孕期预防性补充不同剂量维生素D对孕前肥胖症孕妇维生素D水平、性激素水平和妊娠结局的影响  

Effects of prophylactic supplementation of different doses of vitamin D during pregnancy on vitamin D levels,sex hormone levels and pregnancy outcomes in pregnant women with preconception obesity

作　　者：李文丹[1] 李芳[1] 孙黎[1] 宋颍丽 Li Wendan;Li Fang;Sun Li;Song Yingli(Zhengzhou Maternal and Child Health Hospital,Zhengzhou 450000,Henan,China)

机构地区：[1]郑州市妇幼保健院,河南郑州450000

出　　处：《辽宁医学杂志》2025年第1期14-18,共5页Medical Journal of Liaoning

基　　金：河南省医学科技攻关项目(编号:LHGJ20220888)。

摘　　要：目的探索孕期预防性补充不同剂量维生素D对孕前肥胖症孕妇维生素D水平、性激素水平和妊娠结局的影响。方法选取我院2020年10月至2022年10月期间131例肥胖症孕妇作为研究对象,依照维生素D剂量不同分为低剂量组和高剂量组。低剂量组65例在孕16~20周预防性口服400U维生素D滴剂胶囊,高剂量组66例在孕16-20周预防性给予肌内注射30万U维生素D_(3)注射液,对比两组孕妇维生素D水平、临床相关指标、性激素水平、妊娠期并发症及新生儿结局。结果两组干预前后HbA1c、FPG水平经比较无差异(P>0.05);两组干预后25(OH)D_(3)水平较干预前升高,高剂量组高于低剂量组;PTH、P、Ca水平较干预前降低,高剂量组低于低剂量组(P<0.05)。两组干预后FSH、LH、E_(2)水平较干预前升高,高剂量组水平低于低剂量组(P<0.05)。经Fisher确切概率法检验,高剂量组妊娠期并发症发生率3.03%(2/66)、早产率3.03%(2/66)、新生儿窒息率1.52%(1/66)、巨大儿率1.52%(1/66)与低剂量组9.23%(6/65)、7.69%(5/65)、4.62%(3/65)、6.15%(4/65)经比较无差异(双侧P=0.1645、0.2737、0.3653、0.2079,均P>0.05)。结论孕期预防性补充高剂量维生素D,可调节孕前肥胖症孕妇性激素水平,改善维生素D水平及临床相关指标,不增加妊娠期并发症、新生儿不良结局的发生风险。Objective To explore the effects of prophylactic supplementation of different doses of vitamin D during pregnancy on vitamin D levels,sex hormone levels and pregnancy outcomes in pregnant women with preconception obesity.Methods A total of 131 obese pregnant women in our hospital from October 2020 to October 2022 were selected as research objects and divided into low-dose group and high-dose group according to different doses of vitamin D.Sixty-five patients in the low-dose group were given 400U vitamin D drops orally at 16-20 weeks of gestation,and 66 patients in the high-dose group were given 300,000 U vitamin D_(3) injection intramuscular at 16-20 weeks of gestation.Vitamin D levels,clinical indicators,sex hormone levels,pregnancy complications and neonatal outcomes were compared between the two groups.Results There were no differences in HbA1c and FPG levels between the two groups before and after intervention(P>0.05).After intervention,the level of 25(OH)D_(3) in both groups was higher than that before intervention,and the high dose group was higher than the low dose group.The levels of PTH,P and Ca were lower than before intervention,and the high dose group was lower than the low dose group(P<0.05).After intervention,the levels of FSH,LH and E_(2) in both groups were higher than before intervention,and the levels in high-dose group were lower than those in low-dose group(P<0.05).Tested by Fisher′s exact probability method,The incidence of pregnancy complications in the high-dose group was 3.03%(2/66),the rate of preterm birth was 3.03%(2/66),the rate of neonatal asphyxia was 1.52%(1/66),the rate of macrosomia was 1.52%(1/66),and the rate of macrosomia was 9.23%(6/65),7.69%(5/65),4.62%(3/65),6.15%(5/65)in the low-dose group.(4/65)There was no difference between the two sides(P=0.1645,0.2737,0.3653,0.2079,all P>0.05).Conclusion Prophylactic supplementation of high dose vitamin D during pregnancy can regulate the level of sex hormones in pregnant women with preconception obesity,improve vitamin D levels and

关 键 词：维生素D 孕前肥胖症 性激素 妊娠结局 

分 类 号：R71[医药卫生—妇产科学]