孕妇维生素 D 水平的影响因素分析

ABSTRACT

Objective：To analyze the influencing factors of vitamin D in pregnant women in three stages of pre⁃outbreak，post⁃outbreak and normalization of COVID ⁃19 pandemic. Methods：The pregnant women who received prenatal examination in the First Hospital of Shanxi Medical University from May 2018 to May 2021 were selected as the research objects to detect vitamin D level，and analyze the effects of different pregnancy methods，delivery methods，age，gestational age，parity，number of parities and season on vitamin D level. Results：Totally 1 679 pregnant women were involved，the level of serum 25（OH）D in pregnant women was 18. 70（ 12. 60，27. 20）ng/mL. The rate of vitamin D deficiency was 24. 41%，51. 01% and 34. 23% of three stages of pre⁃outbreak，post⁃outbreak and normalization of COVID ⁃ 19 pandemic，the difference was statistically significant（P<0. 001）. Orderly multiple Logistic regression analysis showed that early pregnancy［ OR=0. 359，95%CI（0. 257，0. 502）］，maternal age <35 years old［ OR=0. 766，95%CI（0. 598，0. 980）］，winter ［OR=0. 388，95%CI（0. 290，0. 520）］，spring［OR=0. 350，95%CI（0. 258，0. 475）］ and summer ［OR=1. 533，95%CI（1. 166， 2. 014）］ had an effect on vitamin D deficiency in pregnant women. Conclusion：The rate of vitamin D deficiency in pregnant women is high. Pregnancy，season and age are independent influencing factors of vitamin D deficiency in pregnant women. After the normaliza⁃ tion of COVID⁃19 pandemic，pregnant women should supplement vitamins scientifically and individually，strengthen the education of nutrition during pregnancy，and regularly monitor the level of vitamin D. 目的分析新型冠状病毒肺炎疫情前、疫情暴发到疫情常态化3 个阶段孕妇维生素D 水平及其影响因素。方法选取2 0 1 8 年 5 月--2021 年5 月在山西医科大学第一医院产检的孕妇作为研究对象，检测维生素D 水平，分析不同怀孕方式、分娩方式、年龄、孕 周、胎次、胎数、季节等对维生素D 水平的影响。结果共纳入1 679 例孕妇，血清25（OH）D 水平为18. 70（12. 60，27. 20）ng/mL。疫 情前维生素D 缺乏率为24. 41%，疫情暴发期间维生素D 缺乏率为51. 01%，疫情常态化后维生素D 缺乏率为34. 23%，差异有统计 学意义（P<0. 001）;有序多分类Logistic 回归分析显示，孕早期［OR=0. 359，95%CI（0. 257，0. 502）］、孕妇年龄<35 岁［OR= 0. 766，95%CI（0. 598，0. 980）］、冬季［OR=0. 388，95%CI（0. 290，0. 520）］、春季［OR=0. 350，95%CI（0. 258，0. 475）］及夏季［OR= 1. 533，95%CI（1. 166，2. 014）］对孕妇维生素D 缺乏有影响。结论孕妇维生素D 缺乏率较高，孕期、季节、年龄是孕妇维生素D 缺乏 的独立影响因素。提示孕妇应科学、个性化地补充维生素，加强孕期营养，定期监测维生素D 水平.