Research progress of rational supplementation of vitamin D and calcium during pregnancy and its relationship with neonates
孕期合理补充维生素D与钙的研究进展及与新生儿的关联性

摘要

目的 探讨孕妇孕期维生素D及钙适宜的补充剂量。方法 选取2017年1月-2021年1月在浙江省台州市天台县妇幼保健计划生育服务中心孕早期建卡遵医嘱产检的孕妇1911例作为研究对象，检测孕妇13+6周内、孕14至20+6周、21至31+6周、32周至分娩前等4个阶段血 25-（OH）D 水平， 按照孕妇血清25-（OH）D水平测定结果补充一定剂量的维生素D与钙剂，收集孕妇孕各期维生素D、钙补充剂量及饮食日照等情况，分析维生素D与其相关影响因素的关系，探讨孕各期不同25-（OH）D 水平其维生素D合适剂量的补充。结果 13+6周内维生素D不足及缺乏者建议最低补充400IU/d及以上，不足者钙最低补充400mg/d及以上；孕14至20+6周期间不足及缺乏者建议最低补充800IU/d及以上，缺乏者钙最低补充600mg/d及以上；21至31+6周期间正常、不足及缺乏者均建议最低补充600-400IU/d及以上，不足者钙最低补充600mg/d及以上；32周至分娩前期间正常及不足者建议最低补充600IU/d及以上。结论 不同孕期建议合理补充不同剂量维生素D和钙剂，从而有效减少孕妇及新生儿维生素D缺乏。

Abstract

Objective To investigate the appropriate supplemental dose of vitamin D and calcium in pregnant women during pregnancy.
Methods From January 2017 to January 2021, a total of 1911 pregnant women in Tiantai County Maternal and Child Health and family Planning Service Center of Taizhou City, Zhejiang Province were selected as the study objects. The blood 25- (OH) D level of pregnant women was detected during 13+6 weeks, 14-20+6 weeks, 21-31+6 weeks and 32 weeks before delivery, and a certain dose of vitamin D and calcium were added according to the determination result of serum 25- (OH) D level of pregnant women. The vitamin D and calcium supplemental dose and dietary sunshine of pregnant women during each pregnancy period were collected. To analyze the relationship between vitamin D and its related influencing factors, and to explore the appropriate dose of vitamin D supplementation with different 25- (OH) D levels in different stages of pregnancy.
Results Within 13+6 weeks, vitamin D deficiency and deficiency patients were recommended to supplement 400IU/d and above, and calcium deficiency patients were recommended to supplement 400mg/d and above. During 14 to 20+6 weeks of pregnancy, the minimum supplementation of 800IU/d and above is recommended for insufficient and deficient patients, and the minimum supplementation of 600mg/d and above is recommended for deficient patients. During 21 to 31+6 weeks, the minimum supplementation of 600-400IU/d and above is recommended for normal, insufficient and deficient patients, and the minimum supplementation of 600mg/d and above is recommended for inadequate patients. A minimum supplement of 600IU/d or more is recommended for normal and inadequate patients from 32 weeks to the time before delivery.
Conclusion   It is recommended to supplement vitamin D and calcium in different doses during different pregnancies, so as to effectively reduce vitamin D deficiency in pregnant women and newborns.