Vitamin D, pregnancy, breastfeeding, and postpartum multiple sclerosis relapses.
Arch Neurol
; 68(3): 310-3, 2011 Mar.
Article
em En
| MEDLINE
| ID: mdl-21059988
ABSTRACT
OBJECTIVE:
To determine whether low levels of 25-hydroxyvitamin D (25[OH]D) contribute to the increased risk of postpartum multiple sclerosis (MS) relapses.DESIGN:
Prospective cohort study.SETTING:
Outpatients identified through membership records of Kaiser Permanente Northern California or Stanford University outpatient neurology clinics. PATIENTS Twenty-eight pregnant women with MS.INTERVENTIONS:
We prospectively followed up patients through the postpartum year and assessed exposures and symptoms through structured interviews. Total serum 25(OH)D levels were measured using the DiaSorin Liaison Assay during the third trimester and 2, 4, and 6 months after giving birth. The data were analyzed using longitudinal multivariable methods. MAIN OUTCOMEMEASURES:
Levels of 25(OH)D and relapse rate.RESULTS:
Fourteen (50%) women breastfed exclusively, and 12 women (43%) relapsed within 6 months after giving birth. During pregnancy, the average 25(OH)D levels were 25.4 ng/mL (range, 13.7-42.6) and were affected only by season (P=.009). In contrast, in the postpartum period, 25(OH)D levels were significantly affected by breastfeeding and relapse status. Levels of 25(OH)D remained low in the exclusive breastfeeding group, yet rose significantly in the nonexclusive breastfeeding group regardless of season (P=.007, unadjusted; P=.02, adjusted for season). By 4 and 6 months after childbirth, 25(OH)D levels were, on average, 5 ng/mL lower in the women who breastfed exclusively compared with the nonbreastfeeding group (P=.001).CONCLUSIONS:
Pregnancy and exclusive breastfeeding are strongly associated with low 25(OH)D levels in women with MS. However, these lower vitamin D levels were not associated with an increased risk of postpartum MS relapses. These data suggest that low vitamin D in isolation is not an important risk factor for postpartum MS relapses.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Deficiência de Vitamina D
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Aleitamento Materno
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Período Pós-Parto
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Esclerose Múltipla
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Qualitative_research
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Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Pregnancy
Idioma:
En
Ano de publicação:
2011
Tipo de documento:
Article