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孕妇维生素 D 缺乏:受多种危险因素影响,增加自然流产和胎儿生长受限的风险。

Vitamin D deficiency in pregnant women: Influenced by multiple risk factors and increase the risks of spontaneous abortion and small-for-gestational age.

机构信息

Department of Clinical Laboratory, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.

Department of Nuclear Medicine, Chaohu Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China.

出版信息

Medicine (Baltimore). 2021 Oct 15;100(41):e27505. doi: 10.1097/MD.0000000000027505.

Abstract

OBJECTIVE

To analyze the level of vitamin D and its influencing factors in pregnant women, and to explore the influence of vitamin D deficiency on common adverse pregnancy outcomes in pregnant women, providing evidence for prevention and intervention of vitamin D deficiency in pregnant women.

METHODS

The basic data and blood samples of pregnant women in our hospital from January 2019 to June 2020 were collected, and the 25-(OH) D levels of the serum samples were detected. Then the vitamin D levels and its influencing factors were analyzed, and the relationships between vitamin D levels and common adverse pregnancy outcomes in the pregnant women as well as the incidence of small-for-gestational-age newborns were analyzed.

RESULTS

The vitamin D deficiency rate, insufficiency rate and sufficiency rate of pregnant women were 83.28%, 15.36%, and 1.36% respectively, with vast majority of the pregnant women in a state of vitamin D deficiency. Analysis of the influencing factors on the vitamin D level of pregnant women showed "28 weeks ≤ gestational age ≤32 weeks, summer and autumn, high school education and above, weekly time outdoors ≥10 hours, supplement of vitamin D and trace elements during pregnancy" were protective factors for vitamin D sufficiency in pregnant women. Linear correlation analysis showed the vitamin D level of pregnant women was highly positively correlated with temperature, the higher the temperature, the higher the vitamin D level (r = 0.907, t = 6.818, P < .001). The level of vitamin D in pregnant women was related to the occurrence of spontaneous abortion and small-for-gestational age (SGA), with the incidence of spontaneous abortion and SGA in the "vitamin D deficiency group" higher than those of other groups (P = .018, P = .016).

CONCLUSIONS

The vitamin D level of pregnant women in this area is relatively low, which is affected by multiple factors such as gestational age, season, education level of pregnant women, weekly time outdoors, vitamin D and trace element supplement during pregnancy. Low vitamin D levels can increase the risk of spontaneous abortion and SGA in pregnant women, so relevant measures should be adopted to improve the vitamin D status of pregnant women.

摘要

目的

分析孕妇维生素 D 水平及其影响因素,并探讨维生素 D 缺乏对孕妇常见不良妊娠结局的影响,为预防和干预孕妇维生素 D 缺乏提供依据。

方法

收集我院 2019 年 1 月至 2020 年 6 月期间的孕妇基本资料和血样,检测血清样本 25-(OH)D 水平,分析维生素 D 水平及其影响因素,分析维生素 D 水平与孕妇常见不良妊娠结局及小于胎龄儿发生率的关系。

结果

孕妇维生素 D 缺乏率、不足率和充足率分别为 83.28%、15.36%和 1.36%,绝大多数孕妇处于维生素 D 缺乏状态。孕妇维生素 D 水平的影响因素分析表明,“28 孕周≤孕周≤32 孕周、夏秋季、高中及以上文化程度、每周户外活动时间≥10 小时、孕期补充维生素 D 和微量元素”是孕妇维生素 D 充足的保护因素。线性相关分析显示,孕妇维生素 D 水平与温度呈高度正相关,温度越高,维生素 D 水平越高(r=0.907,t=6.818,P<.001)。孕妇维生素 D 水平与自然流产和小于胎龄儿(SGA)的发生有关,“维生素 D 缺乏组”的自然流产和 SGA 发生率高于其他组(P=.018,P=.016)。

结论

本地区孕妇维生素 D 水平相对较低,受孕妇孕周、季节、文化程度、每周户外活动时间、孕期补充维生素 D 和微量元素等多种因素影响。低维生素 D 水平会增加孕妇自然流产和 SGA 的风险,因此应采取相关措施改善孕妇维生素 D 状况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/32e5/8519205/eb251fc21d91/medi-100-e27505-g001.jpg

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