母体孕期血清25-(OH)D水平与新生儿风险的相关性

Correlation between maternal serum 25-(OH)D level and neonatal risk during pregnancy

目的母体维生素D状况和新生儿成长有着密切关系,本研究旨在探究母体孕期维生素D状况对新生儿平均体质量及低体质量初生儿(low birth weight,LBW)和小于胎龄婴儿(small for gestational age,SGA)的影响。方法选择2012-01-01-2016-12-31沈阳市第五人民医院进行产检的孕妇2 348名作为研究对象,检测其母体血清25-羟基维生素D(25-hydroxyvitamin D,25-(OH)D)水平。分析25-(OH)D水平与新生儿体质量之间相关性及母体维生素D水平对SGA及LBW影响。结果孕妇血清25-(OH)D水平<40ng/mL时,其新生儿平均体质量和孕妇血清25-(OH)D呈正相关,r=0.46,P<0.05。当孕妇血清25-(OH)D水平>40ng/mL时,新生儿体质量与孕妇血清25-(OH)D水平不再呈正相关性,r=-0.12,P>0.05。维生素D水平充分,孕妇分娩胎儿无LBW和SGA情况;维生素D水平不足孕妇分娩胎儿发生LBW为1.33%(11/827),SGA为5.56%(46/827);维生素D水平缺乏孕妇分娩胎儿发生LBW为3.33%(29/872),SGA为14.68%(128/872),维生素D水平极度缺乏孕妇分娩胎儿发生LBW为53.33%(16/30),SGA为56.67%(17/30)。结论母体孕期维生素D缺乏不仅会增加分娩LBW的风险,也会增加分娩SGA的风险,所以注意维持母体孕期维生素D水平,加强血清25-(OH)D水平检测在临床上具有深远的现实意义。

OBJECTIVE Vitamin D level is closely related to newborn growth.This study aims to explore the influence of vitamin D level during pregnancy on average weight of newborn and low birth weight（LBW）and small for gestational age（SGA）.METHODS A total of 2 348 pregnant women who carried out prenatal examinations in the Fifth People＇s Hospital of Shenyang from January 1,2012 to December 31,2016 were selected as research subjects with detection of 25-hydroxyvitamin D [25-（OH）D level]in the maternal serum.The correlation between 25-hydroxyvitamin D [25-（OH）D]level and newborn weight was analyzed,as well as the effect of maternal vitamin D on SGA and LBW.RESULTS When the serum level of 25-（OH）D was less than 40 ng/mL,the average weight of newborns was positively correlated with the serum 25-（OH）D of pregnant women,r=0.46,P〈0.05.When the serum level of 25-（OH）D was more than 40 ng/mL,the average weight of newborns was no positively correlated with the serum 25-（OH）D of pregnant women,r=-0.12,P〈0.05.There was no LBW and SGA condition when the level of vitamin D was sufficient.When vitamin D level was insufficient,the incidences of LBW and SGA were 1.33%（11/827）and 5.56%（46/827）respectively.When vitamin D level was deficient,the incidences of LBW and SGA increased to 3.33%（29/872）and 14.68%（128/872）.When vitamin D level was extremely deficient,the incidences of LBW and SGA were 53.33%（16/30）and 56.67%（17/30）respectively.CONCLUSION Vitamin D deficiency during pregnancy increases the risk of LBW and SGA,It is of clinical significance to maintain the level of vitamin D during pregnancy and strengthen the detection of serum 25-（OH）D level.