بررسی سیستماتیک و متاآنالیز میانگین غلظت ویتامین D در زنان باردار و نوزادان ایران

نوع مقاله: مروری

نویسندگان

1 دانشجوی پزشکی، کمیته تحقیقات دانشجویی، دانشکده پزشکی، دانشگاه علوم پزشکی ایلام، ایلام، ایران.

2 استادیار، گروه کودکان، دانشکده پزشکی، دانشگاه علوم پزشکی بهبهان، بهبهان ، ایران.

3 استادیار، گروه پرستاری و مامایی، دانشکده پیراپزشکی، دانشگاه علوم پزشکی ایلام، ایلام، ایران.

4 کارشناس ارشد پرستاری داخلی جراحی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی جندی شاپور اهواز، اهواز، ایران.

5 دانشجوی کارشناسی رادیولوژی، کمیته تحقیقات دانشجویی، دانشکده پرستاری، مامایی و پیراپزشکی شرق گیلان، دانشگاه علوم پزشکی گیلان، رشت، ایران.

6 استادیار، گروه داخلی، دانشکده پزشکی، دانشگاه علوم پزشکی ایلام، ایلام، ایران.

7 دانشجوی کارشناسی ارشد اپیدمیولوژی، کمیته تحقیقات دانشجویی، دانشکد بهداشت، دانشگاه علوم پزشکی ایلام، ایلام، ایران.

8 کارشناس ارشد مدیریت دولتی، گروه مالی، دانشکده پزشکی، دانشگاه علوم پزشکی دزفول، دزفول، ایران.

9 استادیار، گروه زنان و مامایی، مرکز تحقیقات سلامت باروری زنان، دانشکده پزشکی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

چکیده

مقدمه: زنان باردار و نوزادان در خطر کمبود ویتامین D قرار دارند که می­تواند باعث عوارض متعدد مادری و جنینی شود. مطالعه حاضر با هدف تعیین میانگین غلظت ویتامین D در زنان باردار و نوزادان ایران انجام شد.
روش‌کار: این مطالعه مروری بدون محدودیت زمانی تا مرداد 1395 بر اساس پروتکل مقالات مرور سیستماتیک و متاآنالیز (PRISMA) انجام شد. پایگاه‌های Magiran، Iranmedex، SID، Medlib، IranDoc، Scopus، PubMed، Science Direct، Cochrane، Web of Science، CINAHL و موتور جستجویGoogle Scholar توسط دو نفر از پژوهشگران به صورت مستقل با استفاده از کلیدواژه های MeSH جستجو شدند. میانگین اشتراکی با توجه به معنی­دار شدن شاخص I2بر اساس مدل اثرات تصادفی برآورد شد. آنالیز داده­ها با استفاده از نرم‌افزار متاآنالیز Review Manager version 5.3.5 انجام شد.
یافته‌ها: در 19 مطالعه، 4829 زن باردار و 1195 نوزاد بررسی شدند. میانگین سنی زنان باردار 31/0±01/27 سال به‌دست آمد. میانگین غلظت ویتامین D در زنان باردار ایران 02/15 نانوگرم بر میلی‌لیتر (CI 95%: 35/16-68/13) برآورد شد. این میزان در نوزادان در 6 مطالعه، 59/14 نانوگرم بر میلی‌لیتر (CI 95%: 23/19-94/9) برآورد گردید. تفاوت میانگین استاندارد شده غلظت ویتامین D در نان باردار در سه ماهه سوم و نوزادانشان از نظر آماری معنی­دار بود (001/0=p).
نتیجه‌گیری: میانگین غلظت ویتامین D در زنان باردار و نوزادان ایرانی بسیار پایین می­باشد و بین غلظت ویتامین D مادر در سه ماهه سوم و نوزاد ارتباط مستقیم وجود دارد، لذا پرداختن به مسئله کمبود ویتامین D در زنان باردار و نوزادان ایران باید به عنوان یک اولویت مهم بهداشتی در نظر گرفته شود.

کلیدواژه‌ها


عنوان مقاله [English]

A Meta-Analysis of Mean Vitamin D Concentration among Pregnant Women and Newborns in Iran

نویسندگان [English]

  • Milad Azami 1
  • Gholamreza Badfar 2
  • Masoumeh Shohani 3
  • Akram Mansouri 4
  • Mohammad Hosein Yekta-Kooshali 5
  • Ali Sharifi 6
  • Shoboo Rahmati 7
  • Atefeh Navader 1
  • Ali Soleymani 8
  • Marzieh Parizad Nasirkandy 9
1 Medical Student, Student Research Committee, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran.
2 Assistant Professor, Department of Pediatrics, School of Medicine, Behbahan Medical University, Behbahan, Iran.
3 Assistant Professor, Department of Midwifery and Nursing, Faculty of Paramedicine, Ilam University of Medical Sciences, Ilam, Iran.
4 MSc of Internal Surgery Nursing, School of Nursing and Midwifery, Ahvaz Jundishapour University of Medical Sciences, Ahvaz, Iran.
5 BSc student in Radiology, Student Research Committee, School of Nursing, Midwifery and Paramedicine, Guilan University of Medical Sciences, Rasht, Iran.
6 Assistant Professor, Department of Internal Medicine, School of Medicine, Ilam University of Medical Sciences , Ilam, Iran.
7 MSc student in Epidemiology, Student Research Committee, School of Health, Ilam University of Medical Sciences, Ilam, Iran.
8 M.Sc. in Management, Department of Finance, School of Medicine, Dezful University of Medical Sciences, Dezful, Iran.
9 Assistant Professor, Department of Obstetrics and Gynecology, Women’s Reproductive Health Research Center, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
چکیده [English]

Introduction: Pregnant women and newborns are at risk of vitamin D deficiency (VDD). VDD during pregnancy can lead to several maternal and fetal complications. This study was performed with aim to determine the mean concentration of 25-hydroxyvitamin D [25(OH)D] in pregnant women and newborns in Iran.
Methods: This meta-analysis study was performed without time limitation up to August 2016 based on the protocol of systematic review and meta-analysis studies (PRISMA). To access relevant studies, databases of Magiran, Iranmedex, SID, Medlib, IranDoc, Scopus, PubMed, Science Direct, Cochrane, Web of Science, CINAHL and Google Scholar were independently searched by two researchers. Search was performed using MeSH keywords. Pooled estimator was calculated according to significant I2 index based on the random effects model. Data were analyzed using Review Manager software version 5.3.5.
Results: Among 19 studies, 4,829 pregnant women and 1,195 newborns were enrolled. The mean age of pregnant women was 27.01±0.31 years. Mean concentration of vitamin D in pregnant women was 15.02 ng/ml (95% CI: 13.68-16.35). This rate in newborns of 6 studies was calculated 14.59 ng/ml (95% CI: 9.94-19.23). The standardized mean difference (SMD) of 25(OH)D concentration was significant in pregnant women at third-trimester and their newborns (P=0.001).
Conclusion: Mean concentration of vitamin D in pregnant women and newborns in Iran is very low and there is a direct relationship between maternal concentrations of vitamin D at third-trimester and newborn. Therefore, addressing VDD in Iranian pregnant women and newborns should be considered as a health priority.

کلیدواژه‌ها [English]

  • Iran
  • Meta-analysis
  • Newborns
  • Pregnant Women
  • Vitamin D
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