Prevalence and determinants of vitamin D deficiency in the third trimester of pregnancy: a multicentre study in Switzerland.

BRITISH JOURNAL OF NUTRITION(2018)

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摘要
Vitamin D deficiency during pregnancy is associated with negative health consequences for mothers and their infants. Data on the vitamin D status of pregnant women in Switzerland are scarce. A three-centre study was conducted in the obstetric departments of Zurich, Bellinzona and Samedan (Switzerland) to investigate the prevalence and determinants of vitamin D deficiency (serum 25-hydroxyvitamin D (25(OH) D) < 50 nmol/l) in 3rd-trimester pregnant women living in Switzerland (n 305), and the correlation between 25(OH) D in pregnant women and their offspring at birth (n 278). Demographic and questionnaire data were used to explore the determinants of vitamin D deficiency. Median concentration of serum 25(OH) D in the third trimester of pregnancy was 46.0 nmol/l (1st-3rd quartiles: 30.5-68.5), representing a 53.4% prevalence of vitamin D deficiency. 25(OH) D levels in the umbilcal cord blood (median: 50.0 nmol/l; 1st-3rd quartiles: 31.0-76.6) strongly correlated with mothers' serum 25(OH) D (Spearman's correlation rho = 0.79, P < 0.001). Multivariable logistic regression analysis showed that significant determinants of vitamin D deficiency in pregnant women were centre of study, country of origin, season of delivery and vitamin D supplement intake. Near-term BMI, skin colour, use of sunscreen and mothers' education, although each not individually significant, collectively improved the ability of the model to explain vitamin D status. Low vitamin D levels were common in this sample of pregnant women and their newborns' cord blood. Vitamin D supplement intake was the most actionable determinant of vitamin D status, suggesting that vitamin D supplementation during pregnancy should receive more attention in clinical practice.
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关键词
25-Hydroxy-vitamin D,Hypovitaminosis,Cord blood,Vitamin supplementation,Neonates
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