Vitamin D deficiency during the second trimester is associated with adverse pregnancy outcomes
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.
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