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孟加拉国维生素 D 缺乏与子痫前期和子痫风险。

Vitamin D deficiency and the risk of preeclampsia and eclampsia in Bangladesh.

机构信息

Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA.

出版信息

Horm Metab Res. 2013 Sep;45(9):682-7. doi: 10.1055/s-0033-1345199. Epub 2013 Jun 3.

Abstract

Maternal vitamin D deficiency has been proposed as a risk factor for preeclampsia, but no significant studies have been conducted to evaluate its relationship with eclampsia. Our goal in this study was to assess the prevalence and potential risk of vitamin D deficiency for both preeclampsia and eclampsia in Bangladesh. Using a case-control design, we measured serum 25(OH)D levels in pregnant women receiving care at the Dhaka Medical College Hospital with preeclampsia (n=33), eclampsia (n=79), and normal pregnancy (controls, n=76). Odds of developing preeclampsia and eclampsia with vitamin D deficiency were calculated using logistic regression analysis. The prevalence of vitamin D insufficiency was very high with more than 3 quarters (78%) of all subjects having a serum 25(OH)D level<30 ng/ml. The mean serum 25(OH)D level was 24.86 ng/ml in controls, 23.96 ng/ml in pre-eclamptic women, and 21.56 ng/ml in eclampsia patients. Comparing to those who had a serum 25(OH)D level of ≥30 ng/ml, the odds ratio (95% CI) of developing preeclampsia and eclampsia in mothers with vitamin D insufficiency were 3.9 (95% CI=1.18-12.87) and 5.14 (95% CI=1.98-13.37), respectively (adjusting for age, BMI and duration of pregnancy). The odds of developing preeclampsia and eclampsia may increase by up to 5-fold in women with vitamin D insufficiency. Since preeclampsia and eclampsia can lead to serious complications for both mother and the offspring, vitamin D may be supplemented during pregnancy in high risk populations to decrease these adverse consequences.

摘要

母体维生素 D 缺乏被认为是子痫前期的一个危险因素,但尚未有研究评估其与子痫的关系。本研究旨在评估维生素 D 缺乏与孟加拉国子痫前期和子痫的患病率和潜在风险。我们采用病例对照设计,测量了达卡医学院医院就诊的子痫前期(n=33)、子痫(n=79)和正常妊娠(对照组,n=76)孕妇的血清 25(OH)D 水平。使用逻辑回归分析计算维生素 D 缺乏与子痫前期和子痫发生的比值比(OR)。所有受试者中超过 3/4(78%)的人血清 25(OH)D 水平<30ng/ml,维生素 D 不足的患病率非常高。对照组血清 25(OH)D 平均水平为 24.86ng/ml,子痫前期妇女为 23.96ng/ml,子痫患者为 21.56ng/ml。与血清 25(OH)D 水平≥30ng/ml的母亲相比,维生素 D 不足的母亲发生子痫前期和子痫的 OR(95%CI)分别为 3.9(95%CI=1.18-12.87)和 5.14(95%CI=1.98-13.37)(调整年龄、BMI 和妊娠持续时间)。维生素 D 不足的女性发生子痫前期和子痫的风险可能增加 5 倍。由于子痫前期和子痫可导致母婴严重并发症,高危人群在妊娠期间可能需要补充维生素 D,以降低这些不良后果。

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