妊娠期维生素D缺乏的流行病学特征、 母婴健康影响及补充策略研究进展

Research Progress on the Epidemiological Characteristics, Maternal and Infant Health Impacts, and Supplementation Strategies of Vitamin D Deficiency during Pregnancy

摘要: 维生素D作为人体必需的脂溶性维生素，具有广泛且关键的生理功能。它能够有效维持血清钙和磷浓度的稳定，在促进肠道对钙、磷的吸收以及钙在骨骼中的沉积过程中发挥着核心作用，进而保障骨骼系统的正常发育与健康。维生素D在免疫系统调节方面也表现出重要活性，可增强机体免疫力，抵御病原体入侵。故而，维生素D在母婴健康方面也会产生积极作用。充足的维生素D有助于提高孕妇的胰岛素敏感性，降低妊娠糖尿病风险；其免疫调节特性可减少先兆子痫等孕期严重并发症的发生。在胎儿发育方面，能促进胎儿骨骼和牙齿的良好形成，对母乳喂养的婴儿，母亲乳汁中充足的维生素D可改善新生儿神经认知功能，增强其免疫防御能力。然而，流行病学研究显示，孕妇群体中维生素D缺乏现象较为普遍，这种缺乏状态对母婴健康结局产生了诸多不利影响。对于孕妇自身而言，维生素D缺乏会显著增加妊娠糖尿病、先兆子痫等妊娠并发症的发生风险，还可能导致孕期骨量流失、骨质疏松，影响孕妇的生活质量与身体健康。从胎儿角度分析，孕期维生素D缺乏会阻碍胎儿骨骼的正常发育，提高新生儿低钙血症、先天性佝偻病的发病几率，甚至对胎儿神经认知功能的发育产生负面影响，不利于新生儿的远期健康。本文综述维生素D的生理功能、孕妇维生素D缺乏的流行病学、对母婴健康的影响以及补充策略，旨在为临床实践提供更丰富的理论指导，推动母婴健康事业的持续发展。

Abstract: Vitamin D, an essential fat-soluble vitamin for the human body, possesses extensive and crucial physiological functions. It effectively maintains the stability of serum calcium and phosphorus concentrations, plays a central role in promoting the intestinal absorption of calcium and phosphorus as well as the deposition of calcium in bones, thereby safeguarding the normal development and health of the skeletal system. Vitamin D also exhibits significant activity in immune system regulation, which can enhance the body’s immunity and resist pathogen invasion. Consequently, vitamin D exerts positive effects on maternal and infant health. Sufficient vitamin D helps improve insulin sensitivity in pregnant women and reduce the risk of gestational diabetes mellitus; its immunomodulatory properties can decrease the incidence of severe pregnancy-related complications such as preeclampsia. In terms of fetal development, it promotes the sound formation of fetal bones and teeth. For breastfed infants, adequate vitamin D in maternal breast milk can improve neonatal neurocognitive function and enhance their immune defense capabilities. However, epidemiological studies have shown that vitamin D deficiency is relatively prevalent among pregnant women, and this deficient state exerts numerous adverse impacts on maternal and infant health outcomes. For pregnant women themselves, vitamin D deficiency significantly increases the risk of pregnancy complications such as gestational diabetes mellitus and preeclampsia, and may also lead to bone loss and osteoporosis during pregnancy, affecting their quality of life and physical health. From the fetal perspective, maternal vitamin D deficiency during pregnancy hinders the normal development of fetal bones, increases the incidence of neonatal hypocalcemia and congenital rickets, and even exerts negative effects on the development of fetal neurocognitive function, which is detrimental to the long-term health of newborns. This review summarizes the physiological functions of vitamin D, the epidemiology of vitamin D deficiency in pregnant women, its impacts on maternal and infant health, and corresponding supplementation strategies, aiming to provide more comprehensive theoretical guidance for clinical practice and promote the sustainable development of maternal and infant health undertakings.