不同妊娠期女性维生素D缺乏的危险因素分析

An analysis of risk factors for vitamin D deficiency in pregnant women in different pregnancy stages

目的分析不同妊娠期女性维生素D缺乏的危险因素。方法维生素D缺乏(血清25-羟维生素D<50 nmol/L)妊娠期女性478例分为妊娠早期组(≤12周,171例)、妊娠中期组(>12周且<28周,139例)和妊娠晚期组(≥28周,168例)。采用ELISA法测定血清25-羟维生素D浓度。分析不同妊娠期女性维生素D缺乏的危险因素。结果本组妊娠期女性维生素D缺乏发生率52.0%(478/920),妊娠早期组、中期组和晚期组维生素D缺乏率分别为42.5%(171/402)、45.1%(139/308)和80.0%(168/210)。多因素logistic回归分析结果显示,年龄≥30岁、冬春季采血、妊娠前BMI≥30 kg/m2、有妊娠反应史和妊娠期每日户外活动时间<1 h是妊娠早期女性维生素D缺乏的危险因素(P<0.05);年龄≥30岁、冬春季采血、妊娠期不使用维生素D补充剂、妊娠期体重增加<40 g/d、妊娠期每日户外活动时间<1 h和妊娠期每日摄入奶制品<200 mL是妊娠中期女性维生素D缺乏的危险因素(P<0.05);年龄≥30岁、冬春季采血、妊娠期不使用维生素D补充剂、妊娠期体重增加<40 g/d、妊娠期每日摄入奶制品<200 mL、妊娠期每日户外活动时间<1 h和妊娠期住院时间≥30 d等是妊娠晚期女性维生素D缺乏的危险因素(P<0.05)。结论维生素D缺乏在不同妊娠期女性中普遍存在,且危险因素不尽相同,针对以上危险因素早期防治可改善预后。

Objective To analyze the risk factors for vitamin D deficiency in pregnant women in different pregnancy stages.Methods A total of 478 pregnant women with vitamin D deficiency(serum 25-hydroxyvitamin D<50 nmol/L) were divided into three groups of A(≤12 weeks of pregnancy stage, 171 cases),B(>12 weeks and <28 weeks of pregnancy stage, 139 cases), and C(≥28 weeks of pregnancy stage, 168 cases).ELISA was used to determine serum concentration of 25-hydroxyvitamin D.The risk factors for vitamin D deficiency were analyzed.Results The incidence of vitamin D deficiency was 52.0%(478/920),which was 42.5%(171/402) for group A,45.1%(139/308) for group B and 80.0%(168/210) for group C.Multivariate logistic regression analysis showed that age≥30 years old, blood collection in the winter and spring, BMI≥30 kg/m2 before pregnancy, history of pregnancy reactions, and daily outdoor activities during pregnancy <1 hour were the risk factors for vitamin D deficiency in group A(P<0.05).Age≥30 years old, blood collection in the winter and spring, no vitamin D supplements during pregnancy, weight gain during pregnancy<40 g per day, daily outdoor activities during pregnancy <1 hour, and daily intake of dairy products during pregnancy <200 mL were the risk factors for vitamin D deficiency in group B(P<0.05).Age≥30 years old, blood collection in the winter and spring, no vitamin D supplements during pregnancy, weight gain during pregnancy <40 g per day, daily intake of dairy products during pregnancy <200 mL,daily outdoor activities during pregnancy <1 hour, and hospitalization during pregnancy≥30 days were the risk factors for vitamin D deficiency in group C(P<0.05).Conclusion Vitamin D deficiency is the common in women in different pregnancy stages, and the risk factors for that are not the same.Early prevention and treatment of the above risk factors can improve the prognosis.