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维生素D缺乏与新生儿早发型败血症的相关性研究
Relationship between vitamin D deficiency and early-onset neonatal sepsis
目的 评估血清维生素D水平对足月新生儿早发型败血症 （EOS）的影响。方法 78例足月EOS新生儿设为研究组 （EOS组），60例无感染相关临床和/或实验室表现的健康足月新生儿设为对照组。两组新生儿及其母亲均在产后72 h内采血进行25-羟基维生素D （25-OHD）水平检测，比较两组新生儿维生素D缺乏发生率及母亲孕期维生素D补充情况。结果 两组母亲和新生儿之间血清25-OHD水平均呈显著正相关 （EOS组：r = 0.797，P < 0.01，对照组：r = 0.929，P < 0.01）。EOS组新生儿及其母亲血清25-OHD水平显著低于对照组 （P < 0.01）。EOS组新生儿维生素D缺乏发生率显著高于对照组 （P < 0.01），而母亲孕末期3个月补充足量维生素D的比率显著低于对照组 （P < 0.01）。结论 低血清25-OHD水平与足月新生儿EOS的发生具有相关性。
Objective To evaluate the effect of vitamin D level on early-onset sepsis (EOS) in neonates. Methods Seventy-eight full-term neonates with EOS were used as the research group (EOS group). sixty healthy fullterm neonates without clinical and/or laboratory features related to infections were used as the control group. Blood samples of the neonates and their mothers in both groups were collected within 72 hours of delivery to determine 25-hydroxyvitamin D (25-OHD) levels. The rate of vitamin D deficiency in the neonates and the level of 25-OHD supplemented to their mothers during pregnancy were compared between the two groups. Results There was a significant positive correlation between the serum level of 25-OHD of the mothers and that of the neonates in both groups (EOS group:r = 0.797, P < 0.01; control group:r = 0.929, P < 0.01). The neonates and their mothers in the EOS group had significantly lower 25-OHD levels than those in the control group (P < 0.01). The rate of vitamin D deficiency among the neonates in the EOS group was significantly higher than that of the control group (P < 0.01). The level of vitamin D supplemented to the mothers during the last 3 months of pregnancy in the EOS group was significantly lower than that in the control group (P < 0.01). Conclusions Low serum level of 25-OHD is associated with the development of earlyonset sepsis in full-term neonates.
[1] Black RE, Cousens S, Johnson HL, et al. Global, regional, and national causes of child mortality in 2008:a systematic analysis[J]. Lancet, 2010, 375(9730):1969-1987.
[2] Simonsen KA, Anderson-Berry AL, Delair SF, et al. Early-onset neonatal sepsis[J]. Clin Microbiol Rev, 2014, 27(1):21-47.
[3] Clancy N, Onwuneme C, Carroll A, et al. Vitamin D and neonatal immune function[J]. J Matern Fetal Neonatal Med, 2013, 26(7):639-646.
[4] Hatun ?, Ozkan B, Bereket A. Vitamin D deficiency and prevention:Turkish experience[J]. Acta Paediatr, 2011, 100(9):1195-1199.
[5] Gitto E, Karbownik M, Reiter RJ, et al. Effects of melatonin treatment in septic newborns[J]. Pediatr Res, 2001, 50(6):756-760.
[6] 王晨, 禹松林, 王丹华. 新生儿维生素D水平及其相关因素[J]. 中国新生儿科杂志, 2015, 30(4):241-245.
[7] 张名旭, 李磊. 孕妇维生素D缺乏对母体及子代的影响[J]. 中华临床营养杂志, 2015, 23(1):60-64.
[8] 中华医学会儿科学分会儿童保健学组, 《中华儿科杂志》编辑委员会. 儿童微量营养素缺乏防治建议[J]. 中华儿科杂志, 2010, 48(7):502-509.
[9] Stoll BJ, Hansen NI, Sánchez PJ, et al. Early onset neonatal sepsis:the burden of group B Streptococcal and E. coli disease continues[J]. Pediatrics, 2011, 127(5):817-826.
[10] Mukhopadhyay S, Puopolo KM. Risk assessment in neonatal early onset sepsis[J]. Semin Perinatol, 2012, 36(6):408-415.
[11] Youssef DA, Miller CW, El-Abbassi AM, et al. Antimicrobial implications of vitamin D[J]. Dermatoendocrinol, 2011, 3(4):220-229.
[12] Belderbos ME, Houben ML, Wilbrink B, et al. Cord blood vitamin D deficiency is associated with respiratory syncytial virus bronchiolitis[J]. Pediatrics, 2011, 127(6):e1513-e1520.
[13] Grant CC, Kaur S, Waymouth E, et al. Reduced primary care respiratory infection visits following pregnancy and infancy vitamin D supplementation:a randomised controlled trial[J]. Acta Paediatr, 2015, 104(4):396-404.
[14] Schroth RJ, Lavelle C, Tate R, et al. Prenatal vitamin D and dental caries in infants[J]. Pediatrics, 2014, 133(5):e1277-e1284.
[15] Braun A, Chang D, Mahadevappa K, et al. Association of low serum 25-hydroxyvitamin D levels and mortality in the critically ill[J]. Crit Care Med, 2011, 39(4):671-677.
[16] Madden K, Feldman HA, Smith EM, et al. Vitamin D deficiency in critically ill children[J]. Pediatrics, 2012, 130(3):421-428.
[17] McNally JD, Menon K, Chakraborty P, et al. The association of vitamin D status with pediatric critical illness[J]. Pediatrics, 2012, 130(3):429-436.
[18] Cetinkaya M, Cekmez F, Buyukkale G, et al. Lower vitamin D levels are associated with increased risk of early-onset neonatal sepsis in term infants[J]. J Perinatol, 2015, 35(1):39-45.
[19] Principi N, Bianchini S, Baggi E, et al. Implications of maternal vitamin D deficiency for the fetus, the neonate and the young infant[J]. Eur J Nutr, 2013, 52(3):859-867.
[20] Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency:an Endocrine Society clinical practice guideline[J]. J Clin Endocrinol Metab, 2011, 96(7):1911-1930.
[21] Hollis BW, Wagner CL. Vitamin D and pregnancy:skeletal effects, nonskeletal effects, and birth outcomes[J]. Calcif Tissue Int, 2013, 92(2):128-139.
[22] Hollis BW, Johnson D, Hulsey TC, et al. Vitamin D supplementation during pregnancy:double-blind, randomized clinical trial of safety and effectiveness[J]. J Bone Miner Res, 2011, 26(10):2341-2357.
[23] Wagner CL, McNeil R, Hamilton SA, et al. A randomized trial of vitamin D supplementation in 2 community health center networks in South Carolina[J]. Am J Obstet Gynecol, 2013, 208(2):137.e1-137.13.
