海岛地区2614例孕妇血清维生素D水平及影响因素分析

Status and influencing factors of serum vitamin D in 2614 pregnant women in Zhoushan island area

目的了解舟山海岛地区妊娠期妇女维生素D营养现状,分析维生素D缺乏的影响因素,为指导海岛妊娠妇女正确补充维生素D提供参考依据。方法随机选取2017年6月—2020年12月在舟山市妇幼保健院进行孕检、常住舟山本地、年龄≥20周岁及自然单胎怀孕的2614例健康妊娠妇女作为调查对象,采用电化学发光法检测25-羟基维生素D[25(OH)D]浓度,对不同孕期、季节及年龄的变化进行描述性统计分析。结果2614例妊娠妇女孕早、中及晚期检测25(OH)D总的平均水平M(Q_(R))为22.20(10.90)ng/ml,维生素D不足和缺乏率占82.57%。其中,孕早期25(OH)D水平最低,浓度为18.10(8.70)ng/ml,孕晚期25(OH)D水平最高,浓度达25.70(11.00)ng/ml。维生素D缺乏率和充足率在孕早、中及晚期分别为59.98%、32.36、24.33%和5.36%、17.33%、29.61%,25(OH)D缺乏状况呈现随孕周呈现逐步改善的趋势(P<0.01)。结论舟山海岛地区妊娠期妇女普遍缺乏维生素D,目前孕期常规施行的400~800 IU的补充剂量并不能保证大部分孕妇对维生素D的需求。应该尽早甚至孕前开始检测25(OH)D浓度并在孕期持续监测其水平,结合孕妇年龄、孕期及季节变化,充分考虑补充依从性等情况,可适当对常规施行的维生素D补充剂量作出调整。

Objective To understand the status quo of 25-hydroxyl vitamin D[25(OH)D]levels of women in the pregnancy in Zhoushan Island region,and to analyze the influencing factors of vitamin D deficiency,so as to provide basis for guiding the personalized vitamin D supplementation of pregnant women in Islands.Methods The serum 25(OH)D level of 2614 case health pregnant women aged≥18 years old who had a natural single pregnancy and lived in ZhouShan Maternity and Child Care Hospital from June 2017 to December 2020 were detected by electrochemical luminescence immunoassay(ECLIA),descriptive statistical analysis and multivariate regression analysis were performed on the changes of pregnancy,season and age.Results Of 2614 cases,the mean level M(Q_(R))of 25(OH)D level was 22.20(10.90)ng/ml.vitamin D deficiency and deficiency rate accounted for 82.57%.The serum 25(OH)D level was the lowest in early pregnancy median 18.10(8.70)ng/ml,and the highest in late pregnancy median 25.70(11.00)ng/ml.The rate of vitamin D deficiency and sufficiency in early,middle and late pregnancy were 59.98%,32.36,24.33%and 5.36%,17.33%,29.61%,respectively,25(OH)D deficiency gradually improved with gestational weeks(P<0.01).Conclusion Vitamin D deficiency is prevalent in pregnant women in Zhoushan Island region,the current recommended dose of 400-800 IU does not guarantee the vitamin D needs of most pregnant women.The concentration of 25(OH)D should be detected as early as possible or even before pregnancy,and its level should be continuously monitored during pregnancy.Taking into account the age,pregnancy and seasonal changes of pregnant women,and the full consideration of supplement compliance,routine vitamin D supplementation can be appropriate.