不同孕期妇女血清25(OH)D水平及与新生儿生长发育关系探讨

The study of the levels of serum 25-hydroxy-vitamin D of pregnant women in different gestational weeks and its correlation with infant growth and development

目的:探讨不同孕期妇女血清25羟维生素D[25(OH)D]水平变化及其对婴儿生长发育影响。方法:选取2016年6月—2017年6月本院建档定期接受产前检查并住院分娩的孕妇989例,根据不同孕周分为孕早期组182例(孕周≤12周)、孕中期组517例(孕周12~28周)、孕晚期组301例(孕周≥28周)。检测其血清25(OH)D水平并评估婴儿生长发育指标。结果:孕妇25(OH)D水平(35.56±11.49)nmol/L,78.6%的孕妇维生素D缺乏或不足,其中孕早期组的维生素D缺乏(不足)率(92.3%)高于孕中期组(77.9%)和孕晚期组(71.4%),冬春季节血清25(OH)D水平低于夏秋季节(均P<0.05);干预后产前维生素D缺乏(不足)率占37.5%。产前维生素D不同状况组新生儿出生体重、身长、头围比较未见差异,3月龄时仍未见差异(P>0.05);6月龄时,维生素D缺乏组的婴儿身长、头围低于维生素D充足组(P<0.05)。结论:孕妇普遍存在维生素D缺乏或不足现象,且以孕早期尤为突出,应尽早监测血清25(OH)D水平并及时采取干预措施;母体维生素D缺乏对婴儿生长发育影响有限。

Objective:To investigate the levels of serum 25-hydroxy-vitamin D[25(OH)D]of pregnant women in different gestational weeks,and to explore its correlation with infant growth and development.Methods:989 pregnant women who regularly received prenatal care and hospitalized for delivery were selected and divided into three groups according to different gestational weeks from June 2016 to June 2017,which included group A(≤12 gestational weeks,n=182),the group B(12-28 gestational weeks,n=517),and the group C(≥28 gestational weeks,n=301).The serum levels of 25(OH)D of the women in the three groups were measured,the growth and development of infants in the three groups were evaluated.Results:The average serum 25(OH)D level of all women was(35.56±11.49)nmol/L,and 78.6%of pregnant women were vitamin D lack or deficiency.Among them,the rate of vitamin D lack or deficiency of women in group A was 92.3%,which was significant lower than that of women in group B(77.9)or that(71.4%)of women in group C(P<0.05).The serum 25(OH)D levels of pregnant women in winter and spring were significant lower than those of women in summer and autumn(P<0.05).After treatment,only 37.6%of prenatal women were vitamin D lack or deficiency.There were no significant difference in birth weight,body length and head circumference of the newborns among the prenatal women with different vitamin D lack.As for 3 months infants,there were also no significant difference in birth weight,body length and head circumference weight length,head circumference(P>0.05).When the infants were 6 months old,the length and head circumference of the infants of women with the vitamin D lack during pregnancy was significant lower than that of the infants of women with the vitamin D sufficient(P<0.05).Conclusion:Vitamin D lack during pregnancy is prevalent in pregnant women,especially during early pregnancy,so it is necessary to monitor serum level of 25(OH)D of pregnant women and to take some necessary intervention measures.While the maternal vitamin D lack has limited adverse effect on infant growth and development.