母亲的维生素D状况是否会影响胎盘体重或血管和炎症病理? 来自凯洛格怀孕研究的二次分析
Molly J Mead1, Caroline A McWhorter1, Megan D Rodgers1
1College of Medicine, Medical University of South Carolina, Charleston, SC, United States.
概括
怀孕期间高剂量维生素D补充与胎盘体重增加有关,对胎盘形态没有不良影响. 母亲的维生素D状况,以血清25(OH) D表示,与胎盘体重呈正相关,即使在较大的胎盘中也是如此.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 营养科学 营养科学
背景情况:
- 已知维生素D补充对妊娠并发症的积极影响,但其对胎盘发育的影响尚不清楚.
- 胎盘体重在妊娠年龄的第10至90百分位之间与改善妊娠结果有关.
- 了解母亲的维生素D状况与胎盘形态之间的联系对于优化妊娠健康至关重要.
研究的目的:
- 评估由高剂量或低剂量维生素D补充产生的母体血清25(OH) D度对胎盘发育和形态的影响.
- 调查假设,母亲维生素D状况不足与胎盘体重减小和胎盘病理增加有关.
主要方法:
- 一项随机对照试验的二次分析,涉及297名孕妇,每天分配400 IU或4400 IU维生素D.
- 使用2016年阿姆斯特丹共识标准,对132个胎盘进行了病理和体重评估.
- 测量了母体血清25(OH) D水平,回归模型分析了维生素D状态,胎盘特征和母体因素 (BMI,种族/种族) 之间的关联.
主要成果:
- 孕产妇血清25(OH) D水平与更大的胎盘体重 (p=0.023) 有显著的关联.
- 较高的母亲BMI (p=0.046) 和白人/西班牙裔种族与与黑人母亲相比更大的胎盘体重有关 (p=0.025).
- 妊娠年龄≥90百分点 (n=7) 的胎盘显著高于母体血清25(OH) D AUC (p=0.03),但与增加的围产死亡率无关.
结论:
- 通过维生素D补充剂增加母亲血清25(OH) D并没有对胎盘形态产生不利影响.
- 母亲的维生素D状况,反映在血清25(OH) D AUC中,与胎盘体重有显著的相关性.
- 较大的胎盘 (≥90百分位数) 并没有与日产期死亡率的增加有关,这表明胎盘重量较高的潜在安全边际.
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