Relationship between serum vitamin A,D and E levels and hypothyroidism in the third trimester of pregnancy and its influence on pregnancy outcomes
Objective To explore the relationship between serum vitamin A,D and E levels and hypothyroidism in the third trimester of pregnancy and its influence on pregnancy outcomes.Methods A total of 196 pregnant women in the third trimester who underwent planned prenatal examinations and were hospitalized for delivery at Baoji Maternal and Child Health Hospital from May 2019 to April 2023 were selected as study subjects,according to the results of thyroid function test,they were divided into normal thyroid function group(n=120)and hypothyroidism group(n=76).Serum levels of vitamins A,D and E were measured in both groups,multivariate logistic regression analysis was used to assess the risk factors for hypothyroidism in the third trimester of pregnancy,and the influence of serum levels of vitamins A,D and E on pregnancy outcomes was analyzed.Results Serum vitamin A and D levels in hypothyroidism group were negatively correlated with TSH level and positively correlated with FT4 level(r values were-0.673,-0.742,0.653 and 0.695,respectively,P＜0.05);the serum vitamin E level was positively correlated with TSH level and negatively correlated with FT4 level(r values were 0.524 and-0.561,respectively,P＜0.05).Advanced age,primiparity,low pre-pregnancy BMI,gestational anemia,low serum vitamin A levels,low serum vitamin D levels,and high serum vitamin E levels were identified as independent risk factors for hypothyroidism in the third trimester of pregnancy(OR values ranged from 1.076 to 3.672,P＜0.05).The incidence of fetal distress,premature rupture of membranes,uterine atony,and low birth weight infants in pregnant women with insufficient vitamin A was higher than that in those with normal vitamin A,the incidence of preterm birth and spontaneous abortion in pregnant women with excessive vitamin A was higher than that in those with normal vitamin A,and the differences were statistically significant(x2 values ranged from 14.577 to 74.862,P＜0.05).The incidence of low birth weight infants in pregnant women with insufficient vitamin D was higher than that in those with normal vitamin D,and the difference was statistically significant(x2=5.814,P＜0.05).The incidence of spontaneous abortion in pregnant women with insufficient vitamin E was higher than that in those with normal vitamin E,while the incidence of premature rupture of membranes,preterm birth,and low birth weight infants in pregnant women with excessive vitamin E was higher than that in those with normal vitamin E,and the differences were statistically significant(X2 values ranged from 7.349 to 28.161,P＜0.05).Conclusion Low levels of serum vitamins A,D,and high levels of vitamin E are independent risk factors for hypothyroidism in the third trimester of pregnancy,and reasonable intake and supplementation of vitamins A,D and E are of great significance in reducing adverse pregnancy outcomes.
hypothyroidismthe third trimester of pregnancyvitamin Avitamin Dvitamin Epregnancy outcome
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