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合并胎儿先天性膈疝的妊娠和正常妊娠中血清维生素D和钙的水平。

Levels of serum vitamin D and calcium in pregnancies complicated with fetal congenital diaphragmatic hernia and normal pregnancies.

作者信息

Turkmen Gulenay Gencosmanoglu, Timur Hakan, Tokmak Aytekin, Yilmaz Zehra, Kirbas Ayse, Daglar Korkut, Sanhal Cem Yasar, Uygur Dilek

机构信息

a Department of Obstetrics and Gynecology , Division of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey.

出版信息

J Matern Fetal Neonatal Med. 2017 Apr;30(8):990-994. doi: 10.1080/14767058.2016.1196662. Epub 2016 Jun 17.

Abstract

OBJECTIVE

Vitamin D (VD) deficiency is a common public health problem worldwide in all age groups. Receptors and enzymes related to VD metabolism have been shown in many cells and tissues of the body. VD plays a crucial role in cellular growth and differentiation during embryogenesis. It has been suggested that VD deficiency may be associated with various diseases, and that lower maternal serum levels may be associated with adverse perinatal outcomes. In this study, we aimed to compare serum VD levels of pregnant women whose pregnancies complicated by congenital diaphragmatic hernia (CDH) with healthy pregnant women. We also evaluated perinatal outcomes of these pregnancies.

METHODS

Total of 77 patients was included in this prospective and cross-sectional case-controlled study. 24 pregnant women having a fetus with CDH diagnosed prenatally formed the study group, and 53 healthy pregnants were eligible for the control group. Demographics and clinical characteristics of the cases with some laboratory parameters were recorded. Perinatal outcomes were also investigated.

RESULTS

No significant differences were observed between two groups in terms of demographics and clinical features. Mean maternal serum VD levels were significantly lower in the study group than in the controls (p: 0.019). Ionized calcium and corrected calcium levels were also found to be lower in pregnant women with CDH (p < 0.001). Moreover, the calcium-rich dietary habits were also more common in the control group. Four (16.7%) patients chose termination and one (4.2%) experienced a stillbirth. Fourteen (58.3%) infants died in the early neonatal period; although some had undergone surgical interventions, only 5 (20.8%) were still alive after surgery.

CONCLUSIONS

Maternal serum VD and calcium levels were significantly lower in pregnancies complicated by CDH than healthy pregnant women. Hipovitaminosis D may play a vital role in the pathogenesis of CDH.

摘要

目的

维生素D(VD)缺乏是全球各年龄组普遍存在的公共卫生问题。与VD代谢相关的受体和酶已在人体许多细胞和组织中被发现。VD在胚胎发育过程中的细胞生长和分化中起关键作用。有人提出,VD缺乏可能与多种疾病有关,而母亲血清水平较低可能与不良围产期结局有关。在本研究中,我们旨在比较妊娠合并先天性膈疝(CDH)的孕妇与健康孕妇的血清VD水平。我们还评估了这些妊娠的围产期结局。

方法

本前瞻性横断面病例对照研究共纳入77例患者。24例产前诊断胎儿患有CDH的孕妇组成研究组,53例健康孕妇符合对照组条件。记录病例的人口统计学和临床特征以及一些实验室参数。还调查了围产期结局。

结果

两组在人口统计学和临床特征方面未观察到显著差异。研究组孕妇血清VD平均水平显著低于对照组(p:0.019)。还发现CDH孕妇的离子钙和校正钙水平较低(p < 0.001)。此外,富含钙的饮食习惯在对照组中也更常见。4例(16.7%)患者选择终止妊娠,1例(4.2%)发生死产。14例(58.3%)婴儿在新生儿早期死亡;尽管一些婴儿接受了手术干预,但术后只有5例(20.8%)存活。

结论

妊娠合并CDH的孕妇血清VD和钙水平显著低于健康孕妇。VD缺乏可能在CDH的发病机制中起重要作用。

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