孕妇维生素D水平与妊娠期糖尿病及新生儿体质量关系研究

The association of maternal vitamin D level with gestational diabetes mellitus and infant birth weight

目的分析维生素D水平与妊娠期糖尿病(gestational diabetes mellitus,GDM)及新生儿出生体质量之间的关系。方法选取2014年10月至2017年9月,在台州恩泽医疗中心(集团)浙江省台州医院附属妇产医院行系统保健的孕妇938例,在妊娠24~28周做葡萄糖耐量试验并检测孕妇血清维生素D水平,记录孕妇足月分娩时新生儿出生体质量。结果938例孕妇中,维生素D缺乏者535例(57.04%)。维生素D缺乏组年龄<25岁孕妇124例(23.18%),维生素D正常组年龄<25岁孕妇69例(17.12%),差异有统计学意义(X^2=5.518,P=0.023)。孕妇维生素D水平与新生儿性别、体质量无相关性。GDM孕妇中,维生素D缺乏组与正常组新生儿体质量差异无统计学意义(P=0.616)。非GDM孕妇,维生素D缺乏组新生儿体质量低于维生素D正常组新生儿体质量,差异有统计学意义(P=0.014)。结论育龄妇女普遍存在维生素D缺乏现象,尤以<25岁年龄组维生素D缺乏最为明显。孕妇血糖正常但维生素D缺乏,可能影响新生儿体质量。当胎儿发育迟缓时,建议作维生素D检测,及时补充维生素D。

Objective To explore the association of maternal vitamin D level with gestational diabetes mellitus(GDM)and infant birth weight. Methods A total of 938 pregnant women who had regular check up in Enze Women′s &Children′s Hospital Affiliated with Zhejiang Enze Medical Guoup from October 2014 to September2017 were enrolled into the study.The glucose tolerance and the maternal vitamin D level were tested and measured during 24~28 weeks of pregnancy.The birth weight of newborns who reached full-term was recorded. Results 535 out of 938 pregnant women were vitamin D deficient and 23.18% were women under25 years old,which was significantly higher than women with normal vitamin D level in the same age group(23.18%vs 17.12%,χ~2=5.518,P=0.023).The vitamin D levels of pregnant women were not associated with the gender and birth weight of newborn babies.Among pregnant women with GDM,the birth weights of newborn babies delivered by women with vitamin D deficiency were not significantly different from those delivered by women with normal vitamin D levels(P=0.616),while among women without GDM,the difference was statistically significant(P=0.014). Conclusions Vitamin D deficiency is very common among pregnant women especially those under 25 years old.The birth weight of new born baby might be impacted by low level of vitamin D.Therefore,vitamin D should be supplemented if intrauterine growth restriction is suspected during pregnancy.