孕期抑郁对母婴25(OH)D代谢及胎儿发育的影响

目的探讨孕期抑郁对新生儿的发育影响及VitD3补充干预的临床意义.方法回顾性收集486例行产前检查并分娩的孕妇,分析孕期抑郁对胎儿发育的影响.前瞻性收集480例在本院建卡并分娩的孕妇,将存在抑郁症状的孕妇随机分为干预组、单纯抑郁组,干预组给予口服VD 800IU/d,对比三组(干预组、单纯抑郁组与正常组)孕妇外周血25(OH)D水平、新生儿发育指标的差异.结果冬春季节抑郁组孕妇的新生儿脐血25(OH)D显著较低,VitD缺乏风险显著提高(OR=1.58,P=0.043).在冬春季,25(OH)D母胎比与孕妇CES-D得分呈负线性相关关系.在冬春季节,干预组与正常组新生儿头围高于单纯抑郁组(P<0.05).结论孕期抑郁会导致新生儿VD水平较低,进而影响形态发育.冬春季节补充VD可有效提高抑郁孕妇及胎儿25(OH)D水平,保障胎儿发育.

Objective To investigate the influence of depression during pregnancy on neonatal development. Methods 486 pregnant women (retrospectively)and 480 pregnant women(prospectively)were collected. The pregnant women(prospectively)with depressive symptoms were randomly divided into the intervention group and the simple depression group. The intervention group was given oral VD 800 IU/d. Results In winter and spring,the neonatal umbilical cord 25(OH)D was significantly lower in pregnant women with depression,and the risk of VitD deficiency was significantly higher(OR=1.58,P=0.043). In winter and spring,25(OH)D maternal-fetal ratio was negatively correlated with pregnant women's CES-D score. In winter and spring,the neonatal head circumference of intervention group and normal group were higher than that of the simple depression group(P<0.05). Conclusion VD supplementation in winter and spring can effectively increase the levels of 25(OH)D in pregnant women and fetuses,and protect the development of the fetus.