妊娠晚期母儿维生素D水平与重度子痫前期相关性研究

Study on the correlation between maternal and fetal vitamin D levels during the third trimester of pregnancy and severe preeclampsia

目的探讨妊娠晚期母儿维生素D水平与重度子痫前期（severe preeclamsia，SPE）的关系。方法：选取2011年10月-2013年2月在该院定期产检，符合重度子痫前期诊断标准的孕妇33例，为观察组；正常孕妇36例，为对照组。于分娩时分别抽取产妇肘上静脉血、脐静脉血各2 ml，采用酶联免疫吸附测定法（enzyme linked immunosorbent assay，ELISA）分别检测血清25-（OH）D水平。结果：观察组母血25-（OH）D水平（29．17±9．18）nmol／L与对照组母血25-（OH）D水平（44．14±16．30）nmol／L比较，差异有统计学意义（P〈0．01）；观察组脐血25-（OH）D水平（37．13±11．69）nmol／L与对照组脐血25-（OH）D水平（40．12±14．69）nmol／L比较，差异无统计学意义（P〉0．05）；正常孕妇和重度子痫前期孕妇25-（OH）D水平差异时，分娩孕周和胎儿出生体重比较，差异无统计学意义（P〉0．05），正常孕妇和重度子痫前期患者分娩孕周和胎儿出生体重与新生儿脐血25-（OH）D水平间差异无统计学意义（P〉0．05）。结论：妊娠晚期母血25-（OH）D水平的下降可能与重度子痫前期发病相关，但在脐血25（OH）D水平上重度子痫前期胎儿与正常妊娠胎儿无明显差异；妊娠晚期的母胎维生素D水平对分娩孕周和胎儿出生体重无明显影响。

Objective To explore the relationship between maternal and fetal vitamin D levels during the third trimester of pregnancy and severe preeelampsia. Methods： Thirty - three pregnant women receiving prenatal examination regularly and meeting the diagnostic criteria of severe preeclampsia in the hospital from October 2011 to February 2013 were selected as observation group; 36 normal pregnantwomen were selected as control group; maternal upper extremity venous blood （2 ml） and umbilical cord blood （2 ml） were abstracted during delivery; ELISA was used to detect serum 25 - （OH） D level. Results： The serum levels of 25 - （OH） D in observation group andcontrol group were （29.17 ±9.18 ） nmoL/L and （44.14 ± 16.30） nmoL/L, respectively, there was statistically significant difference betweenthe two groups （P 〈0. 01 ） ; the levels of 25 - （OH） D in umbilical cord blood in observation group and control group were （37.13 ±11.69） nmol/L and （40. 12± 14. 69） nmol/L, respectively, there was no statistically significant difference between the two groups （P 〉0. 05 ） ; in the two groups, there was no statistically significant difference in gestational week and birth weight among the pregnant women withdifferent serum 25 - （OH） D levels and neonates with different 25 - （OH） D levels in umbilical cord blood （ P 〉 0. 05 ） . Conclusion ：The decrease of maternal serum 25 - （OH） D level during the third trimester of pregnancy may be correlated with occurrence of severe preeclampsia, but there is no significant difference in 25 - （OH） D level in umbilical cord blood between fetuses with severe preeclampsia andnormal fetuses ; maternal and fetal vitamin D levels during the third trimester of pregnancy have no significant impact on gestational week andbirth weight.