[1]程　珂,何全中,潘　莹.妊娠晚期孕妇血清25-羟维生素D水平与妊娠结局的相关性[J].新乡医学院学报,2021,38(2):161-165.[doi:10.7683/xxyxyxb.2021.02.013]
　CHENG Ke,HE Quanzhong,PAN Ying.Correlation between serum 25-hydroxyvitamin D level and pregnancy outcome in pregnant woman at late trimester of pregnancy[J].Journal of Xinxiang Medical University,2021,38(2):161-165.[doi:10.7683/xxyxyxb.2021.02.013]
点击复制

妊娠晚期孕妇血清25-羟维生素D水平与妊娠结局的相关性
分享到：

《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
38
期数:
2021年2
页码:
161-165
栏目:
临床研究
出版日期:
2021-02-05

文章信息/Info

Title:
Correlation between serum 25-hydroxyvitamin D level and pregnancy outcome in pregnant woman at late trimester of pregnancy
作者:
程　珂; 何全中; 潘　莹
（新乡医学院第三附属医院妇产科，河南　新乡　453003）
Author(s):
CHENG Ke; HE Quanzhong; PAN Ying
(Department of Gynaecology and Obstetrics,the Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453003,Henan Province,China)
关键词:
妊娠晚期; 25-羟维生素D; 妊娠结局; 妊娠相关并发症
Keywords:
late trimester of pregnancy25-hydroxyvitamin Dpregnancy outcomepregnancy related complications
分类号:
R715.3
DOI:
10.7683/xxyxyxb.2021.02.013
文献标志码:
A
摘要:
目的　探讨妊娠晚期孕妇血清25-羟维生素D［25-(OH)D］水平与妊娠结局的关系。方法　选择2019年3月至2019年12月于新乡医学院第三附属医院进行规律产前检查且分娩的孕妇303例为研究对象，根据血清25-(OH)D水平将孕妇分为维生素D充足组［血清25-(OH)D≥30 μg·L-1］46例、维生素D不足组［血清25-(OH)D 20～≥30 μg·L-1］ 62例和维生素D缺乏组［血清25-(OH)D＜20 μg·L-1］195例，对3组孕妇血清25-(OH)D水平、妊娠相关并发症及妊娠结局进行比较。结果　维生素D充足组、维生素D不足组和维生素D缺乏组孕妇血清25-(OH)D水平分别为（36.33±5.23）、（23.51±2.74）、（10.32±5.18）μg·L-1，维生素D充足组孕妇血清25-(OH)D水平显著高于维生素D不足组和维生素D缺乏组（P＜0.05），维生素D不足组孕妇血清25-(OH)D水平显著高于维生素D缺乏组（P＜0.05）。维生素D充足组孕妇妊娠高血压、妊娠糖尿病、胎膜早破和贫血的发生率分别为8.70%（4/46）、10.87%（5/46）、10.87%（5/46）、60.87%（28/46），维生素D不足组孕妇妊娠高血压、妊娠糖尿病、胎膜早破和贫血的发生率分别为8.06%（5/62）、11.29%（7/62）、14.52%（9/62）、48.39%（30/62），维生素D缺乏组孕妇妊娠高血压、妊娠糖尿病、胎膜早破和贫血的发生率分别为20.50%（40/195）、23.59%（46/195）、15.89%（31/195）、50.26%（98/195）；3组孕妇胎膜早破、贫血的发生率比较差异无统计学意义（P＞0.05），维生素D缺乏组孕妇妊娠高血压、妊娠糖尿病的发生率显著高于维生素D充足组和维生素D不足组（P＜0.05），维生素D充足组与维生素D不足组孕妇妊娠高血压、妊娠糖尿病的发生率比较差异无统计学意义（P＞0.05）。维生素D充足组早产、剖宫产、低出生体质量儿、胎儿窘迫、羊水污染的发生率分别为2.17%（1/46）、21.74%（10/46）、2.17%（1/46）、2.17%（1/46）、4.35%（2/46），维生素D不足组早产、剖宫产、低出生体质量儿、胎儿窘迫、羊水污染的发生率分别为6.45%（4/62）、24.19%（15/62）、6.45%（4/62）、4.84%（3/62）、6.45%（4/62），维生素D缺乏组早产、剖宫产、低出生体质量儿、胎儿窘迫、羊水污染的发生率分别为13.89%（27/195）、32.82%（64/195）、9.74%（19/195）、14.36%（28/195）、15.38%（30/195）；3组低出生体质量儿发生率比较差异无统计学意义（P＞0.05），维生素D缺乏组早产、剖宫产、胎儿窘迫、羊水污染的发生率显著高于维生素D充足组和维生素D不足组（P＜0.05），维生素D充足组与维生素D不足组早产、剖宫产、胎儿窘迫、羊水污染的发生率比较差异无统计学意义（P＞0.05）。结论　孕妇维生素D缺乏发生率较高，维生素D缺乏可能与妊娠相关并发症和不良妊娠结局的发生有关。
Abstract:
Objective　To investigate the relationship between serum 25-hydroxyvitamin D ［25-(OH)D］ level and pregnancy outcome in pregnant woman at late trimester of pregnancy.Methods　　A total of 303 pregnant women with regular prenatal examination and delivery in the Third Affiliated Hospital of Xinxiang Medical University from March 2019 to December 2019 were selected as the research subjects.The pregnant women were divided into vitamin D sufficiency ［25-(OH)D≥30 μg·L-1］group (n=46),vitamin D insufficiency ［25-(OH)D≥20-30 μg·L-1］group (n=62) and vitamin D deficiency ［25-(OH)D<20 μg·L-1］group (n=195) according to the serum 25-(OH)D level.The levels of serum 25-(OH)D,Pregnancy related complications and pregnancy outcomes of the pregnant woman were compared among the three groups.Results　The serum 25-(OH)D level of pregnant women in the vitamin D sufficiency group,vitamin D insufficiency group and vitamin D deficiency group was (36.33±5.23),(23.51±2.74) and (10.32±5.18) μg·L-1,respectively.The serum 25-(OH)D level of pregnant women in the vitamin D sufficiency group was significantly higher than that in the vitamin D insufficiency group and vitamin D deficiency group(P＜0.05).The serum 25-(OH)D level of pregnant women in the vitamin D insufficiency group was significantly higher than that in the vitamin D deficiency group(P＜0.05).The incidence of gestational hypertension,gestational diabetes mellitus,Premature rupture of membranes and anemia of pregnant women in the vitamin D sufficiency group was 8.70% (4/46),10.87% (5/46),10.87% (5/46) and 60.87% (28/46),respectively.The incidence of gestational hypertension,gestational diabetes mellitus,Premature rupture of membranes and anemia of pregnant women in the vitamin D insufficiency group was 8.06%(5/62),11.29%(7/62),14.52%(9/62) and 48.39%(30/62),respectively.The incidence of gestational hypertension,gestational diabetes mellitus,Premature rupture of membranes and anemia of pregnant women in the vitamin D deficiency group was 20.50%(40/195),23.59%(46/195),15.89%(31/195) and 50.26%(98/195),respectively.There was no significant difference in the incidence of premature rupture of membranes and anemia among the three groups (P>0.05).The incidences of gestational hypertension and gestational diabetes mellitus in the vitamin D deficiency group were significantly higher than those in the vitamin D sufficiency group and vitamin D insufficiency group (P<0.05).There was no significant difference in the incidences of gestational hypertension and gestational diabetes between the vitamin D sufficiency group and vitamin D insufficiency group (P>0.05).The incidence of premature birth,cesarean section,low birth weight infants,fetal distress and amniotic fluid pollution in the vitamin D sufficiency group was 2.17% (1/46),21.74% (10/46),2.17% (1/46),2.17% (1/46) and 4.35% (2/46),respectively.The incidence of premature birth,cesarean section,low birth weight infants,fetal distress and amniotic fluid pollution in the vitamin D insufficiency group was 6.45% (4/62),24.19% (15/62),6.45% (4/62),4.84% (3/62) and 6.45% (4/62),respectively.The incidence of premature birth,cesarean section,low birth weight infants,fetal distress and amniotic fluid pollution in the vitamin D deficiency group was 13.89% (27/195),32.82% (64/195),9.74% (19/195),14.36% (28/195) and 15.38% (30/95),respectively.There was no significant difference in the incidence of low birth weight infants among the three groups (P>0.05).The incidences of premature birth,cesarean section,fetal distress and amniotic fluid pollution in the vitamin D deficiency group were significantly higher than those in the vitamin D sufficiency group and vitamin D insufficiency group (P<0.05).There was no significant difference in the incidences of preterm birth,cesarean section,fetal distress and amniotic fluid pollution between the vitamin D sufficiency group and vitamin D insufficient group (P>0.05).Conclusion　The incidence of vitamin D deficiency in pregnant women is high.The vitamin D deficiency may be related to the pregnancy related complications and adverse pregnancy outcomes.

参考文献/References:

［1］　ZHOU J,SU L,LIU M.Associations between 25-hydroxyvitamin D levels and pregnancy outcomes:a prospective observational study in southern China［J］.Eur J Clin Nutr,2014,68(8):925-930.
［2］　张名旭，李磊.孕妇维生素D 缺乏对母体及子代的影响［J］.中华临床营养杂志，2015，23（1）：60-64.
［3］　MAKISHIMA M.Bone and calcium metabolism associated with malignancy,vitamin D and cancer［J］.Clin Calcium,2018,28(11):1465-1472.
［4］　CHEN S C,SUN Y X,AGRAWAL D K,et al.Vitamin D deficiency and essential hypertension［J］.J Am Soc Hypert,2015,9(11):885-901.
［5］　TROCHOUTSOU A I,KLOUKINA V,SAMITAS K,et al.Vitamin D in the immune system:genomic and non-genomic actions［J］.Mini Rev Med Chem,2015,15(11):953-963.
［6］　VAN BELLE T L,GYSEMANS C,MATHIEU C.Vitamin D and diabetes:the odd couple［J］.Trends Endocrinol Metabol,2013,24(11):561-568.
［7］　付雪，周晓玉.维生素D缺乏与新生儿肺发育相关性研究进展［J］.中华实用儿科临床杂志，2020，35（23）：1835-1837.
［8］　周婷婷，谈勇.维生素D及氧化应激在多囊卵巢综合征中的作用研究进展［J］.新乡医学院学报，2019，36（2）：198-201.
［9］　朱学创.维生素D和高血压发病的研究进展［J］．中国动脉硬化杂志，2010，18（12）：1001-1003.
［10］　ARNOLD D L,ENQUOBAHRIE D A,QIU C,et al.Early pregnancy maternal vitamin D concentrations and risk of gestational diabetes mellitus［J］.Paediatr Perinat Epidemiol,2015,29(3):200-210.
［11］　POWE C E,SEELY E W,RANA S,et al.First trimester vitamin D,vitamin D binding protein,and subs-equent preeclampsia［J］.Hypertension,2010,56(4):758-763.
［12］　EI-LITHY A,ABDELLA R M,EL-FAISSAL Y M,et al.The relationship between low maternal serum vitamin D levels and glycemic control in gestational diabetes assessed by HbA1c levels:an observational cross-sectional study［J］.BMC Pregnancy Childbirth,2014,14:362.
［13］　FARRANT H J,KRISHNAVENI G V,HILL J C,et al.Vitamin D insufficiency is common in Indian mothers but is not associated with gestational diabetes or variation in newborn size［J］.Eur J Clin Nutr,2009,63(12):646-652.
［14］　LOY S L,LEK N,YAP F,et al.Association of maternal vitamin D status with glucose tolerance and caesarean section in a mul-tiethnic asian cohort:the growing up in singapore towards healthy outcomes study［J］.PLoS One,2015,10(11):e0142239.
［15］　SUNMIN P,HYUN-KOO Y,HYUN-MEE R,et al.Maternal vitamin D deficiency in early pregnancy is not associated with gestational diabetes mellitus development or pregnancy outcomes in Korean pregnant women in a prospective study［J］.J Nutr Sci Vitaminol,2014,60(4):269-275.
［16］　贺锦华，罗小梅，陈芷，等.热性惊厥患儿血清25-羟基维生素Ｄ的多维度分析［J］.中华实用儿科临床杂志，2020，35（13）：1004-1008.
［17］　ZHOU X,LI Z H,LI B,et al.Expression and clinical significance of serum 25-OH-D in pregnant women with SCH (subclinical hypothyroidism) and GDM (gestational diabetes mellitus)［J］.Pak J Med Sci,2018,34(5):1278-1282.
［18］　耿佳庆，方成志，张丙宏，等.维生素Ｄ在儿童常见呼吸系统疾病中的研究进展［J］.中华实用儿科临床杂志，2019，34（21）：1674-1677.
［19］　DURAZO-ARVIZU R A,DAWSON-HUGHES B,SEMPOS C T,et al.Three-phase model harmonizes estimates of the maximal suppression of parathyroid hormone by 25-hydroxyvitamin D in persons 65 years of age and older［J］.J Nutr,2010,140(3):595-599.
［20］　LEFFELAAR E R,VRIJKOTTE T G,VAN EIJSDEN M.Maternal early pregnancy vitamin D status in relation to fetal and neonatal growth:results of the multiethnic amsterdam born children and their development cohort［J］.Br J Nutr,2010,104(1):108-117.
［21］　ZHANG Q Y，CHENG Y，HE M，et al.Effect of various doses of vitamin D supplementation on pregnant women with gestational diabetes mellitus:a randomized controlled trial［J］.Exp Ther Med,2016,12(3):1889-1895.
［22］　FERNNDEZ-ALONSO A M,DIONIS-SNCHEZ E C,CHEDRAUI P,et al.First-trimester maternal serum 25-hydroxyvitamin D3 status and pregnancy outcome［J］.Int J Gynaecol Obster,2012,116(1):6-9.
［23］　李智慧，陶瑞环，冯雪兰.血清维生素D水平与胎膜早破的相关性研究［J］.中国妇幼卫生杂志，2016，7（5）：44-46.
［24］　DAVIS L M,CHANG S C,MANCINI J,et al.Vitamin D insufficiency is prevalent among pregnant African American adolescents［J］.J Pediatr Adolesc Gynecol,2010,23(1):45-52.

相似文献/References:

[1]贾自晓.血清抗环瓜氨酸肽抗体、25-羟维生素D、基质金属蛋白酶-2和基质金属蛋白酶-9对类风湿性关节炎患者骨侵蚀的预测价值[J].新乡医学院学报,2023,40(10):932.[doi:10.7683/xxyxyxb.2023.10.005]
　JIA Zixiao.Predictive value of serum anti-cyclic citrullinated peptide antibody,25-hydroxyvitamin D,matrix metalloproteinase-2 and matrix metalloproteinase-9 for bone erosion in patients with rheumatoid arthritis[J].Journal of Xinxiang Medical University,2023,40(2):932.[doi:10.7683/xxyxyxb.2023.10.005]
[2]贾晓丹,刘阳,宋哲.血清淀粉样蛋白A和25-羟维生素D水平与反复呼吸道感染患儿预后的相关性[J].新乡医学院学报,2023,40(10):955.[doi:10.7683/xxyxyxb.2023.10.009]
　JIA Xiaodan,LIU Yang,SONG Zhe.Correlation between the serum amyloid A and 25-hydroxyvitamin D levels and prognosis in children with recurrent respiratory tract infection[J].Journal of Xinxiang Medical University,2023,40(2):955.[doi:10.7683/xxyxyxb.2023.10.009]
[3]高扬.复发性流产危险因素分析及预测模型构建[J].新乡医学院学报,2024,(2):128.[doi:10.7683/xxyxyxb.2024.02.005]
　GAO Yang.Analysis of risk factors for recurrent spontaneous abortion and construction of prediction model[J].Journal of Xinxiang Medical University,2024,(2):128.[doi:10.7683/xxyxyxb.2024.02.005]

更新日期/Last Update: 2021-02-05