NEJM:孕中后期及产后补充维生素D不会促进新生儿生长发育

2018-08-09 zhangfan MedSci原创

维生素D缺乏人群中,女性在孕中期或产后6个月补充维生素D不能改善胎儿或婴儿的生长

近日研究人员在维生素D缺乏症高发地区,考察了怀孕和哺乳期间孕妇补充维生素D对胎儿和婴儿生长的影响。

研究在孟加拉开展,根据世界卫生组织(WHO)儿童生长标准,评估每周产前补充维生素D(妊娠17至24周至分娩前)和产后补充维生素D对婴儿1岁生长发育z评分的影响。1组参与者不接受补充(对照组),3组参与者仅接受产前维生素D补充,剂量为4200IU、16800IU以及28000IU,第5组接受产前补充和26周产后补充,共计28 000 IU。

1164名新生儿在1岁接受生长评估,组间年龄-身高z分数差异不显著,各组数据如下:安慰剂组,-0.93±1.05;产前4200IU组,-1.11±1.12;产前16800IU组,-0.97±0.97;产前28000IU组,-1.06±1.07;产前产后组,-0.94±1.00。其他生长指标、出生结果和发病率在各组间没有显著差异。补充维生素D对母婴血清25-羟基维生素D和钙浓度、产妇尿钙排泄和甲状旁腺激素浓度有预期的影响。各组间不良事件的发生率无显著性差异,但接受最高剂量治疗的妇女高钙尿的发生率较高。

维生素D缺乏人群中,女性在孕中期或产后6个月补充维生素D不能改善胎儿或婴儿的生长。

原始出处:

Daniel E. Roth et al.Vitamin D Supplementation in Pregnancy and Lactation and Infant Growth. N Engl J Med,Aug 09, 2017

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1945786, encodeId=ed301945e861c, content=<a href='/topic/show?id=49ce6961069' target=_blank style='color:#2F92EE;'>#生长发育#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69610, encryptionId=49ce6961069, topicName=生长发育)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35a460, createdName=fengyi812, createdTime=Wed Dec 05 22:53:00 CST 2018, time=2018-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1347320, encodeId=224c134e32028, content=<a href='/topic/show?id=88713e938c1' target=_blank style='color:#2F92EE;'>#发育#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37938, encryptionId=88713e938c1, topicName=发育)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f4c124, createdName=neurowu, createdTime=Fri Aug 10 21:53:00 CST 2018, time=2018-08-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337486, encodeId=d8d733e4865e, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b8fe2414101, createdName=远*方, createdTime=Thu Aug 09 08:41:59 CST 2018, time=2018-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337473, encodeId=72a033e473cf, content=谢谢分享,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1bb241978, createdName=phoebeyan520, createdTime=Thu Aug 09 07:44:05 CST 2018, time=2018-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337472, encodeId=d7f233e4725e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://login.medsci.cn/upload/avatar/f3d88083d8829740786bed95c22464d1/e325f3af93bb747a620d16c209094d69.jpg, createdBy=9efb2014947, createdName=小小小麦兜, createdTime=Thu Aug 09 07:41:59 CST 2018, time=2018-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337456, encodeId=0c0733e456a3, content=意思是要提前补充吗?还是说什么时候都没用, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7e71713450, createdName=太阳系小猪, createdTime=Thu Aug 09 07:25:35 CST 2018, time=2018-08-09, status=1, ipAttribution=)]
    2018-08-10 neurowu
  3. [GetPortalCommentsPageByObjectIdResponse(id=1945786, encodeId=ed301945e861c, content=<a href='/topic/show?id=49ce6961069' target=_blank style='color:#2F92EE;'>#生长发育#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69610, encryptionId=49ce6961069, topicName=生长发育)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35a460, createdName=fengyi812, createdTime=Wed Dec 05 22:53:00 CST 2018, time=2018-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1347320, encodeId=224c134e32028, content=<a href='/topic/show?id=88713e938c1' target=_blank style='color:#2F92EE;'>#发育#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37938, encryptionId=88713e938c1, topicName=发育)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f4c124, createdName=neurowu, createdTime=Fri Aug 10 21:53:00 CST 2018, time=2018-08-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337486, encodeId=d8d733e4865e, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b8fe2414101, createdName=远*方, createdTime=Thu Aug 09 08:41:59 CST 2018, time=2018-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337473, encodeId=72a033e473cf, content=谢谢分享,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1bb241978, createdName=phoebeyan520, createdTime=Thu Aug 09 07:44:05 CST 2018, time=2018-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337472, encodeId=d7f233e4725e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://login.medsci.cn/upload/avatar/f3d88083d8829740786bed95c22464d1/e325f3af93bb747a620d16c209094d69.jpg, createdBy=9efb2014947, createdName=小小小麦兜, createdTime=Thu Aug 09 07:41:59 CST 2018, time=2018-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337456, encodeId=0c0733e456a3, content=意思是要提前补充吗?还是说什么时候都没用, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7e71713450, createdName=太阳系小猪, createdTime=Thu Aug 09 07:25:35 CST 2018, time=2018-08-09, status=1, ipAttribution=)]
    2018-08-09 远*方

    学习

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1945786, encodeId=ed301945e861c, content=<a href='/topic/show?id=49ce6961069' target=_blank style='color:#2F92EE;'>#生长发育#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69610, encryptionId=49ce6961069, topicName=生长发育)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35a460, createdName=fengyi812, createdTime=Wed Dec 05 22:53:00 CST 2018, time=2018-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1347320, encodeId=224c134e32028, content=<a href='/topic/show?id=88713e938c1' target=_blank style='color:#2F92EE;'>#发育#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37938, encryptionId=88713e938c1, topicName=发育)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f4c124, createdName=neurowu, createdTime=Fri Aug 10 21:53:00 CST 2018, time=2018-08-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337486, encodeId=d8d733e4865e, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b8fe2414101, createdName=远*方, createdTime=Thu Aug 09 08:41:59 CST 2018, time=2018-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337473, encodeId=72a033e473cf, content=谢谢分享,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1bb241978, createdName=phoebeyan520, createdTime=Thu Aug 09 07:44:05 CST 2018, time=2018-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337472, encodeId=d7f233e4725e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://login.medsci.cn/upload/avatar/f3d88083d8829740786bed95c22464d1/e325f3af93bb747a620d16c209094d69.jpg, createdBy=9efb2014947, createdName=小小小麦兜, createdTime=Thu Aug 09 07:41:59 CST 2018, time=2018-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337456, encodeId=0c0733e456a3, content=意思是要提前补充吗?还是说什么时候都没用, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7e71713450, createdName=太阳系小猪, createdTime=Thu Aug 09 07:25:35 CST 2018, time=2018-08-09, status=1, ipAttribution=)]
    2018-08-09 phoebeyan520

    谢谢分享,谢谢分享

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1945786, encodeId=ed301945e861c, content=<a href='/topic/show?id=49ce6961069' target=_blank style='color:#2F92EE;'>#生长发育#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69610, encryptionId=49ce6961069, topicName=生长发育)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35a460, createdName=fengyi812, createdTime=Wed Dec 05 22:53:00 CST 2018, time=2018-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1347320, encodeId=224c134e32028, content=<a href='/topic/show?id=88713e938c1' target=_blank style='color:#2F92EE;'>#发育#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37938, encryptionId=88713e938c1, topicName=发育)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f4c124, createdName=neurowu, createdTime=Fri Aug 10 21:53:00 CST 2018, time=2018-08-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337486, encodeId=d8d733e4865e, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b8fe2414101, createdName=远*方, createdTime=Thu Aug 09 08:41:59 CST 2018, time=2018-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337473, encodeId=72a033e473cf, content=谢谢分享,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1bb241978, createdName=phoebeyan520, createdTime=Thu Aug 09 07:44:05 CST 2018, time=2018-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337472, encodeId=d7f233e4725e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://login.medsci.cn/upload/avatar/f3d88083d8829740786bed95c22464d1/e325f3af93bb747a620d16c209094d69.jpg, createdBy=9efb2014947, createdName=小小小麦兜, createdTime=Thu Aug 09 07:41:59 CST 2018, time=2018-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337456, encodeId=0c0733e456a3, content=意思是要提前补充吗?还是说什么时候都没用, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7e71713450, createdName=太阳系小猪, createdTime=Thu Aug 09 07:25:35 CST 2018, time=2018-08-09, status=1, ipAttribution=)]
    2018-08-09 小小小麦兜

    学习了

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1945786, encodeId=ed301945e861c, content=<a href='/topic/show?id=49ce6961069' target=_blank style='color:#2F92EE;'>#生长发育#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69610, encryptionId=49ce6961069, topicName=生长发育)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35a460, createdName=fengyi812, createdTime=Wed Dec 05 22:53:00 CST 2018, time=2018-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1347320, encodeId=224c134e32028, content=<a href='/topic/show?id=88713e938c1' target=_blank style='color:#2F92EE;'>#发育#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37938, encryptionId=88713e938c1, topicName=发育)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f4c124, createdName=neurowu, createdTime=Fri Aug 10 21:53:00 CST 2018, time=2018-08-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337486, encodeId=d8d733e4865e, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b8fe2414101, createdName=远*方, createdTime=Thu Aug 09 08:41:59 CST 2018, time=2018-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337473, encodeId=72a033e473cf, content=谢谢分享,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1bb241978, createdName=phoebeyan520, createdTime=Thu Aug 09 07:44:05 CST 2018, time=2018-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337472, encodeId=d7f233e4725e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://login.medsci.cn/upload/avatar/f3d88083d8829740786bed95c22464d1/e325f3af93bb747a620d16c209094d69.jpg, createdBy=9efb2014947, createdName=小小小麦兜, createdTime=Thu Aug 09 07:41:59 CST 2018, time=2018-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337456, encodeId=0c0733e456a3, content=意思是要提前补充吗?还是说什么时候都没用, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7e71713450, createdName=太阳系小猪, createdTime=Thu Aug 09 07:25:35 CST 2018, time=2018-08-09, status=1, ipAttribution=)]
    2018-08-09 太阳系小猪

    意思是要提前补充吗?还是说什么时候都没用

    0

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既往研究提示维生素D(VitD)可能可以降低患癌风险,目前关于VitD补充与癌症发病风险的关系,尚无定论。近期发表在《JAMA Oncology》杂志的研究,对一项大型社区随机对照研究进行了事后分析,以探索VitD补充是否可以降低癌症发病风险。

J Natl Cancer I:一项大型的国际研究表明,维生素D可以防癌

一项由美国癌症协会、哈佛大学公共卫生学院、美国国家癌症研究所和其他20多家医疗中心和组织的科学家共同完成的新研究发现,血液中的维生素D浓度越高,患大肠癌的风险越低。这项研究加强了先前认为不确定的关于保护关系的证据。在大肠癌预防中,维生素D的最佳浓度可能高于目前美国国家医学研究院(National Academy of Medicine)仅基于骨骼健康的建议。

BMJ:有力证据!高水平维生素D或能降低患癌风险

不久前,发表在BMJ上的一篇论文证实,一项针对日本成年人的大型研究发现,高水平的维生素D可能与患癌(包括肝癌)风险降低有关。本周,又有新成果证明了血液中的维生素D水平与患癌风险之间的关联!

Nutr Neurosci:推翻传统观点!高水平维生素D并不能预防痴呆

半年,探索君先后报道了维生素D降低患癌风险、治疗糖尿病、提高出生几率等方面的好消息。然而,7月9日发表的一项新成果却给维生素D泼了点冷水。研究称,维生素D不太可能保护个体免受多发性硬化症、帕金森病、阿尔茨海默症或其他大脑相关疾病的侵害。

JAMA Pediatr: 妊娠期补充维生素D是否对后代安全有益?

妊娠期补充维生素D是否对后代安全有益尚不清楚。2018年5月,发表在《JAMA Pediatr》的一项系统评价和荟萃分析调查了妊娠期维生素D补充剂与后代成长、发病和死亡的相关性。