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维生素 D 预防子痫前期有效吗?

Could Vitamin D Be Effective in Prevention of Preeclampsia?

机构信息

Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, 20-954 Lublin, Poland.

出版信息

Nutrients. 2021 Oct 28;13(11):3854. doi: 10.3390/nu13113854.

Abstract

Prevention of preeclampsia (PE) remains one of the most significant problems in perinatal medicine. Due to the possible unpredictable course of hypertension in pregnancy, primarily PE and the high complication rate for the mother and fetus/newborn, it is urgent to offer pregnant women in high-risk groups effective methods of preventing the PE development or delaying its appearance. In addition, due to the association of PE with an increased risk of developing cardiovascular diseases (CVD) in later life, effective preeclampsia prevention could also be important in reducing their incidence. Ideal PE prophylaxis should target the pathogenetic changes leading to the development of PE and be safe for the mother and fetus, inexpensive and freely available. Currently, the only recognized method of PE prevention recommended by many institutions around the world is the use of a small dose of acetylsalicylic acid in pregnant women with risk factors. Unfortunately, some cases of PE are diagnosed in women without recognized risk factors and in those in whom prophylaxis with acetylsalicylic acid is not adequate. Hence, new drugs which would target pathogenetic elements in the development of preeclampsia are studied. Vitamin D (Vit D) seems to be a promising agent due to its beneficial effect on placental implantation, the immune system, and angiogenic factors. Studies published so far emphasize the relationship of its deficiency with the development of PE, but the data on the benefits of its supplementation to reduce the risk of PE are inconclusive. In the light of current research, the key issue is determining the protective concentration of Vit D in a pregnant woman. The study aims to present the possibility of using Vit D to prevent PE, emphasizing its impact on the pathogenetic elements of preeclampsia development.

摘要

预防子痫前期 (PE) 仍然是围产期医学中最重大的问题之一。由于妊娠期间高血压的可能不可预测的病程,主要是子痫前期和母婴/新生儿的高并发症发生率,因此迫切需要为高危孕妇提供预防子痫前期发展或延迟其出现的有效方法。此外,由于子痫前期与以后生活中发生心血管疾病 (CVD) 的风险增加有关,有效的子痫前期预防也可能对降低其发病率很重要。理想的子痫前期预防应针对导致子痫前期发展的发病机制变化,对母亲和胎儿安全、廉价且易于获得。目前,全世界许多机构推荐的唯一被认可的子痫前期预防方法是在有危险因素的孕妇中使用小剂量乙酰水杨酸。不幸的是,有些子痫前期病例在没有公认危险因素的妇女中被诊断出来,并且在那些用乙酰水杨酸预防不足的妇女中被诊断出来。因此,正在研究针对子痫前期发展中的发病机制因素的新药。维生素 D (Vit D) 似乎是一种很有前途的药物,因为它对胎盘植入、免疫系统和血管生成因子有有益的影响。迄今为止发表的研究强调了其缺乏与子痫前期发展之间的关系,但关于补充其以降低子痫前期风险的益处的数据尚无定论。根据目前的研究,关键问题是确定孕妇中 Vit D 的保护浓度。本研究旨在介绍使用 Vit D 预防子痫前期的可能性,强调其对子痫前期发病机制因素的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bed0/8621759/47bd7f9927fb/nutrients-13-03854-g001.jpg

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