【摘要】 目的 结合维生素D(vitaminD, VD)补充剂量和补充时长前瞻性探讨孕早期VD补充与小于胎龄儿(small forgestationalage, SGA)发生风险的关系。方法 选取2018-2022年纳入同济出生队列的研究对象。通过面对面调查收集孕妇的基本情况、生活方式及营养补充剂服用情况。SGA指新生儿出生体重低于同性别同胎龄平均体重第10百分位数者。根据孕早期VD补充剂量和时长，将孕妇分为四组：不补充组(non-users, VD=0 IU/d)、低剂量组(VD-L, VD<400IU/d且补充任意时长)、高剂量短期组(VD-HS,VD≥400IU/d且补充时长<2月)和高剂量长期组(VD-HL,VD≥400IU/d且补充时长≥2月)。采用多因素Logistic回归模型评估孕早期VD补充与SGA的关联。结果 本研究共纳入2558名孕妇，平均年龄(28.89±3.49)岁。与non-users相比，VD-HL组文化程度、家庭人均月收入及防晒霜使用比例更高，且更有可能是初产妇(P<0.05)。多因素Logistic回归模型显示，与non-users相比，VD-HL组与SGA发生风险降低50%有关(OR=0.50, 95%CI:0.33, 0.75)，未显示VD-L组和VD-HS组与SGA发生风险的显著关联。结论 孕早期高剂量长期补充VD可降低SGA发生风险。[营养学报，2024,46(5):423-430]更多还原

【Abstract】 Objective To prospectively explore the association between vitamin D(VD) supplementation in early pregnancy and the risk of small for gestational age(SGA) among pregnant women in Wuhan. Methods Participants were all from the Tongji birth cohort conducted from 2018 to 2022. Information on socio-demographic characteristics, lifestyle, and nutritional supplement consumption was collected through face-to-face surveys. SGA refers to an infant with a birth weight below the 10th percentile for the gestational age. According to the dosage and duration of VD supplementation, participants were divided into four groups: non-user group(VD=0 IU/d), low-dose group(VD-L, VD<400 IU/d for any duration),high-dose short-term group(VD-HS, VD≥400 IU/d with<2 months), and high-dose long-term group(VD-HL, VD≥400IU/d with≥2 months). Multiple logistic regressions were used to evaluate the correlation between VD supplementation and SGA risk. Results A total of 2558 subjects were included. The average age was 28.89±3.49 years. Compared with the Non-users, pregnant women in the VD-HL group had higher education levels, per capita monthly household income, and the proportion of sunscreen use, and were more likely to be primiparous women(P<0.05). The multivariate logistic regression model showed that compared to the non-users, women in VD-HL group was associated with a 50% reduction in the risk of SGA(OR=0.50, 95% CI: 0.33, 0.75). No significant association was found between VD-L, VD-HS groups and the risk of SGA. Conclusion High-dose and long-term VD supplementation in early pregnancy reduces the risk of SGA. [ACTA NUTRIMENTA SINICA,2024,46(5):423-430]更多还原