孕妇维生素D缺乏及其对胎儿的影响

Vitamin D deficiency in pregnant women and its effect on the newborns

目的：维生素D缺乏累及的人群非常广泛，而且与多种疾病的发生有关，特别是孕妇维生素D缺乏还可能影响到胎儿的健康。目前关于我国女性维生素D的资料报道很少。本研究的目的是了解健康孕妇（孕15～21w）以及同龄未孕对照组妇女维生素D水平以及孕妇维生素D水平对新生儿出生大小的影响。方法本文随机选取单胎妊娠孕妇63例和同龄对照妇女35例，用酶联免疫的方法测定血中25-羟维生素D水平。结果显示99％的检测病例25-羟维生素D水平低于正常值（≥75 nmol/L），有近93％的妇女为维生素D缺乏（＜50 nmol/L）。孕妇25-羟维生素D水平（28.40±9.19 noml/L）明显低于对照组妇女（38.46±10.77 noml/L；P＜0.001），两组维生素D缺乏的比率分别为孕妇96.8％，对照组85.7％，但重度维生素D缺乏的病例孕妇组接近半数，而对照组为零。新生儿身长与孕妇25-羟维生素D水平成显著正相关（ r＝0.323； P＜0.01。结论我国北方女性特别是孕妇是维生素D缺乏患病的高危人群，而且孕妇维生素D缺乏可能会影响到胎儿的生长发育。应该积极采用有效的措施防治维生素D的缺乏，从而减少维生素D缺乏对健康的影响对提高人口质量将具有重要的意义。

Objective Vitamin D deficiency is very common and associated with various diseases, especially in pregnant women, which may affect the fetal health.At present, little is known about the vitamin D status in Chinese women.The aim of this study was to investigate the vitamin D status in healthy pregnant women （ 15 ~21 weeks ） and a group of age-matched non-pregnant control women, and to observe the effect of the vitamin D status on the size of the newborns.Methods Sixty-three pregnant women and 35 non-pregnant women were selected.The serum 25-hydroxyvitamin D （25-（OH） D） level was determined using enzyme-linked immunosorbent assay.Results The serum 25-（ OH） D level in 99%subjects was lower than 75 nmol/L （ normal range）.And 93%subjects had 25-（OH）D deficiency （〈50 nmol/L）.The serum 25-（OH）D level in pregnant women （28.40 ± 9.19 nmol/L） was significantly lower than that in non-pregnant women （38.46 ±10.77 nmol/L;P〈0.001）.The rate of vitamin D deficiency in pregnant women and non-pregnant women was 96.8%and 85.7%, respectively.Near half of the pregnant women had severe vitamin D deficiency, while none in the control group.The height of the newborns was significantly positively correlated with the maternal 25-（OH）D levels （r=0.323;P〈0.01）.Conclusion Women, especially the pregnant women in the northern part of China, are high risk population of vitamin D deficiency.Fetal development may be influenced by maternal vitamin D deficiency.Measures should be taken to prevent women from vitamin D deficiency in China, thus reducing the effect of vitamin D＆amp;nbsp;deficiency on the health of population.