妊娠期血清25-羟基维生素D水平对围生结局的影响

Effect of serum 25-OH-VD levels during pregnancy on perinatal outcome

目的分析妊娠期妇女血清25-羟基维生素D(25-OH-VD)水平对围生结局的影响,阐明妊娠期适当补充维生素D的重要性。方法选取常规产检的妊娠期妇女1502例,于妊娠20周左右测定血清25-OH-VD水平。将孕妇分为血清25-OH-VD水平<50nmol/L 425例(维生素D缺乏组)和血清25-OH-VD水平≥50nmol/L 1077例(维生素D正常组)两组。两组孕妇进行常规孕期检查,包括口服葡萄糖耐量试验,监测血压,分娩时记录分娩孕周、是否胎膜早破、新生儿出生体重、产后出血情况、产褥感染情况。结果维生素D缺乏组孕妇妊娠期糖尿病、子痫前期、早产和足月小样儿发生率均高于维生素D正常组孕妇,差异均有统计学意义(均P<0.05)。两组胎膜早破、产后出血和产褥感染发生率比较差异均无统计学意义(均P>0.05)。结论妊娠期妇女维生素D缺乏将增加围生期并发症的发生,对维生素D缺乏孕妇及时补充维生素D制剂,提高孕妇血清25-OH-VD水平,对改善围生结局具有重要意义。

ObjectiveTo investigate the effect of serum 25-OH-VD levels on perinatal outcome in pregnant women.Methods Serum 25-OH-VD levels were measured in 1502 pregnant women underwent routine prenatal examinations in our hospital.There were 425 cases with serum 25-OH-VD level50nmol/L（vitamin D deficiency group）and 1077 cases with serum 25-OH-VD level≥50nmol/L（vitamin D normal group）.The oral glucose tolerance test and monitoring blood pressure were measured;the gestational age,premature rupture of membranes,neonatal birth weight,postpartum hemorrhage and puerperal infection were documented and compared between two groups.Results The incidence of gestational diabetes,preeclampsia,preterm labor and small-for-date infant in vitamin D deficiency group were significantly higher than that in vitamin D normal group（all P〈0.05）.There were no significant differences in the incidence of premature rupture of membranes,postpartum hemorrhage and puerperal infection between the two groups（all P〈0.05）.Conclusion Vitamin D deficiency in pregnant women will increase risk of perinatal complications.Appropriate supplementation of vitamin D during pregnancy to improve serum25-OH-VD level is of great significance in improving perinatal outcomes.