血清维生素D状况对妊娠女性子代胎儿期长骨发育的影响

Impact of maternal serum vitamin D status on fetal long bone development

目的探究血清维生素D状况对妊娠女性子代胎儿期长骨发育的影响。方法回顾性收集2018年7月至2020年6月在我院产前诊断中心就诊的第1胎妊娠女性1193例,均行产前胎儿超声检查与血清维生素D水平检测,根据第1次检测维生素D后的给药剂量分为基础剂量组(维生素D3,1600 IU/d,口服)、足量补充组(维生素D2注射液60万U/2周,肌肉注射),比较两组妊娠女性在治疗12周和24周时血清25-(OH)D水平及妊娠女性其胎儿长骨生长情况,采用多因素logistic回归分析胎儿长骨长度的相关影响因素。结果足量补充组相比基础剂量组在治疗8周、治疗12周、治疗24周均能明显提升妊娠女性血清25-(OH)D水平。两组妊娠女性在给予治疗12周[(4.93±0.75)cm对(4.61±0.73)cm,P<0.05]和治疗24周[(7.92±0.84)cm对(7.25±0.92)cm,P<0.05],足量补充组相比基础剂量组更能增加胎儿的长骨长度,尤以治疗24周时两组长骨的差异更为明显。母亲身高、基础维生素D水平、孕24周维生素D水平与胎儿长骨长度呈正相关。结论孕妇应保持相对较高的基础维生素D水平,并在孕期重视维生素D水平对胎儿的影响,足量补充维生素D对胎儿长骨发育具有重要意义。

Objective To investigate the effect of maternal serum vitamin D on fetal long bone development.Methods A retrospective collection of 1193 first-time pregnant women who visited our hospital′s prenatal diagnosis center from July 2018 to June 2020 was conducted.All underwent prenatal fetal ultrasound examination and serum vitamin D level detection.Based on the dosage of vitamin D administered after the first vitamin D test,participants were divided into the basic dosage group(vitamin D3,1600 IU/d,orally)and the adequate supplementation group(vitamin D2 injection 600000 IU/2 weeks,intramuscular injection).The serum 25-(OH)D levels of the two groups of pregnant women were compared at 12 and 24 weeks of treatment,as well as the long bone growth of their fetuses.Multivariable logistic regression analysis was used to analyze the factors influencing fetal long length.Results Compared to the basic dosage group,the adequate supplementation group showed a significant increase in serum 25-(OH)D levels in pregnant women at 8 weeks,12 weeks,and 24 weeks of treatment.The adequate supplementation group also significantly increased fetal long bone length at 12 weeks[(4.93±0.75)cm vs(4.61±0.73)cm,P<0.05]and 24 weeks of treatment[(7.92±0.84)cm vs(7.25±0.92)cm,P<0.05],with the difference between the two groups being more pronounced at 24 weeks of treatment.Maternal height,basal vitamin D level,and vitamin D level at 24 weeks of gestation were positively correlated with fetal long bone length.Conclusion Pregnant women should maintain a relatively high level of basal vitamin D,and pay attention to the effect of vitamin D level on the fetus.A sufficient amount of vitamin D supplementation is of great significance for the long bone development of the fetus.