论文部分内容阅读
目的 探讨新生儿脐血维生素D水平及影响因素.方法 选取2016年1～3月在温州医科大学附属第二医院产检并分娩的孕妇及其新生儿为研究对象,根据母亲孕晚期补充维生素D情况分为未补充组、＜ 400 IU/d组和≥400 IU/d组,采用二分类Logistic回归分析新生儿脐血维生素D水平的影响因素,采用受试者工作特征曲线分析母亲孕晚期摄入维生素D剂量对于新生儿脐血维生素D水平的预测价值.结果 共纳入109对孕妇及其新生儿,脐血25 (OH)D水平为(17.5 ±7.7)ng/ml,25 (OH)D充足37例(33.9％),不足24例(22.0％),缺乏43例(39.4％),严重缺乏5例(4.6％).未补充组、＜ 400 IU/d组、≥400 IU/d组新生儿25(OH)D水平分别为(12.9±6.5)、(1 8.2±6.9)、(21.7±8.4) ng/ml,差异有统计学意义(P＜0.05);各组新生儿出生体重、身长、前囟、头围比较差异均无统计学意义(P＞0.05).新生儿脐血25 (OH)D水平与母亲孕晚期补充维生素D剂量成正相关(P＜0.05),直线回归方程为Y =4.5X +8.87.母亲孕晚期补充维生素D剂量为187 IU/d时约登指数最大(0.403),对应的灵敏度为0.514,特异度为0.889,受试者工作特征曲线下面积为0.777 (95％ CI0.685～0.870).结论 本区域新生儿脐血维生素D水平普遍较低,母亲孕晚期补充维生素D剂量与新生儿维生素D水平相关,对新生儿维生素D水平有一定预测价值.“,”Objective To study neonatal umbilical cord blood vitamin D status and related factors.Method From January to March 2016,pregnant mothers and their neonates admitted to our hospital were enrolled.According to maternal intake of vitamin D in the third trimester,they were assigned into non supplement group,＜ 400 IU/d group and ≥ 400 IU/d group.Binary Logistic regression was used to examine factors related to neonatal umbilical cord blood vitamin D status.The predictive value of maternal third trimester vitamin D intaken and umbilical cord blood vitamin D level were determined using receiver operator characteristic (ROC) curve.Result A total of 109 newborns were enrolled in the study.The median concentration of 25 (OH)D in the umbilical cord blood was (17.5 ± 7.7) ng/ml.The incidences of 25 (OH) D sufficiency,insufficiency and deficiency was 33.9％ (37/109),22.0％ (24/109) and 39.4％(43/109),and 4 cases(4.6％) had serious deficiency.The median concentration of 25 (OH)D were (12.9 ± 6.5),(18.2 ± 6.9),(21.7 ± 8.4) ng/ml in the non-supplementation group,＜ 400 IU/d intake group and ≥400 IU/d intake group,respectively,with statistically significant differences(P ＜ 0.05).The three groups had similar birth weight,height,bregma and head circumference (P ＞ 0.05).25 (OH) D level in neonatal umbilical cord blood was positively correlated with the amount of maternal third trimester vitamin D supplementation (P ＜ 0.05).The Youden index was highest (0.403) when vitamin D supplement was 187 IU/d,the corresponding sensitivity was 0.514,the specificity was 0.889 and the area under the ROC curve was 0.777 (95％ CI 0.685 ～ 0.870).Conclusion Vitamin D insufficiency is common in neonatal umbilical cord blood among our patients.The maternal third trimester vitamin D supplementation dosage is related to the neonatal umbilical cord blood vitamin D level,which has a certain predictive value for vitamin D level in newborn.