孕妇维生素D水平与妊娠期甲状腺功能减退的相关性研究

Correlation of blood vitamin D levels with hypothyroidism during pregnancy

目的探讨孕妇维生素D水平与妊娠期甲状腺功能减退(甲减)的相关性,为妊娠晚期甲减的预防提供新的思路。方法选取2018年6月1日至2019年6月1日在温州市人民医院和温州医科大学附属第二医院产检的妊娠妇女1715例。比较妊娠早、晚期不同维生素D水平孕妇甲减患病率。分析妊娠期维生素D水平与甲减发生的相关性。结果妊娠早、晚期维生素D缺乏组孕妇甲减患病率均高于维生素D不足组和维生素D充足组,差异均有统计学意义(均P<0.05)。妊娠早期维生素D不足孕妇妊娠晚期维生素D缺乏组孕妇甲减患病率均高于妊娠晚期维生素D不足组和维生素D充足组,差异均有统计学意义(均P<0.05)。二分类logistic回归分析显示妊娠晚期BMI为妊娠晚期甲减发生的危险因素(OR=1.028,95%CI:1.008~1.048,P<0.05);妊娠早期血清25(OH)D水平为妊娠晚期甲减发生的保护因素(OR=0.949,95%CI:0.935~0.964,P<0.05)。结论妊娠期维生素D缺乏可能增加妊娠期甲减患病率。妊娠早期进行维生素D补充可减少妊娠晚期甲减患病率。

Objective To investigate the correlation between vitamin D levels and hypothyroidism in pregnant women.Methods A total of 1715 singleton pregnant women scheduled for regular prenatal examination from June 2018 to June 2019 were enrolled.The prevalence rates of hypothyroidism at early and late pregnancy were compared among pregnant women with different vitamin D levels.The correlation between vitamin D level and hypothyroidism during pregnancy was analyzed.Results The prevalence rates of hypothyroidism at the first trimester and third trimester in pregnant women with vitamin D deficiency were higher than those with insufficient or sufficient vitamin D(all P<0.05).In the women with insufficient vitamin D in the first trimester of pregnancy,the prevalence of hypothyroidism was higher in those with 25(OH)D decreased in the third trimester than those with 25(OH)D increased to sufficient level(both P<0.05).Logistic regression analysis showed that BMI in the third trimester was an independent risk factor for occurrence of hypothyroldism in the third trimester(OR=1.028,95%CI:1.008-1.048,P<0.05),the high 25(OH)D level in the first trimester was an independent protective factor for occurrence of hypothyroidism in the third trimester(OR=0.949,95%CI:0.935-0.964,P<0.05).Conclusion Vitamin D deficiency raise the prevalence of hypothyroidism during pregnancy.Vitamin D supplementation in the first trimester may reduce the prevalence of hypothyroidism in the third trimester of pregnancy.