孕妇产前血清25羟维生素D[25(OH)D]水平与产后出血关联性研究  

Study on the level of 25 hydroxyvitamin D in prenatal serum of pregnant women and the relationship between its concentration and postpartum hemorrhage in pregnant women

作　　者：郭武辉[1] 韦娟 Guo Wuhui;Wei Juan(Department of Clinical Laboratory,Yulin City Second People’s Hospital,Yulin 719000,Shanxi,China;Department of Obstetrics,Puchen County Traditional Chinese Medical Hospital of Weinan City in Shanxi Province,Weinan 715500,Shanxi,China)

机构地区：[1]榆林市第二医院医学检验科,陕西榆林719000 [2]渭南市蒲城县中医医院产科,陕西渭南715500

出　　处：《贵州医药》2023年第1期16-18,共3页Guizhou Medical Journal

基　　金：国家重点研发计划项目(编号:2019YFF0216502)。

摘　　要：目的观察分析孕妇产前血清25羟维生素D表达情况,并探讨25羟维生素D浓度与孕妇产后出血之间的关系。方法在本院妇产科接受产前检查的孕妇1000例作为观察主体,收集其临床资料,采血检验其血清25羟维生素D水平,观察记录其妊娠分娩结局,Logistic分析血清25羟维生素D表达与产后出血之间的关系。结果产前检查孕妇中,维生素不足(血清25羟维生素D<50 nmol/L)616例(61.60%)。相比于32岁以上、25~32岁的孕妇,25岁以下的孕妇血清25羟维生素D更低,各年龄阶段的孕妇产前血清25羟维生素D差异显著(P<0.05)。既往存在或无不良孕产史的孕妇产前血清25羟维生素D差异显著(P<0.05)。经产妇、高龄、BMI指数、疾病史、不良孕产史、维生素D不足、子宫肌瘤极易增大孕妇产后出血风险;亚组以及关联分析提示血清25羟维生素D>70 nmol/L、血清25羟维生素D<50 nmol/L孕妇产后出血风险相比于血清25羟维生素D水平50~75 nmol/L而言并未显著增加。无疾病史、子宫肌瘤孕妇中,血清25羟维生素D<50 nmol/L的孕妇产后出血风险有可能会显著增加。结论孕妇产前维生素D不足情况比较明显,维生素D缺乏并未明显升高孕妇产后出血发生率,而在无疾病史、子宫肌瘤孕妇中,血清25羟维生素D水平低于50 nmol/L有可能会升高产后出血发生率。Objective To observe and analyze the expression of 25 hydroxyvitamin D in prenatal serum of pregnant women,and explore the relationship between its concentration and postpartum hemorrhage in pregnant women,so as to guide clinical targeted intervention to avoid postpartum massive hemorrhage.Methods From July 2020 to July 2021,1000 pregnant women who received prenatal examination in our hospital were treated as subjects of observation.Their clinical data were collected,blood samples were collected to test their serum 25-hydroxyvitamin D levels,pregnancy and delivery outcomes were observed and recorded,and the relationship between serum 25-hydroxyvitamin D expression and postpartum hemorrhage was analyzed by Logistic analysis.Results There were 616 cases(61.60%)of vitamin deficiency that serum 25-hydroxyvitamin D<50 nmol/L among 1000 pregnant women in prenatal examination.Compared with pregnant women over 32 years old and 25~32 years old,pregnant women under 25 years old had lower serum 25-hydroxyvitamin D,and there were statistical significantly differences in prenatal serum 25-hydroxyvitamin D among pregnant women of all ages(P<0.05).There were statistical significantly differences in prenatal serum 25hydroxyvitamin D among pregnant women with or without adverse pregnancy history(P<0.05).The risk of postpartum hemorrhage in pregnant women was easily increased due to the advanced age,BMI index,disease history,poor pregnancy history,vitamin D deficiency and uterine fibroids.Subgroup and association analysis suggested that the risk of postpartum hemorrhage in women with serum 25hydroxyvitamin D>70 nmol/L and serum 25hydroxyvitamin D<50 nmol/L was not significantly increased compared with serum 25hydroxyvitamin D levels of 50~75 nmol/L.In pregnant women with no history of disease and uterine fibroids,women with serum 25hydroxyvitamin D<50 nmol/L may had a significantly increased risk of postpartum hemorrhage.Conclusion Prenatal vitamin D deficiency is more obvious in pregnant women,and vitamin D deficiency does not si

关 键 词：25羟维生素D 孕妇 产前分析 产后出血 维生素D不足 

分 类 号：R714.461[医药卫生—妇产科学]