Kokkinari Artemisia, Antoniou Evangelia, Orovou Eirini, Dagla Maria, Tzitiridou-Chatzopoulou Maria, Sarantaki Antigoni, Gourounti Kleanthi, Iatrakis Georgios
Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece.
Department of Midwifery, School of Health & Care Sciences, University of Western Macedonia, 54636 Kozani, Greece.
Clin Pract. 2025 May 26;15(6):102. doi: 10.3390/clinpract15060102.
Vitamin D deficiency (VDD) during pregnancy has been associated with various obstetric complications, including preeclampsia, gestational diabetes, and premature rupture of membranes. However, its potential link to placental abruption remains underexplored. The aim of this study was to investigate whether low maternal vitamin D levels are associated with an increased risk of placental abruption in pregnancies considered otherwise low-risk.
We conducted a cross-sectional study involving 248 pregnant women who were admitted for delivery at a public hospital in Athens, Greece. Serum levels of 25-hydroxyvitamin D [25(OH)D] were measured upon admission. Levels below 30 ng/mL were classified as insufficient. Although this threshold corresponds to insufficiency according to the Endocrine Society, for the purposes of this study, levels < 30 ng/mL were treated as indicative of vitamin D deficiency in order to capture broader physiological implications. Cases of placental abruption were identified based on obstetric history and clinical documentation at the time of delivery. A Chi-square test was used to assess the association between vitamin D status and placental abruption, and a multivariate logistic regression model was applied to control for potential confounders, including hypertensive disorders of pregnancy, smoking, and preterm birth. The potential role of vitamin D supplementation during pregnancy was also explored as part of the analysis.
Our analysis revealed that women with VDD had a significantly higher incidence of placental abruption ( < 0.05). In the multivariate model, VDD remained an independent risk factor (adjusted OR: 3.2, 95% CI: 1.1-9.6). Additional risk factors that showed significant associations with placental abruption included pregnancy-induced hypertension and maternal smoking.
These findings support the hypothesis that insufficient maternal vitamin D levels may contribute to adverse pregnancy outcomes, including placental abruption. Further prospective studies are warranted to clarify the causal mechanisms and to evaluate whether early detection and correction of vitamin D deficiency could serve as a preventive strategy in prenatal care.
孕期维生素D缺乏(VDD)与多种产科并发症有关,包括先兆子痫、妊娠期糖尿病和胎膜早破。然而,其与胎盘早剥的潜在联系仍未得到充分研究。本研究的目的是调查在其他方面被认为是低风险的妊娠中,母亲维生素D水平低是否与胎盘早剥风险增加有关。
我们进行了一项横断面研究,涉及248名在希腊雅典一家公立医院入院分娩的孕妇。入院时测定血清25-羟基维生素D[25(OH)D]水平。低于30 ng/mL的水平被归类为不足。尽管根据内分泌学会的标准,这个阈值对应于不足,但在本研究中,为了捕捉更广泛的生理影响,<30 ng/mL的水平被视为维生素D缺乏的指标。根据分娩时的产科病史和临床记录确定胎盘早剥病例。使用卡方检验评估维生素D状态与胎盘早剥之间的关联,并应用多变量逻辑回归模型控制潜在的混杂因素,包括妊娠高血压疾病、吸烟和早产。作为分析的一部分,还探讨了孕期补充维生素D的潜在作用。
我们的分析显示,VDD女性发生胎盘早剥的发生率显著更高(<0.05)。在多变量模型中,VDD仍然是一个独立的危险因素(调整后的OR:3.2,95%CI:1.1-9.6)。与胎盘早剥有显著关联的其他危险因素包括妊娠高血压和母亲吸烟。
这些发现支持以下假设,即母亲维生素D水平不足可能导致不良妊娠结局,包括胎盘早剥。有必要进行进一步的前瞻性研究,以阐明因果机制,并评估早期发现和纠正维生素D缺乏是否可作为产前护理中的预防策略。