摘要
目的 探讨孕早期每日补充不同剂量维生素D与妊娠期及新生儿结局的相关性.方法 回顾性收集2020年1月1日至2023年3月6日广州医科大学附属第六医院妇产科在妊娠早期检验了25羟基维生素D[25(OH)D]并且可追踪到在该院有分娩结局的2 099名孕妇的临床资料,并按孕早期每日补充维生素D剂量分为以下四组:0 IU组(N1=710)为孕早期未口服维生素D制剂的孕妇,400～800 IU组(N2=751)为孕早期维生素D补充剂量为400～800 IU的孕妇,1200～1600 IU组(N3=564)为孕早期维生素D补充剂量为1200～1600 IU的患者,2000～2400 IU组(N4=74)为孕早期维生素D补充剂量为2000～2400 IU的患者.比较四组间妊娠期高血压疾病发生率、妊娠期糖尿病发病率、胎膜早破率、产后出血率、早产率、新生儿住院率、新生儿窒息、新生儿高胆红素血症、巨大儿及低出生体重儿的发生率.结果 妊娠期高血压疾病的发生率补充组均低于未补充组,其中400～800 IU组发生率最低,组间差异有统计学意义(P＜0.05).新生儿高胆红素血症及新生儿窒息发生率补充组均低于未补充组,组间差异有统计学意义(P＜0.05),且随着补充剂量升高呈下降趋势.妊娠期糖尿病发生率、胎膜早破率、早产率、产后出血率、新生儿住院率、低出生体重儿发生率及巨大儿发生率组间差异均无统计学意义(P＞0.05).结论 孕早期不同剂量维生素D的补充均有一定程度获益,孕早期补充维生素D制剂可有效降低妊娠期高血压疾病、新生儿窒息及新生儿高胆红素血症的发生率.
Abstract
Objective To investigate the correlation between different daily doses of vitamin D supplementation in the first trimester and pregnancy and neonatal outcomes.Methods Clinical data were retrospectively collected from 2 099 pregnant women who were tested 25 hydroxyvitamin D[25(OH)D]in early pregnancy and who were traceable to the delivery outcome at the Sixth Hospital of Guangzhou Medical University from January 1,2020,to March 6,2023,and were divided into the following four groups according to the dose of daily supplementation of vitamin D in the first trimester:0 IU group(N1=710)were pregnant women who did not take oral vitamin D preparation in the first trimester,400-800 IU group(N2=751)were pregnant women who received vitamin D supplementation at a dose of 400-800 IU in the first trimester.The 1200-1600 IU group(N3=564)included patients who received vitamin D supplementation at a dose of 1200-1600 IU during the first trimester,and the 2000-2400 IU group(N4=74)included patients who received vitamin D supplementation at a dose of 2000-2400 IU during the the first trimester.The incidence of gestational hypertension,gestational diabetes,premature rupture of membranes,postpartum hemorrhage,premature delivery,neonatal hospitalization,neonatal asphyxia,neonatal hyperbilirubinemia,macroia and low birth weight were compared among the four groups.Results The incidence of hypertensive diseases in pregnancy in supplemental group was lower than that in non-supplemental group,and the incidence in 400-800 IU group was the lowest,the difference between groups was statistically significant(P＜0.05).The incidence of neonatal hyperbilirubinemia and neonatal asphyxia in supplemental group was lower than that in non-supplemental group,the difference between groups was statistically significant(P＜0.05),and showed a downward trend with the increase of supplemental dose.There were no significant differences in the incidence of gestational diabetes mellitus,premature rupture of membrane,preterm birth,postpartum hemorrhage,neonatal hospitalization,incidence of low birth weight infants and incidence of macrocephaly among groups(P＞0.05).Conclusions Supplementation of vitamin D at different doses in the first trimester can benefit to some extent,and supplementation of vitamin D preparation in the first trimester can effectively reduce the incidence of hypertensive diseases,neonatal asphyxia and neonatal hyperbilirubinemia.
维普
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