林芝地区妊娠期糖尿病孕妇维生素D含量与妊娠结局的关联研究

Correlation between vitamin D and pregnancy outcome in pregnant women with gestational diabetes mellitus in Nyingchi region

目的探讨林芝地区妊娠期糖尿病孕妇外周血血清25-羟基维生素D浓度与妊娠结局的关系。方法回顾性分析林芝地区产检并分娩的妊娠期糖尿病孕妇498例及非妊娠期糖尿病孕妇1628例的外周血血清25-羟基维生素D浓度,统计并分析该2126例孕妇的维生素D浓度与分娩结局及新生儿结局的关联。结果498例妊娠期糖尿病孕妇外周血血清25-羟基维生素D浓度统计显示,107例(21.5%)<20 ng/L,346例(69.5%)为20~30 ng/L,45例(9%)>30 ng/L,1628例非妊娠期糖尿病孕妇外周血血清25-羟基维生素D浓度统计显示,490例(30.1%)<20 ng/L,1009例(62%)为20~30 ng/L,129例(7.9%)>30 ng/L,妊娠期糖尿病组与非妊娠期糖尿病组比较,两组间维生素D浓度差异有统计学意义(Z=-3.474,P<0.05)。498例妊娠期糖尿病孕妇分娩结局显示,其中56例(11.2%)为早产,70例(14.1%)流产,372例(74.7%)为足月产;1628例非妊娠期糖尿病孕妇分娩结局显示,其中250例(15.4%)为早产,306例(18.8%)流产,1072例(65.8%)为足月产;按维生素D的不同浓度分析,妊娠期糖尿病组(χ^2=172.806,P=0.00)及非妊娠期糖尿病组(χ^2=458.167,P=0.00)两组间分娩结局差异均有统计学意义。498例妊娠期糖尿病孕妇新生儿结局显示,其中53例(10.6%)为低出生体重儿,60例(12.0%)为巨大儿,315例(63.2%)为适于胎龄儿;1628例非妊娠期糖尿病孕妇分娩结局显示,其中142例(8.7%)为低出生体重儿,93例(5.7%)为巨大儿,1087例(66.8%)为适于胎龄儿;按维生素D的不同浓度分析,妊娠期糖尿病组(χ^2=142.191,P=0.00)及非妊娠期糖尿病组(χ^2=395.682,P=0.00)两组组间新生儿结局差异均有统计学意义。结论维生素D与妊娠期糖尿病发病相关,孕妇孕期的维生素D含量对妊娠结局有一定的影响。

Objective To investigate the correlation between 25-hydroxy vitamin D concentration and pregnancy outcome in pregnant women with gestational diabetes mellitus in Nyingchi region.Methods Retrospective analysis was conducted on the concentrations of 25-hydroxy vitamin D in peripheral blood of 498 pregnant women with gestational diabetes and 1628 pregnant women without diabetes,who were examined and delivered in Nyingchi region.The correlation between the concentrations of vitamin D and the outcomes of childbirth and neonate were analyzed.Results Among 498 pregnant women with gestational diabetes,peripheral blood 25-hydroxy vitamin D concentrations<20 ng/L was revealed in 107 cases(21.5%),20-30 ng/L in 346 cases(69.5%),and>30 ng/L in 45 cases(9%);while those were revealed in 490 cases(30.1%),1009 cases(62%)and 129 cases(7.9%),respectively,among 1628 gestational women without diabetes.There was a statistically significant difference in vitamin D concentration between the gestational diabetes group and the non-gestational diabetes group(Z=-3.474,P<0.05).Among the 498 cases pregnant women with gestational diabetes,56 cases(11.2%)were preterm,70 cases(14.1%)miscarried,and 372 cases(74.7%)were full-term.Among the 1628 cases non-gestational diabetic women,250 cases(15.4%)were preterm,306 cases(18.8%)miscarried,and 1072 cases(65.8%)were full-term.There were statistically significant results in delivery between the two groups(P=0.00).The neonatal outcomes of 498 cases pregnant women with gestational diabetes showed that 53 cases were low birth weight infants,60 cases were macrosomia infants,and 315 cases were suitable for gestational age infants.Among the 1628 cases without diabetes,142 cases were low birth weight babies,93 cases were macrosomia babies,and 1087 cases were suitable for gestational age infants.According to the analysis of different concentrations of vitamin D,neonatal outcomes were statistically significant in both the gestational diabetes group(χ^2=142.191,P=0.00)and the non-gestational diabetes group(χ^2=395.682,P=0.00).Conclusion Vitamin D is associated with gestational diabetes,has a certain impact on pregnancy outcome.