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根据孕期 trimester,考虑血液稀释因素对日本孕妇维生素 D 状态变化的纵向研究。

Changes in vitamin D status considering hemodilution factors in Japanese pregnant women according to trimester: A longitudinal survey.

机构信息

Department of Public Health, Dokkyo Medical University School of Medicine, Mibu, Japan.

Office of International Affairs, Center for International Cooperation, Dokkyo Medical University, Mibu, Japan.

出版信息

PLoS One. 2020 Oct 2;15(10):e0239954. doi: 10.1371/journal.pone.0239954. eCollection 2020.

Abstract

OBJECTIVES

There have been no longitudinal surveys on the changes in 25-hydroxyvitamin D [25(OH)D] while considering hemodilution factors among pregnant Japanese women. Therefore, we examined 25(OH)D levels as well as red blood cell count (RBC), hemoglobin (Hb), and Hematocrit (Hct) at the three trimesters among pregnant Japanese women to determine the distribution of serum 25(OH)D levels and the influence of hemodilution.

DESIGN

This was a longitudinal study.

SETTING

The study was conducted at Ibaraki Seinan Medical Center Hospital in Japan.

PARTICIPANTS

The participants comprised 50 women in the first trimester with singleton pregnancies and without any complications.

OUTCOME MEASURES

Participants were recruited from June to August 2018, and followed up till their postpartum period. Blood samples were collected at the first, second, and third trimesters, i.e., at 4-15, 16-27, and 28-39 weeks, respectively. 25(OH)D levels, RBC, Hb, and Hct were analyzed across the three trimesters.

RESULTS

Comparing the first, second, and third trimesters, 25(OH)D, RBC, and Hb were significantly declined in the second and third trimesters (p < 0.001). According to Spearman's correlation coefficient with 25(OH)D and RCB, Hb, Hct, significant correlations were found between 25(OH)D and Hb (p < 0.001), as well as Hct (p < 0.001) in the third trimester.

CONCLUSIONS

The present study had two major findings. First, it showed that the vitamin D status of most pregnant Japanese women were considered as vitamin D deficient. Second, the maternal serum 25(OH)D levels, RBC, Hb, and Hct of the pregnant women declined in the second and third trimesters. Thus we propose to have routine screening of vitamin D status of pregnant women, especially in the second trimester.

摘要

目的

在考虑日本孕妇血液稀释因素的情况下,目前尚无关于 25-羟维生素 D [25(OH)D]变化的纵向研究。因此,我们检测了日本孕妇在三个孕期的 25(OH)D 水平以及红细胞计数(RBC)、血红蛋白(Hb)和血细胞比容(Hct),以确定血清 25(OH)D 水平的分布和血液稀释的影响。

设计

这是一项纵向研究。

地点

本研究在日本茨城县仙南医疗中心医院进行。

参与者

参与者包括 50 名处于孕早期且无任何并发症的单胎妊娠女性。

观察指标

参与者于 2018 年 6 月至 8 月招募,并随访至产后。在第 1、2 和 3 个孕期(即 4-15、16-27 和 28-39 周)分别采集血样。分析了三个孕期的 25(OH)D 水平、RBC、Hb 和 Hct。

结果

与第 1 、2 和 3 个孕期相比,第 2 和第 3 个孕期的 25(OH)D、RBC 和 Hb 显著下降(p < 0.001)。根据 Spearman 相关系数与 25(OH)D 和 RBC、Hb、Hct 的相关性,第 3 个孕期 25(OH)D 与 Hb(p < 0.001)以及 Hct(p < 0.001)呈显著相关。

结论

本研究有两个主要发现。首先,它表明大多数日本孕妇的维生素 D 状态被认为是维生素 D 缺乏。其次,孕妇的血清 25(OH)D 水平、RBC、Hb 和 Hct 在第 2 和第 3 个孕期下降。因此,我们建议对孕妇进行常规的维生素 D 状态筛查,尤其是在第 2 个孕期。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a23/7531781/dbc4484bcf72/pone.0239954.g001.jpg

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