高龄对妊娠期糖尿病患者孕中期叶酸、维生素B12水平的影响  

Effect of Advanced Mature Age on Folate and Vitamin B12 During the Second Trimesters of Gestation in Patients with Gestational Diabetes Mellitus

作　　者：石敏 倪爱华 杨沐怿 王雅萍[1] 雷磊 Shi Min;Ni Aihua;Yang muyi(Department of Obstetrics,Nanjing First Hospital,Nanjing Medical University,Nanjing,Jiangsu 210006;Department of Maternity Health,Yuhuatai Maternity and Child Health Care Center,Nanjing,Jiangsu 210006,China.)

机构地区：[1]南京医科大学附属南京医院·南京市第一医院产科,江苏南京210006 [2]南京市雨花台区妇幼保健所孕产保健部,江苏南京210006

出　　处：《四川医学》2024年第5期486-490,共5页Sichuan Medical Journal

基　　金：江苏省妇幼健康科研项目(编号:F202128)。

摘　　要：目的探讨高龄对妊娠期糖尿病(GDM)患者孕中期血清叶酸及维生素B12水平的影响,以及与妊娠结局的关系,以期为高龄GDM患者提供更好的临床诊疗和保健指导。方法选取2021年1月至2022年7月由定点社区医院转入我院产检并分娩的GDM患者212例,其中高龄GDM组(≥35岁)75例、适龄GDM组(<35岁)137例。比较两组患者孕中期血清叶酸及维生素B12水平,分析其与新生儿出生体质量等妊娠结局的相关性。结果高龄GDM组患者孕中期血清维生素B12水平显著低于适龄GDM组[(232.04±65.79)pmol/L vs.(257.62±92.86)pmol/L,P<0.05];两组孕妇血清叶酸及叶酸/维生素B12比值比较差异无统计学意义。高龄GDM组孕妇分娩孕周[(38.57±1.32)周vs.(38.95±1.32)周,P<0.05]及新生儿体质量[(3306.33±441.01)g vs.(3429.82±426.47)g,P<0.05]低于适龄GDM组。本研究未发现叶酸、维生素B12水平及叶酸/维生素B12与GDM患者新生儿出生体质量之间有显著相关性。结论高龄GDM患者孕中期体内的维生素B12缺乏更显著,其分娩的新生儿体质量较低,但未发现两者具有显著相关性。Objective To investigate the effects of advanced mature age on serum folate and vitamin B12 during the second trimesters of gestation in patients with gestational diabetes mellitus(GDM),and the relationship with pregnancy outcomes,with a view to providing betteRclinical diagnosis,treatment and health care guidance foRGDM patients with advanced age.Methods From January 2021 to July 2022,212 GDM patients who were transferred to ouRhospital foRobstetric examination and delivery from designated community hospitals were selected,including 75 patients in the advanced-age GDM group(≥35 years old)and 137 patients in the age-appropriate GDM group(<35 years old).The mid-pregnancy serum folate and vitamin B12 were compared,and theiRcorrelation with neonatal birth weight and otheRpregnancy outcomes were analyzed.Results Serum vitamin B12 during the second trimesters of gestation in the advanced-age GDM group were significantly loweRthan those in the age-appropriate GDM group[(232.04±65.79)pmol/L vs.(257.62±92.86)pmol/L,P<0.05].No differences were found in serum folic acid and folic acid/Vit B12 ratios between two groups.And the numbeRof weeks of delivery in the advanced-age GDM group was significantly loweRthan that in the age-appropriate GDM group[(38.57±1.32)w vs.(38.95±1.32)w,P<0.05]and neonatal weight[(3306.33±441.01)g vs.(3429.82±426.47)g,P<0.05]were loweRthan those of the age-appropriate group.The present study did not find any significant correlation between folic acid,vitamin B12,and folic acid/Vit B12 and the birth weight of neonates in GDM patients.Conclusion Vitamin B12 deficiency during the second trimesters of gestation would be more pronounced in the advanced-age GDM patients,and the newborns delivered by them had loweRbody weights,but no significant correlation was found.

关 键 词：高龄妊娠 妊娠期糖尿病 叶酸 维生素B12 

分 类 号：R714.7[医药卫生—妇产科学]