Taneja Ashima, Gupta Shweta, Kaur Gurleen, Jain Narender Pal, Kaur Jaspreet, Kaur Satinder
Professor and Head.
Professor, Department of Obstetrics and Gynaecology, Dayanand Medical College and Hospital, Ludhiana, Punjab Corresponding Author.
J Assoc Physicians India. 2020 Mar;68(3):47-50.
Vitamin D deficiency is on a rise globally and so are the maternal complications related to it. This deficiency can be easily detected and corrected by simple oral supplementation for a better health outcome in pregnancy.
Antenatal women with no history of Vitamin D intake and first antenatal visit at our hospital between 26 to 28 weeks of gestation or after 34 weeks were tested for levels of Vitamin 25(OH)D. Deficient women (< 30 ng/ml) between 26 to 28 weeks were supplemented and tested again before delivery (Group A). Deficient women after 34 weeks who did not receive supplementation before delivery constituted Group B. Maternal outcome was noted and compared in both the groups.
Out of the 189 Vitamin D deficient women included in the study; 105(55.5%) were enrolled in Group A and 84 (44.4%) in Group B. 24 (12.7%) women were severely deficient (<4 ng/ml), 134 (70.9%) were deficient (<20 ng/ml) and 28(14.8%) were vitamin D insufficient (20-30 ng/ml). A statistically significant reduction (<0.001) was observed in vitamin D deficient women after supplementation in group A. 5.7% women developed preeclampsia in group A as compared to 28.5% in group B (p<0.0001). Higher (13%) incidence of gestational diabetes mellitus was observed in group B as compared to group A (6.6%) though the difference was not significant. A significantly higher incidence of preterm labor was observed in group B (p=0.007).
Vitamin D deficiency is correlated with a higher incidence of preeclampsia, gestational diabetes mellitus and preterm birth. Maternal screening in targeted population and its supplementation is recommended to improve maternal outcome.
全球维生素D缺乏情况呈上升趋势，与之相关的孕产妇并发症也在增加。这种缺乏可以通过简单的口服补充剂轻松检测和纠正，以在孕期获得更好的健康结果。
对我院妊娠26至28周或34周后首次产前检查且无维生素D摄入史的孕妇进行25(OH)D水平检测。妊娠26至28周的维生素D缺乏孕妇（<30 ng/ml）进行补充，并在分娩前再次检测（A组）。34周后维生素D缺乏且分娩前未接受补充的孕妇组成B组。记录并比较两组的孕产妇结局。
纳入研究的189例维生素D缺乏孕妇中，105例（55.5%）纳入A组，84例（44.4%）纳入B组。24例（12.7%）孕妇严重缺乏（<4 ng/ml），134例（70.9%）缺乏（<20 ng/ml），28例（14.8%）维生素D不足（20 - 30 ng/ml）。A组补充维生素D后，维生素D缺乏孕妇的维生素D水平有统计学意义的降低（<0.001）。A组5.7%的孕妇发生先兆子痫，而B组为28.5%（p<0.0001）。B组妊娠期糖尿病的发生率（13%）高于A组（6.6%），尽管差异不显著。B组早产发生率显著更高（p = 0.007）。
维生素D缺乏与先兆子痫、妊娠期糖尿病和早产的较高发生率相关。建议对目标人群进行孕产妇筛查并补充维生素D，以改善孕产妇结局。
