潍坊地区妊娠早期妇女25-羟维生素D水平与不良妊娠发病关系的队列研究  

Relationship between 25-hydroxyvitamin D level among females at the first trimester of pregnancy and adverse pregnancy outcome in Weifang district: a cohort study

作　　者：王兰玲[1] 王彬[2] 牟莹莹[1] 王执勇[3] 马保海[4] WANG Lanling;WANG Bin;MOU Yingying;WANG Zhiyong;MA Baohai(Department of Obstetrics,Weifang Maternal and Child Health Hospital(Maternal and Child Health Hospital of Weifang Medical University),Weifang 261011,P.R.China;Department of Medical,Weifang Maternal and Child Health Hospital(Maternal and Child Health Hospital of Weifang Medical University),Weifang261011,P.R.China;Department of Pediatric,Weifang Maternal and Child Health Hospital(Maternal and Child Health Hospital of Weifang Medical University),Weifang 261011,P.R.China;Department of Nutritional,Weifang Maternal and Child Health Hospital(Maternal and Child Health Hospital of Weifang Medical University),Weifang261011,P.R.China)

机构地区：[1]潍坊市妇幼保健院(潍坊医学院妇幼保健院)产科,山东潍坊261011 [2]潍坊市妇幼保健院(潍坊医学院妇幼保健院)医务科,山东潍坊261011 [3]潍坊市妇幼保健院(潍坊医学院妇幼保健院)儿科,山东潍坊261011 [4]潍坊市妇幼保健院(潍坊医学院妇幼保健院)营养科,山东潍坊261011

出　　处：《中国循证医学杂志》2021年第9期1008-1015,共8页Chinese Journal of Evidence-based Medicine

基　　金：山东省医药卫生科技发展计划项目(编号:2018WS093);潍坊市卫生计生委科研项目(编号:wfwsjs_2018_031)。

摘　　要：目的分析25-羟维生素D[25(OH)D]水平与不良妊娠发病的关系。方法招募2017年1月至2019年12月在潍坊市妇幼保健院产检的妊娠早期妇女作为研究对象,应用液相色谱-串联质谱方法检测25(OH)D浓度。通过门诊产检和住院分娩随访观察孕妇、胎儿、新生儿不良妊娠发生情况,并采用Stata 15.0软件分析妊娠早期妇女血清25(OH)D水平与不良妊娠发病的关系。结果共招募6 770例孕妇,最终纳入4 997例孕妇进行分析。孕妇25(OH)D浓度中位数为15.40 ng/mL,维生素D缺乏[25(OH)D<20 ng/mL]的总发生率为71.26%。GDM、子痫前期、胎膜早破、羊水过少、羊水过多、剖宫产、自然流产或死胎、胎儿畸形、胎儿窘迫、早产、巨大儿、低出生体重儿、小于胎龄儿、新生儿窒息发病率分别为28.31%、2.27%、23.47%、12.68%、0.51%、45.71%、1.44%、0.93%、9.26%、5.05%、11.68%、2.68%、3.18%、1.16%。在调整了年龄、胎次、季节、既往高血压、既往糖尿病、维生素D补充等因素后,25(OH)D水平与不良妊娠发病风险的相关性不具有统计学意义(P>0.05)。结论孕妇妊娠早期25(OH)D水平对不良妊娠发病风险无影响。Objective The research was performed to investigate the relationship between serum 25-hydroxyvitamin D(25(OH)D) levels and the risk of adverse pregnancy outcomes. Methods We enrolled females who were in the first trimester of pregnancy and had arranged antenatal care at the Weifang Maternal and Child Health Hospital between January 2017 and December 2019. The liquid chromatography-tandem mass spectrometry(LC-MS/MS)method was used to detect serum concentrations of 25(OH)D. The health status of the expectant mothers and fetuses and the incidence of adverse pregnancy outcomes of newborns were monitored through the outpatient, prenatal, and delivery stages in the hospital. Results An initial total of 6 770 females were signed up, while 4 997 females were eventually included. The median value of 25(OH)D concentration was 15.40 ng/mL, and the incidence rate of vitamin D deficiency[25(OH)D < 20 ng/mL] was 71.26%. The occurrence rates of gestational diabetes mellitus(GDM), pre-eclampsia,premature rupture of membranes(PROM), oligohydramnios, polyhydramnios, cesarean delivery, spontaneous abortion or stillborn fetus, fetal malformation, premature delivery, fetal macrosomia, low birth weight, small for gestational age infant, and asphyxia of newborn were 28.31%, 2.27%, 23.47%, 12.68%, 0.51%, 45.71%, 1.44%, 0.93%, 9.26%, 5.05%,11.68%, 2.68%, 3.18%, and 1.16%, respectively. After adjusting for age, parity, season, pre-existing hypertension, preexisting diabetes, and vitamin D supplementation, no relationship between 25(OH)D levels and adverse pregnancy outcomes was found(P>0.05). Conclusions Levels of 25(OH)D do not affect the risk of adverse pregnancy outcomes in females during the first trimester of pregnancy.

关 键 词：25-羟维生素D 娠期早期 不良妊娠 潍坊 队列研究 

分 类 号：R714.2[医药卫生—妇产科学]