J Obstet Gynecol Neonatal Nurs. 2022 Sep;51(5):526-535. doi: 10.1016/j.jogn.2022.06.038. Epub 2022 Aug 4.
To investigate the relationships among various factors that affect serum vitamin D levels and vitamin D in the first trimester and the risk of developing gestational diabetes mellitus (GDM).
A prospective cohort design.
The family health center of Ankara, Turkey.
Out of 889 pregnant women who participated in the study in the first trimester (6-13 weeks gestation), 814 participated in GDM screening in the second trimester (24-28 weeks gestation).
We determined serum vitamin D levels, demographic data, various biochemical and anthropometric parameters, and factors that affect vitamin D synthesis of participants in the first trimester and used logistic regression analysis to analyze the effects of the associations among vitamin D deficiency and the other variables on the occurrence of GDM.
Vitamin D deficiency in the first trimester was present in 425 (82.5%) participants. In the second trimester, 198 participants (24.3%) were diagnosed with GDM through oral glucose tolerance test screening. We detected GDM in the second trimester in 5.7% of participants who had vitamin D deficiency in the first trimester. Even after adjustment for vitamin D intake, clothing style, and duration of exposure to the sun, the risk of GDM was significantly greater in participants who were vitamin D deficient than those who were not deficient. The risk of GDM among women with vitamin D deficiency was sustained or increased significantly after we adjusted for age, parity, prepregnancy body mass index, history of diabetes, triglyceride levels, vitamin D intake, clothing style, and length of sun exposure, OR = 10.60, p < .001, 95% confidence interval [2.82, 39.76].
Our results suggest that vitamin D deficiency in the first trimester may significantly increase the risk of developing GDM.
探讨影响血清维生素 D 水平的各种因素与维生素 D 水平及妊娠期糖尿病（GDM）发病风险之间的关系。
前瞻性队列设计。
土耳其安卡拉的家庭健康中心。
889 名在孕早期（6-13 周妊娠）参加研究的孕妇中，814 名在孕中期（24-28 周妊娠）接受 GDM 筛查。
我们测定了参与者在孕早期的血清维生素 D 水平、人口统计学数据、各种生化和人体测量参数，以及影响维生素 D 合成的因素，并采用逻辑回归分析来分析维生素 D 缺乏与其他变量之间的关联对 GDM 发生的影响。
孕早期有 425 名（82.5%）参与者存在维生素 D 缺乏。在孕中期，198 名参与者（24.3%）通过口服葡萄糖耐量试验筛查诊断为 GDM。我们在孕早期维生素 D 缺乏的参与者中发现了 5.7%的人患有 GDM。即使在校正了维生素 D 摄入量、穿衣风格和日照时间后，维生素 D 缺乏的参与者发生 GDM 的风险仍然显著大于不缺乏者。在校正了年龄、产次、孕前体重指数、糖尿病史、甘油三酯水平、维生素 D 摄入量、穿衣风格和日照时间后，维生素 D 缺乏的女性发生 GDM 的风险持续或显著增加，OR=10.60，p<0.001，95%置信区间[2.82，39.76]。
我们的结果表明，孕早期维生素 D 缺乏可能显著增加 GDM 的发病风险。
