孕妇血清维生素D水平与妊娠结局的相关性研究

Correlation of maternal serum vitamin D status and pregnancy outcome

目的探讨妊娠中晚期孕妇血清25羟维生素D[25(OH)D]营养状态对妊娠结局的影响。方法收集中晚期孕妇143例行问卷调查了解生活习惯。应用高效液相色谱-串联质谱法检测血清25(OH)D,根据血清25(OH)D水平将受试者分为维生素D充足组(n=32)、欠当组(n=49)、不足组(n=51)及缺乏组(n=11)。采用回顾性分析的方法,对孕妇的妊娠结局进行跟踪随访。结果 (1)妊娠中晚期孕妇血清25(OH)D平均值为(22.49±9.51)ng/mL。(2)流产率在充足组、欠当组、不足组、缺乏组分别为3.1%(1/32)、2.0%(1/49)、11.8%(6/51)、36.4%(4/11),胎儿窘迫发生率3.1%(1/32)、8.2%(4/49)、11.8%(6/51)、36.4%(4/11)。维生素D缺乏组流产、胎儿窘迫发生率高于其余各组,差异有统计学意义(P<0.05)。(3)各组细菌性阴道病发生率为0(0/32)、4.1%(2/49)、13.7%(7/51)、27.3%(3/11),维生素D缺乏组、不足组细菌性阴道病发生率高于其余各组,差异有统计学意义(P<0.05)。(4)各组孕妇妊娠周期为(39.48±1.44)、(39.00±1.70)、(38.09±2.01)、(37.29±0.49)周,维生素D不足组、缺乏组孕周较充足组、欠当组明显缩短,差异有统计学意义(P<0.05)。结论妊娠中晚期维生素D缺乏可增加流产、胎儿窘迫、细菌性阴道病的发生率,并显著缩短妊娠周期。

Objective To investigate the effects of 25-hydroxy vitamin D [25（OH）D]status on the pregnancy outcome in the second and third trimester pregnant women living.Methods A total of 143 pregnant women（12-42 weeks gestational age）were participated in the study.Their serum 25（OH）D concentrations were detected by liquid chromatography-mass spectrometry method.Finally,vitamin D status was assessed according to sufficiency group（n=32）,inadequacy group（n=49）,insufficiency group（n=51）and deficiency group（n=11）.Retrospective analysis were adopted to follow up the pregnancy outcome of pregnant women.Results（1）The average serum 25（OH）D level was（22.49±9.51）ng/mL in the second and third trimester of pregnancy.（2）Abortion rate were 3.1%（1/32）in sufficient group,2.0%（1/49）in inadequacy group,11.8%（6/51）in insufficiency group,36.4%（4/11）in deficiency group,fetal distress incidence were 3.1%（1/32）,8.2%（4/49）,11.8%（6/51）,36.4%（4/11）in each group.Abortion,fetal distress rate were higher in deficiency group compared with the other three groups（P〈0.05）.（3）Bacterial vaginosis incidence were 0（0/32）,4.1%（2/49）,13.7%（7/51）,27.3%（3/11）in each group,deficiency group and insufficiency group were higher（P〈0.05）.（4）Otherwise,the gestation period were（39.48±1.44）weeks in sufficient group,（39.00±1.70）weeks in inadequacy group,（38.09±2.01）weeks in insufficiency group,（37.29±0.49）weeks in deficiency group,pregnancy cycle was significantly shorter when 25（OH）D〈20.00ng/mL（P〈0.05）.Conclusion Vitamin D deficiency in pregnant women could increase the risk of abortion,fetal distress,bacterial vaginosis,and significantly shorten the gestation period.