212例孕妇维生素D水平及妊娠结局分析
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摘要
目的:了解上海市虹口地区孕妇25-羟维生素D水平及其对妊娠结局的影响。方法:选取该地区孕妇212例,检测维生素D水平,并测定胎儿头围、胸围、体重、身长等指标,并随访妊娠结果及妊娠并发症。结果:212例孕妇中,维生素D充足91例(42.9%),不足87例(41.0%),缺乏34例(16.0%)。孕妇平均维生素D水平在不同年龄组、孕前BMI、文化程度、收入水平者中未见差异(P>0.05),春、冬季调查值低于夏、秋季(P<0.05);维生素D缺乏组流产率、胎儿窘迫及细菌性阴道病发生率高于另外两组(P<0.05),充足组和不足组间上述指标未见差异(P>0.05)。妊娠期糖尿病、妊娠期高血压、剖宫产率组间比较差异均无统计学意义(P>0.05);不同维生素D水平孕妇胎儿身长、体重有差异(P<0.05),低水平组胎儿身长、体重、较小,头围和胸围组间无差异(P>0.05);低体重新生儿发生率缺乏组>不足组>充足组(P<0.05)。结论:上海市虹口地区孕妇维生素D缺乏较为普遍,而缺乏维生素D可增加不良妊娠结局和妊娠合并症风险,影响胎儿正常生长发育,有效预防孕妇维生素D缺乏非常重要。
Objective: To observe the level of 25-hydroxy vitamin D of pregnant women in Hongkou district of Shanghai, and to explore its influence on Pregnancy outcomes. Methods: 212 pregnant women from Hongkou district of Shanghai were selected. The vitamin D level of women, and the head circumference, chest circumference, weight, length and other indicators of their fetus were measured. The pregnancy outcomes and complications of all included women were followed up. Results: 91(42.9%) women were vitamin D adequacy, 87(41.0%) women were vitamin D inadequate, and 34(16.0%) women were vitamin D lacking. There was no significant different in vitamin D level between pregnant women with different age, different pre-pregnancy BMI, women education level, and women income level(P>0.05). The average vitamin D level of pregnant women during spring and winter were significant lower than those of women during summer and autumn(P<0.05).The rates of abortion, fetal distress and bacterial vaginosis of women with Vitamin D deficiency was significant higher than those of women with Vitamin D adequacy and inadequate(P<0.05), but there were no significant different in the incidences of abortion, fetal distress and bacterial vaginosis between women with vitamin D adequate and inadequate(P>0.05). There were no significant different in rates of gestational diabetes, gestational hypertension, and cesarean section among the women with vitamin D deficiency, vitamin D inadequate, and vitamin D adequate(P>0.05). There was significant difference in fetal length and weight between women with different vitamin D level(P<0.05). The incidence of low birth weight neonatal of women with vitamin D deficiency was the highest, and that of women with vitamin D adequate was lowest(P<0.05). Conclusion: The pregnant women with vitamin D deficiency in Hongkou district of Shanghai is common and the lack of vitamin D can significantly increase the risk of adverse pregnancy outcomes and pregnancy complications. Therefore, it is very important to prevent vitamin D deficiency of pregnant women.
Objective: To observe the level of 25-hydroxy vitamin D of pregnant women in Hongkou district of Shanghai, and to explore its influence on Pregnancy outcomes. Methods: 212 pregnant women from Hongkou district of Shanghai were selected. The vitamin D level of women, and the head circumference, chest circumference, weight, length and other indicators of their fetus were measured. The pregnancy outcomes and complications of all included women were followed up. Results: 91(42.9%) women were vitamin D adequacy, 87(41.0%) women were vitamin D inadequate, and 34(16.0%) women were vitamin D lacking. There was no significant different in vitamin D level between pregnant women with different age, different pre-pregnancy BMI, women education level, and women income level(P>0.05). The average vitamin D level of pregnant women during spring and winter were significant lower than those of women during summer and autumn(P<0.05).The rates of abortion, fetal distress and bacterial vaginosis of women with Vitamin D deficiency was significant higher than those of women with Vitamin D adequacy and inadequate(P<0.05), but there were no significant different in the incidences of abortion, fetal distress and bacterial vaginosis between women with vitamin D adequate and inadequate(P>0.05). There were no significant different in rates of gestational diabetes, gestational hypertension, and cesarean section among the women with vitamin D deficiency, vitamin D inadequate, and vitamin D adequate(P>0.05). There was significant difference in fetal length and weight between women with different vitamin D level(P<0.05). The incidence of low birth weight neonatal of women with vitamin D deficiency was the highest, and that of women with vitamin D adequate was lowest(P<0.05). Conclusion: The pregnant women with vitamin D deficiency in Hongkou district of Shanghai is common and the lack of vitamin D can significantly increase the risk of adverse pregnancy outcomes and pregnancy complications. Therefore, it is very important to prevent vitamin D deficiency of pregnant women.
引文
[1] Hollis BW, Johnson D, Hulsey TC, et al. Vitamin D supplementation during pregnancy: double blind, randomized clinical trial of safety and effectiveness[J]. J Bone Miner Res, 2011,26(10):2341-2357.
[2] 吴桐,向菲,欧亚萍,等.孕妇血清维生素D水平与妊娠结局的相关性研究[J].重庆医学,2016,45(7):893-895.
[3] 陈明秋.妊娠晚期孕妇外周血和新生儿脐带血维生素D浓度的测定及其临床意义[J].现代医学,2017,45(2):290-293.
[4] Zhou J. Associations between 25-hydroxyvitamin D levels and pregnancy outcomes: a prospective observational study in southern China[J]. European Journal of Clinical Nutrition, 2014,68(8):925-930.
[5] 信丽艳,米建荣,赵长海.151例晚期孕妇膳食调查[J].中国医药导刊,2012,11(11):1993-1994.
[6] 刘小勇,刘金华,陈霞,等.赣州地区孕妇血清维生素D水平研究[J].中国医学创新,2014,11(27):66-68.
[7] Vieth R. Why the minimum desirable serum 25-hydroxyvita-min D level should be 75nmol/L(30ng/mL)[J]. Best Pract Res Clin Endocrinol Metab, 2011,25(4):681-691.
[8] 杨佳佳,孙玉华,王登兰.乌市孕妇维生素D水平与胎儿宫内生长发育的相关性研究[J].世界最新医学信息文摘,2018,18(13):1-2.
[9] 谢而付,蒋理,陈丹,等.冬季妊娠中期孕妇25-羟维生素D的营养状况[J].中华临床营养杂志,2014,19(4):236-238.
[10] Kaushal M, Magon N. Vitamin D in pregnancy: a metabolic outlook[J]. Indian J Endocrinol Metab, 2013,17(1):76-82.
[11] 祝明,孙笑波.孕产期健康教育对母婴健康的影响[J].保健医学研究与实践,2013,5(1):81-82,90.
[2] 吴桐,向菲,欧亚萍,等.孕妇血清维生素D水平与妊娠结局的相关性研究[J].重庆医学,2016,45(7):893-895.
[3] 陈明秋.妊娠晚期孕妇外周血和新生儿脐带血维生素D浓度的测定及其临床意义[J].现代医学,2017,45(2):290-293.
[4] Zhou J. Associations between 25-hydroxyvitamin D levels and pregnancy outcomes: a prospective observational study in southern China[J]. European Journal of Clinical Nutrition, 2014,68(8):925-930.
[5] 信丽艳,米建荣,赵长海.151例晚期孕妇膳食调查[J].中国医药导刊,2012,11(11):1993-1994.
[6] 刘小勇,刘金华,陈霞,等.赣州地区孕妇血清维生素D水平研究[J].中国医学创新,2014,11(27):66-68.
[7] Vieth R. Why the minimum desirable serum 25-hydroxyvita-min D level should be 75nmol/L(30ng/mL)[J]. Best Pract Res Clin Endocrinol Metab, 2011,25(4):681-691.
[8] 杨佳佳,孙玉华,王登兰.乌市孕妇维生素D水平与胎儿宫内生长发育的相关性研究[J].世界最新医学信息文摘,2018,18(13):1-2.
[9] 谢而付,蒋理,陈丹,等.冬季妊娠中期孕妇25-羟维生素D的营养状况[J].中华临床营养杂志,2014,19(4):236-238.
[10] Kaushal M, Magon N. Vitamin D in pregnancy: a metabolic outlook[J]. Indian J Endocrinol Metab, 2013,17(1):76-82.
[11] 祝明,孙笑波.孕产期健康教育对母婴健康的影响[J].保健医学研究与实践,2013,5(1):81-82,90.