双胎早产儿维生素D水平的临床观察

Clinical observation of vitamin D level in preterm twin infants

目的探讨双胎早产儿维生素D的水平及影响因素。方法选取2016年10月至2018年12月首都医科大学附属北京妇产医院收治的双胎早产儿44例(22对双胎),随机选取同期单胎早产儿作为对照,比较两组早产儿出生时骨代谢指标维生素D、血钙及碱性磷酸酶的水平,分析双胎早产儿维生素D水平及维生素D缺乏的危险因素。结果双胎组维生素D水平[(32.30±13.21)nmol/L]低于单胎组[(44.02±25.75)nmol/L],差异有统计学意义(P<0.05)。双胎组34例维生素D缺乏,单胎组有27例,双胎组发生率(77.3%)高于单胎组(54.0%),差异有统计学意义(χ^2=5.564,P<0.05)。早产儿维生素D缺乏组的剖宫产率、妊娠高血压、妊娠糖尿病、双胎均显著高于非维生素D组(P<0.05)。Logistic回归分析,妊娠高血压(OR=20.878,P=0.000)、妊娠糖尿病(OR=13.035,P=0.022)及双胎(OR=7.525,P=0.001)是早产儿维生素D缺乏的高危因素。结论双胎早产儿维生素D水平低于单胎早产儿,更易出现维生素D缺乏;妊娠高血压、妊娠糖尿病及双胎是早产儿维生素D缺乏的高危因素。

Objective To study the level of vitamin D in preterm twin infants and its influencing factors. Methods A total of 44 preterm twin infants and 50 single preterm infants were selected from October 2016 to December 2018 in Beijing Obstetrics and Gynecology Hospital. The levels of vitamin D, blood calcium and alkaline phosphatase(ALP) were compared between the two groups at birth, and the risk factors of vitamin D deficiency in preterm twin infants were analyzed. Results The average vitamin D level of preterm infants in the twin group was lower than that in the single group, the difference was statistically significant[(32.30±13.21) nmol/L vs.(44.02±25.75) nmol/L, P < 0.05]. Thirty-four cases of preterm twin group were vitamin D deficient, 27 cases of preterm single group were vitamin D deficient, the incidence of the twin group(77.3%)was higher than that of preterm single group(54.0%), the difference was statistically significant(χ^2= 5.564,P < 0.05). There were differences in cesarean section, gestational hypertension, gestational diabetes mellitus and twins between the preterm infants with vitamin D deficiency and non-deficiency. Logistic regression analysis showed that gestational hypertension(OR =20.878, P = 0.000), gestational diabetes mellitus(OR = 13.035, P = 0.022) and twins(OR = 7.525, P = 0.001) were high risk factors for vitamin D deficiency in the preterm infants. Conclusions The vitamin D level of the preterm twin infants is lower than that of the preterm single infants, which is more likely to lead to vitamin D deficiency. Gestational hypertension, gestational diabetes mellitus and twins are the high risk factors for vitamin D deficiency in the preterm infants.