孕妇和新生儿维生素D缺乏症

Neelakanta Kanike, Naveen Kannekanti, Jenny E. Camacho
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引用次数: 1

摘要

维生素d不仅是骨骼健康的必需元素,也是一种促激素。缺乏维生素D是佝偻病最常见的原因,也会增加患呼吸窘迫综合征、下呼吸道感染、食物敏感、哮喘、I型糖尿病、自闭症和精神分裂症的风险。维生素D缺乏限制了膳食中钙和磷的有效吸收。新生儿的维生素D状况完全取决于怀孕期间母亲的供应。怀孕期间母亲维生素D水平低是婴儿佝偻病的主要危险因素。儿童佝偻病是由严重的慢性维生素D缺乏和明显的骨骼异常引起的,但维生素D不足的新生儿没有明显的骨骼或钙代谢缺陷。佝偻病在20世纪早期是一种全球性疾病。在了解了其因果途径以及在人群水平上引入激素维生素D强化牛奶后,它在发达国家几乎消失了。令人惊讶的是,根据最近的证据,佝偻病正在重新出现。维生素D缺乏症在发达国家和发展中国家都很普遍。本章将回顾孕妇和新生儿维生素D缺乏症的患病率及其对妊娠和婴儿健康的不利影响。本章还介绍了预防这些脆弱人群维生素D缺乏症的循证建议。
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Vitamin D Deficiency in Pregnant Women and Newborn
Vitamin-D is not only an essential element in bone health, but it is also a pro-hormone. Deficiency of vitamin D is the most common cause of rickets and is also known to increase the risk of respiratory distress syndrome, lower respiratory infections, food sensitivities, asthma, type I diabetes, autism and schizophrenia. Vitamin D deficiency limits the effective absorption of dietary calcium and phosphorus. Vitamin D status in newborns is entirely dependent on maternal supply during pregnancy. Low maternal vitamin D status during pregnancy is a major risk factor for rickets in infants. Rickets in children is caused by severe, chronic vitamin D deficiency with apparent skeletal abnormalities, but neonates with vitamin D insufficiency have no overt skeletal or calcium metabolism defects. Rickets was a global disease in the early twentieth century. It has nearly disappeared in developed countries after its causal pathway was understood and fortification of milk with the hormone vitamin D was introduced at the population level. Surprisingly, rickets is re-emerging per recent evidence. Vitamin D deficiency is prevalent in both developed and developing countries. The chapter will review the prevalence of vitamin D deficiency in pregnant women and newborn population and its adverse effects on pregnancy and infant’s health. The chapter also describes evidence-based recommendations to prevent vitamin D deficiency in these vulnerable population.
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