孕中晚期补充复合维生素和钙-维生素D对胎儿体格发育的影响

Effects of Calcium-vitamin D Multi-vitamins Supplementation during Pregnancy on the Physical Development of Fetus

目的探索孕中晚期在正常饮食的基础上单独或联合补充复合维生素制剂、钙-维生素D制剂对胎儿体格发育的影响。方法2014年8月至2015年5月，便利抽样法选择上海市3所三级甲等医院产科的558例孕产妇为研究对象，按是否补充复合维生素、钙-维生素D制剂，将其分为复合维生素组、钙-维生素D组、联合组、空白组，通过随访和查阅比例的方式了解四组产妇的胎儿出生体质量、出生身长、38周双顶径，以分层卡方检验探索发生巨大儿的危险因素。结果复合维生素组、钙-维生素D组、联合组出生身长均高于空白组（P〈0．01）；复合维生素组出生体质量、38周双顶径与空白组比较无统计学差异；钙-维生素D组、联合组出生体质量、38周双顶径高于空白组（P〈0．01）；钙-维生素D补充可增加巨大儿发生风险（OR=2．793，95％置信区间1．257-6．209）；复合维生素补充与巨大儿发生无相关性（OR=1．442，95％置信区间0．540-3．850）。结论复合维生素补充可促进胎儿长骨生长；钙-维生素D补充可增加胎儿出生体质量及双顶径，是巨大儿发生的危险因素。

Objective To explore the effect of multi-vitamins and calcium-vitamin D supplementation during the second and third trimester of pregnancy on the physical development of fetus. Methods By convenience sampling, 558 cases of pregnant women were selected, and divided into multi-vitamins group, calcium-vitamin D group, combination group and blank control group. The birth weight, birth length and biparietal diameter in 38 weeks were compared through follow-up and cases review method. The risk factors of macro-somia were investigated by layered chi-square test.Results The birth length in multi-vitamins group, calcium-vitamin D group and combination group were longer than blank control group （P 〈0.01 ）. No statistical significance of birth weight and biparietal diameter in 38 weeks was found between multi-vitamins group and blank control group. The birth weight and biparietal diameter in 38 weeks in calcium-vitamin D group and combination group were higher than blank control group （P 〈0.01 ）. The calcium-vitamin D supplement can increase the risk of macrosomia（OR = 2.793,95 % CI= 1.257 - 6.209 ） and multi-vitamins supplement was not related with macrosomia（OR=1.442,95%CI=0.540-3.850）.Conclusions Multi-vitamins supplement can promote the longitudinal bone growth, calcium-vitamin D supplement can increase birth weight and biparietal diameter, which is the risk factor of macrosomia.