Maternal Late-pregnancy Vitamin D Level And Related Factors And Its Relation With Infant Eczema

1、Maternal late-pregnancy vitamin D level and related factorsObejective: To investigate the maternal late-pregnancy vitamin D nutritional status inSuzhou and evaluate related factors influencing vitamin D level.Methods: healthy pregnant women who attended prenatal examination, gestationalage≥28weeks and agreed the blood test of25(OH) D concentrations in the OutpatientDepartment of Obstetrics and Gynecology in Suzhou Municipal Hospital from March toApril of2013were recruited. We collected the basic information of pregnant women,nutrition intake during pregnancy, daily duration of exposure to the sun and the smokingenvironment during pregnancy according to the medical records and by questionnaires.Maternal late-pregnancy serum25(OH) D levels were measured by enzyme-linkedimmunosorbent assay. Using SPSS17.0statistical software to calculate the data. As for thefactors related to maternal25(OH) D levels, the univariate analysis was done by thechi-square test and the multivariate analysis by the Logistic regression analysis，P＜0.05was considered as statistically significant.Results:1） this study included418cases healthy pregnant women. The mean age ofthese subjects was27.30±3.42years (range20-38years) and the average gestational ageof collecting maternal blood was33.05±3.18week (range28-38weeks).2)The medianof serum25(OH)D concentration in maternal was14.41(6.26-44.08)ng/ml.336cases(80.4%) pregnant women were vitamin D deficiency(<20ng/ml),70cases(16.7%)pregnant women were vitamin D insufficiency, and only12cases(2.9%) pregnant womenwere vitamin D sufficient(≥30ng/ml).3) It was shown by the univariate analysis that theduration of multivitamin supplement, supplement calcium, intake of fish or egg and dailyduration of the sun exposure during mid-late pregnancy had statistical significance (P<0.05).4)Multivariate logistic regression analysis showed that, multivitamin supplement for at least three months and intake of fish or egg more than three times per week duringmid-late pregnancy was contributed to maintain maternal late-pregnancy vitamin D level≥20ng/ml (OR was5.723[95%CI:2.672,12.257],2.975[95%CI:1.067,8.294],respectively). Calcium supplement in pregnancy can reduce the risk of maternallate-pregnancy vitamin D levels <20ng/ml (OR=2.094,95%CI:1.143,3.835). Exposureto0.5-1h sun per day in pregnancy helps maternal late-pregnancy vitamin D levels≥20ng/ml (OR=2.500,95%CI:1.233,5.070), compared with exposed to less than half anhour sun per day, more than one hour a day in the sun can higher4.6-fold risks ofmaintaining maternal vitamin D levels≥20ng/ml (OR=4.634,95%CI:2.129,10.083).Conclusions:1)The prevalence of vitamin D deficency in late pregnant women ishigh in Suzhou. Vitamin D supplement for pregnant women should be taken seriously inorder to guarantee the maternal and neonatal vitamin D in a good status.2)Regularsupplement of multivitamin containing vitamin D, use calcium-vitamin D supplements,increasing intake of vitamin D containing food such as fish, egg and longer duration of thesun exposure in pregnancy help to improve25(OH)D levels of late pregnant women andreduce the risk of maternal vitamin D deficency.2、Maternal late-pregnancy vitamin D level and infant eczemaObejective: To analyze the relation between25(OH)D concentrations in latepregnancy and infant eczema, and to explore the role of vitamin D level in pregnancy onthe primary prevention of infant eczema.Methods: healthy pregnant women who attended prenatal examination, gestationalage≥28weeks and agreed the blood test of25(OH) D concentrations in the OutpatientDepartment of Obstetrics and Gynecology in Suzhou Municipal Hospital from March toApril of2013were recruited and their full-term healthy newborns were included.Premature baby, newborn with neonatal congenital disease and history of mechanicalassisted ventilation were the exceptions. This part of the study included402cases ofmother-child pairs. We collected questionnaire data by telephone interviews and on-siteinvestigation at birth,3months,6months of age, including infant age, gender, mode ofdelivery, gestational age, birth weight, breastfeeding, add vitamin D and calcium after birth,postnatal environmental exposure, parental history of allergies and the occurrence ofinfantile eczema. Potential confounders was adjusted by Logistic regression models toanalyze the relation between maternal late-pregnancy25(OH) D levels and infant eczema at6months.Results:1)The median of402cases maternal late-pregnancy25(OH)D concentrationwas14.38ng/ml.120of whose infants aged6months have eczema with incidence29.9%.2)Supplement vitamin D containing multivitamin during mid-late pregnancy was notasscociated with infant eczema（P＞0.05）.3)Maternal25(OH)D levels observed in infantswith eczema was13.49ng/ml, Maternal25(OH)D levels observed in infants withouteczema was14.98ng/ml，there was significant difference between two groups(P<0.001).4)Maternal late-pregnancy25(OH)D levels＜20ng/ml in relation to the increasing risk ofinfant eczema at6months of age（OR=2.27,95%CI:1.20,4.32)，this association remainedsignificant after adjustment for multiple confounding factor（sOR=3.53,95%CI:1.64,7.60).Conclusions: Maternal late-pregnancy vitamin D level＜20ng/ml were associatedwith increased risk of infant eczema at6months of age. According to the research report,daily intake of vitamin D600IU for pregnant women are recommended to maintainmaternal late-pregnancy vitamin D level≥20ng/ml, which is likely to prevent infants fromthe infantile eczema.