南京某医院妊娠中晚期孕妇维生素D水平及影响因素

Maternal vitamin D level and its relevant factors in the second and third trimesters of pregnancy in a hospital in Nanjing

目的了解南京地区妊娠中晚期孕妇维生素D水平，并分析其与年龄、孕周、孕前体质量指数（BMI）以及季节变化之间的关系，为临床开展维生素D检测及补充提供依据。方法收集2015年1至12月在南京医科大学附属妇产医院建卡并定期产检的880名妊娠21～36周孕妇为研究对象，酶联免疫吸附法（ELISA）测定血清25羟-维生素D[25-（OH）D]浓度。结果孕妇血清维生素D水平为（42．03±19．22）nmol／L，维生素D充足者仅42例（4．77％）。季节变化对维生素D水平有影响（P=0．0164），夏季[（44．61±23．57）nmol／L]和秋季[（43．43±19．31）nmol／L]高于春季[（39．68±16．91）nmo]／L]和冬季[（39．65±13．36）nmol／L]（均P〈0．05）。不同孕周间血清维生素D水平差异无统计学意义（P=0．9294）。不同年龄组间孕妇血清维生素D水平差异有统计学意义（P=0．0383）。维生素D和孕前BMI间无相关性。结论维生素D作为孕妇以及胎儿生长发育的必要营养素，营养状况不容乐观，建议积极开展维生素D检测。

Objective To analyze the serum level of 25-hydroxy vitamin D [ 25-（OH） D ] in pregnant women in Nanjing and its relationship with age, gestational week, pre-pregnaney body mass index （BMI） and season, so as to provide some guidance on clinical application of vitamin D measurement and supplementation. Methods 880 pregnant women （in 21 -36 gestational weeks） regularly visiting antenatal clinic in Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University were selected from January to December 2015. Their serum 25-（OH）D concentrations were measured by enzyme-linked immunosorbent assay （ELISA）. Results The mean serum 25- （OH） D concentration in these pregnant women was （ 42.03 ± 19. 22 ） nmol/L and sufficient in only 42 （4. 77% ）. Vitamin D levels showed seasonal variation （P =0. 0164）, with the levels in summer [ （44. 61 ±23.57） nmol/L] and autumn [ （43.43 ± 19. 31） nmol/L] being higher than spring [ （39. 68 ± 16. 91 ） nmol/L] and winter [ （39. 65 ± 13.36） nmol/L]. There was no statistically significant difference in serum vitamin D level among different gestational weeks （ P = 0. 929 4 ）. There was statistically significant differenee in serum vitamin D level among different age groups （ P = 0. 038 3 ）. Vitamin D level was not associated with pre-pregnaney BMI. Conclusions Vitamin D defieieney is highly prevalent among pregnant women in Nanjing. We suggest vitamin D testing be carried out more actively.