妊娠中期维生素D缺乏与不良妊娠结局的相关性分析
Vitamin D deficiency during the second trimester is associated with adverse pregnancy outcomes
叶开接 1雷琼 2史娇阳 2王玲 2黄萍萍 2何涛君 1吴琳琳 2牛建民2
作者信息
- 1. 中山大学附属第八医院(深圳福田)检验科,广东 深圳 518033
- 2. 中山大学附属第八医院(深圳福田)产科,广东 深圳 518033
- 折叠
摘要
目的 探讨妊娠中期维生素D缺乏(vitamin D deficiency,VDD)状况及其与不良妊娠结局的相关性.方法 回顾性分析2021年1月至2022年12月于中山大学附属第八医院(深圳福田)行产前检查并分娩的单胎妊娠孕妇2627例,根据妊娠16～28周检测的血清25羟基维生素D3[25(OH)D3]水平分为VDD组[25(OH)D3＜50 nmol/L]和非VDD组[25(OH)D3≥50 nmol/L],比较两组孕妇不良妊娠结局.统计学方法采用t检验、x2检验和logistic回归分析.结果 2627例孕妇中,VDD占85.92％(2257例),非VDD占14.08％(370例),25(OH)D3平均水平为(37.99±14.37)nmol/L.(1)营养代谢情况:VDD 组空腹血糖(FPG)水平[(4.38±0.36)vs.(4.51±0.46)mmol/L,P=0.005]、高密度脂蛋白(HDL-C)水平[(1.74±0.32)vs.(1.82±0.37)mmol/L,P=0.046]明显低于非VDD孕妇.(2)VDD与不良妊娠结局的关系:单因素分析显示,VDD组巨大儿、产后出血的发生率分别为4.12％(93/2257)、9.66％(218/2257),明显高于非VDD组[分别为1.62％(6/370)、6.22％(23/370)],差异均具有统计学意义(x2值分别为5.474、4.522,P值分别为0.019、0.033).logistic回归分析显示,在矫正了母体年龄、孕前体重指数(BMI)和分娩孕周等因素后,VDD孕妇发生巨大儿(OR=3.661,95％CI 1.139～11.766,P=0.029)和产后出血(OR=1.547,95％CI 1.046～2.392,P=0.046)的风险均升高.结论 妊娠中期VDD与巨大儿和产后出血发生率升高相关.
Abstract
Objective To investigate the association between vitamin D deficiency(VDD)in the second trimester and adverse pregnancy outcomes.Methods A retrospective study was conducted among 2627 singleton pregnancy pregnant women who underwent prenatal examinations and delivered at the Eighth Affiliated Hospital of Sun Yat-sen University(Futian,Shenzhen)from January 2021 to December 2022.Pregnant women were tested for 25 hydroxyvitamin D3[25(OH)D3]levels between 16-28 weeks of gestation.According to the level of 25(OH)D3,they were divided into VDD group[(25(OH)D3＜50nmol/L)]and non-VDD group[(25(OH)D3≥ 50nmol/L)],and adverse maternal and neonatal outcomes were analyzed.T-tests,Chi-square test and logistic regression analysis were performed by SPSS.Results The average level of 25(OH)D3 was(37.99±14.37)nmol/L in the study subjects,of which 85.92％(2257 cases)were VDD,and 14.08％(370 cases)were non-VDD.(1)Evaluation of maternal nutrition and metabolism:compared with the non-VDD group,the VDD group had significantly lower fasting blood glucose levels[(4.38±0.36)vs.(4.51±0.46)mmol/L,P=0.005]and HDL-C levels[(1.74±0.32)vs.(1.82±0.37)mmol/L,P=0.046)].(2)The association between VDD and adverse pregnancy outcomes:The incidence of macrosomia and postpartum hemorrhage in the VDD group was 4.12％(93/2257)and 9.66％(218/2257),respectively,significantly higher than that in the non-VDD group[1.62％(6/370)and 6.22％(23/370),respectively],and the differences were statistically significant(The x2 values were 5.474 and 4.522 respectively,with P values were 0.019 and 0.033).Logistic regression analysis showed that pregnant women with VDD had an increased risk of macrosomia(OR=3.661,95％CI 1.139-11.766,P=0.029)and postpartum hemorrhage(OR=1.547,95％CI 1.046-2.392,P=0.046)after adjust-ed maternal age、BMI before pregnancy and gestational weeks at delivery.Conclusion VDD during the second trimester is associated with an increased incidence of macrosomia and postpartum hemorrhage.
关键词
维生素D/妊娠中期/妊娠结局/巨大儿/产后出血Key words
vitamin D/pregnancy outcomes/second trimester/macrosomia/postpartum hemorrhage引用本文复制引用
基金项目
国家自然科学基金(82204049)
深圳市科技计划(JCYJ20220530144407016)
出版年
2024
国家科技期刊平台
NSTL
万方数据