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中国孕妇维生素 D 水平对妊娠时间和新生儿体重的预测价值:一项基于人群的回顾性研究。

Predictive value of Vitamin D levels in pregnant women on gestational length and neonatal weight in China: a population-based retrospective study.

机构信息

Department of Gynecology and Obstetrics, The Second Hospital of Jilin University, Changchun, China.

出版信息

Reprod Biol Endocrinol. 2024 Aug 13;22(1):102. doi: 10.1186/s12958-024-01276-w.

Abstract

BACKGROUND

Vitamin D deficiency, a common occurrence among pregnant women, is an emerging public health concern worldwide. According to research, prenatal vitamin D deficiency is associated with various complications. This study assessed the vitamin D status of pregnant women in Yanbian, Jilin Province, as well as the correlation and predictive value of their vitamin D levels in relation to gestational length (weeks) and fetal weight, aiming to provide a basis for clinical diagnosis and treatment.

METHODS

We conducted a population-based retrospective study involving 510 pregnant women from August 2019 to October 2022. Blood samples were collected at 16-20 weeks of gestation for the detection of serum vitamin D levels. Statistical analyses were performed using SPSS 28.0 and R 4.1.0 software. Multifactorial logistic regression analysis was employed to establish whether each variable was a risk factor for deliveries at ≤ 38 gestational weeks and low fetal weight. These results were used to construct a risk prediction model, and the model's predictive efficacy was evaluated. Results or differences with p < 0.05 were considered statistically significant.

RESULTS

Multifactorial logistic regression analysis revealed that vitamin D ≤ 14.7 ng/mL(OR: 1.611; 95% CI: 1.120-2.318; P = 0.010), Bone Mineral Density (BMD) T-value ≤-1(OR: 1.540; 95%CI: 1.067-2.223; P = 0.021), and gestational hypertension(OR: 7.173; 95% CI: 1.482-34.724; P = 0.014) were the independent risk factors for deliveries at ≤ 38 gestational weeks. Additionally, vitamin D ≤ 14.7 ng/mL(OR: 1.610; 95%CI: 1.123-2.307; P = 0.009), BMD T-value ≤ -1(OR: 1.560; 95%CI: 1.085-2.243; P = 0.016), and gestational hypertension(OR: 4.262; 95% CI: 1.058-17.167; P = 0.041) were the independent risk factors for low fetal weight (< 3400 g).

CONCLUSION

This study revealed that low vitamin D levels are an independent risk factor for a short gestational length and low fetal weight. Prenatal low BMD T-value and comorbid hypertensive disorders were also found to increase the risk of a short gestational length and low fetal weight.

摘要

背景

孕妇维生素 D 缺乏是一种常见现象,也是全球范围内新兴的公共卫生问题。研究表明,产前维生素 D 缺乏与多种并发症有关。本研究评估了吉林省延边地区孕妇的维生素 D 状况,以及其维生素 D 水平与妊娠周数和胎儿体重的相关性和预测价值,旨在为临床诊断和治疗提供依据。

方法

我们进行了一项基于人群的回顾性研究,纳入了 2019 年 8 月至 2022 年 10 月的 510 名孕妇。在妊娠 16-20 周时采集血样,检测血清维生素 D 水平。使用 SPSS 28.0 和 R 4.1.0 软件进行统计分析。采用多因素 logistic 回归分析确定每个变量是否为妊娠 38 周前分娩和低胎儿体重的危险因素。基于这些结果构建风险预测模型,并评估模型的预测效果。p 值<0.05 被认为具有统计学意义。

结果

多因素 logistic 回归分析显示,维生素 D≤14.7ng/ml(OR:1.611;95%CI:1.120-2.318;P=0.010)、骨密度 T 值≤-1(OR:1.540;95%CI:1.067-2.223;P=0.021)和妊娠期高血压(OR:7.173;95%CI:1.482-34.724;P=0.014)是妊娠 38 周前分娩的独立危险因素。此外,维生素 D≤14.7ng/ml(OR:1.610;95%CI:1.123-2.307;P=0.009)、骨密度 T 值≤-1(OR:1.560;95%CI:1.085-2.243;P=0.016)和妊娠期高血压(OR:4.262;95%CI:1.058-17.167;P=0.041)是低胎儿体重(<3400g)的独立危险因素。

结论

本研究表明,低维生素 D 水平是妊娠周数短和胎儿体重低的独立危险因素。产前低骨密度 T 值和合并高血压疾病也会增加妊娠周数短和胎儿体重低的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5844/11320780/e6e1dc7cf3f4/12958_2024_1276_Fig1_HTML.jpg

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