VD水平普遍缺乏，孕妇孕中期和孕晚期VD状况以及胎儿分娩季节与新生儿VD缺乏均存在关联。

Study on the levels and risk factors of neonatal vitamin D in Yangzhou

Objective To investigate vitamin D (VD) levels of newborns in Yangzhou, and examine the risk factors of neonatal VD deficiency. Methods The pregnant women who set up health card in Maternal and Child Health Hospital of Yangzhou from May 2014 to May 2015 during the first trimester were selected as the initial study subjects. According to inclusion and exclusion criterion, 3 913 healthy singleton live birth newborns were enrolled in the present study, and related information of pregnant women and newborns were collected with a self-designed questionnaire. The VD concentration of pregnant women and newborns were examined by enzyme-linked immunosorbent assay. The distribution characteristics and risk factors of neonatal VD were described and analyzed. Results The levels of neonatal VD were (28.79±8.37) nmol/L in Yangzhou. The prevalence of sufficiency, insufficiency, and deficiency were 2.2%, 11.7%, and 86.1%, respectively. Multivariate logistic regression model analysis showed that VD deficiency (OR=3.16, 95%CI:2.00-5.00, P<0.001) and VD insufficiency (OR=1.67, 95%CI:1.04-2.67, P=0.033) in the second trimester of pregnancy, VD deficiency (OR=8.64, 95%CI:5.64-13.24, P<0.001) and VD insufficiency (OR=1.63, 95%CI:1.07-2.49, P=0.024) in the third trimester of pregnancy, and fetal delivery in winter-spring (OR=1.49, 95%CI:1.13-1.97, P=0.004) were risk factors of neonatal VD deficiency. Conclusions VD deficiency of newborns were common in Yangzhou. The VD status of pregnant women in the second and third trimesters of pregnancy and the season of fetal delivery were associated with neonatal VD deficiency.