| BackgroundVitD is a fat-soluble vitamin, it not only affects the metabolism of calcium and phosphorus, but also with a wide range of physiological effects, that is to maintain human health, essential for cell growth and differentiation of substance. It is considered a new neuroendocrine-immunoregulatory hormones can affect the immune, nervous, reproductive, endocrine, epithelium and hair growth, etc. With a variety of diseases such as cardiovascular disease, diabetes, autoimmune diseases, neurological diseases, and kidney cancer and other medical diseases are closely related. In addition, serum vitamin D is also involved in gestational diabetes, premature birth, pregnancy induced hypertension, premature rupture of membranes and other pregnancy complications and development. Pregnant women vitamin D deficiency, the possibility of cesarean section delivery, cesarean section and maternal serum 25-(OH)-D levels negative correlation, the multivariate logistic regression analysis found that the levels of serum 25-(OH)-D< 37.5 nmol/L maternal, cesarean section rate four times than the levels of serum 25-(OH)-D≥37.5 nmol/L. Study of 500 cases of pregnant women’s serum in pregnant 16～18 weeks to follow-up pregnant period, found that gestational diabetes (gestational diabetes mellitus, GDM)group of 25-(OH)-D concentration significantly lower than the group of abnormal glucose tolerance (impaired glucose how IGT) group and the control group, It is said that the 16-18 weeks pregnant women serum 25-(OH)-D levels can early to predict the occurrence of GDM.If the 25-(OH)-D concentration is less than 37.5 nmol/L, can increase the risk of gestational hypertension disease five times in the early pregnancy. Following 2960 pregnant women, the study found high vitamin D levels of pregnant women in gestational hypertension disease rate has been falling by half. Otherwise, according to a study by observation of the 469 early pregnancy women, vitamin D deficiency increase Bacterial virginities(Bacterial virginities, BV) the risk of infection, serum 25-(OH)-D concentrations of 20 nmol/L group risk of infection is 75 nmol/L group was 1.65 times; BV infection with serum 25-(OH)-D levels rise. In recent years, people also found that pregnant women vitamin D levels have important effects on the fetal growth and development, inadequate vitamin D deficiency during pregnancy or associated with fetal or neonatal many unusual.1,25-(OH)2-D activity is the strongest, but the content is very few, short half-life and change quickly, not stable response of human body of vitamin D. And 25-(OH)-D in human form stable, easy to detect, can accurately reflect the body vitamin D levels. Most scholars believe that vitamin D deficiency in adults for 25-(OH)-D is less than 50nmol/L,50nmol/L-75nmol/L is insufficient, and adequate vitamin D for 25-(OH)-D is greater than 25-(OH)-D>75nmol/L. Vitamin deficiency is only 25-(OH)-D concentration, without clinical manifestations and when 25-(OH)-D less than 50 nmol/L body calcium phosphorus metabolism, immune regulation, sugar and fat metabolism significantly affected.Because the lack of vitamin D have seriously affected the maternal and child health, so the proper way of reasonable prevention is the first choice. Improve people’s knowledge about vitamin D, reasonable diet, healthy habits, regular outdoor activity and exercise, rid of bad habits is the basis for the prevention of vitamin D deficiency. Because few contain the food with vitamin D type, and the amount of vitamin D in food is less, and sunlight and geographical location, season, weather, pollution and so on, so prenatal vitamin D in pregnant women, pregnant women lack of vitamin D or adequate vitamin D supplements should be the need to take active measures. But how to supplement vitamin D, including the supplement of dosage, the time, there is no research at present.ObjectiveThis topic through maternal vitamin D levels and other indicators of the survey analysis, to understand maternal vitamin D levels and pregnancy complications related factors, specifically maternal vitamin D levels correlated, and explore maternal vitamin D levels with its own relationship, provide the basis for maternal and child public health prevention of vitamin D deficiency in the formulation.MethodsSelect 226 cases in our hospital for check and pregnant women, according to the labor when pregnant women 25-(OH)-D<50nmol/L and 25-(OH)-D≥50nmol/L divided into two groups to collect general information, analyzes factors that influence pregnancy 25-(OH)-D levels, and to observe the incidence of premature rupture of the two groups of pregnant women, preterm labor, gestational diabetes, pregnancy-induced hypertension and other pregnancy complications.Results1. The general situationThe average age is 26.81 ±2.79 years old (22±35 years old),52 (26%)≤25 years old,125 (62.50%) is 26～30 yesrs old,23 (11.50%) is≥30 years old. Pre-pregnancy BMI:≥ 18.5 for 17 (8.50%),18.5～23.9 for 154 (77%),≤24 for 29 (14.50%),. Average daily sunshine time during pregnancy:≥1h/d,0.5～1h,<0.5h of pregnant women respectively,80(40%),49(24.50%),71(35.50%); Smoking during pregnancy (or smoking exposure) is 17(8.50%),6 people drink alcohol during pregnancy (3%). 133 pregnant women during pregnancy (66.50%) with oral vitamin D supplement preparation (multivitamin preparations such as philharmonic D, Dr Turner or mixture such as calcium, vitamin D, calcium), including daily supplement of 83 (41.50%), occasionally added 50 (25%); Began to complement vitamin D time:early pregnancy (4-13 weeks gestation) is 37(18.50%), mid pregnancy (14 to 28 weeks gestation) is 67 (33.50%), late pregnancy (after the 28th week of gestation) 29(14.50%); Vitamin D supplement dose:less than 400 IU/d is 26 (13%),400～600 IU/d is 54 (27%), greater than or equal to 600 IU/d is 53 patients (26.50%).2. The different vitamin D levels in pregnant women200 cases of pregnant women giving birth serum 25-(OH)-D concentrations of median 40.7 nmol/L (17.8～80.2),15 cases (7.50%) of pregnant women 25-(OH) D concentrations greater than or equal to 75 nmol/L (enough),49 cases (24.50%) of pregnant women 25-(OH)-D concentration in 50 nmol/L～75 nmol/L (less than), and another 136 cases (68%) of pregnant women 25-(OH)-D is less than 50 nmol/L (lack of)3. Pregnancy complications46 cases of premature delivery (23%). Premature rupture of membranes and 32 cases (16%); Pregnancy-induced hypertension disease 15 cases (7.50%), gestational diabetes 43 cases (21.50%). Late pregnancy 25-(OH)-D concentrations<50 nmol/L group of premature rupture of membranes, gestational hypertension, gestational diabetes, the incidence of preterm birth is higher than the 25-(OH)-D≥50 nmol/L group of pregnant women, in addition to the premature birth, comparison, are statistically significant (p< 0.05)4. Influencing factors of vitamin D levels in pregnant womenResults showed that the age and BMI before childbirth is no difference, while the average daily sunshine time during pregnancy and the oral vitamin D supplement situation and the season is differences, Logistic regression analysis found that the season, day light time during pregnancy, oral vitamin D supplement, oral vitamin D supplement timing is the influence factors of 25-(OH)-D concentration in the blood of the pregnancy.The late pregnancy serum 25-(OH)-D≥50nmol/L group of the average daily sunshine time≥lh, daily oral vitamin supplements, vitamin D≥600IU/d and early pregnancy the pregnant women vitamin D supplements is higher percentage than the 25-(OH)-D< 50 nmol/L group,59.38%,56.25%,46.88% and 56.25% respectively (P< 0.05).All the research object in the summer when 25-(OH)-D concentration is high than in winter,64 cases of 25-(OH)-D>50 nmol/L in pregnant women, the summer has the highest percentage of childbirth pregnant women, a total of 28 (43.75%), autumn 20 people (31.25%),9 people (14.06%) in spring, winter 7 (10.94%) was statistically significant, (P< 0.05). The early stages of pregnancy can significantly increase the body 25-(OH)-D concentration, (p<0.05). Pregnancy in the sunshine time≥1h/d on average, compared with less than half an hour can make vitamin D levels≥50nnmol rise to 4.5 times more likely.Different vitamin D deficiency during pregnancy (25-(OH)-D<50nmol/L) number of pregnant women (8～12 weeks) respectively, the early stages of pregnancy,142 (71.00%), mid pregnancy (18～24weeks) and 129 (64.50%), late pregnancy (labor) and 136 (68%), the incidence of vitamin D deficiency during different pregnancy had not difference (p> 0.05).Conclusion1.The sunshine time during pregnancy can affect pregnant women serum vitamin D levels’day light time is greater than or equal to 1 h/d is more beneficial to the improvement of the serum vitamin D concentrations.2.Oral vitamin D supplements during pregnancy mixture can raise levels of vitamin D, vitamin D supplement≥ 600IU/d is safe and effective dose.3.Early pregnancy began oral vitamin D supplement agent at middle and late pregnancy to complement effect is better.3.Vitamin D deficiency can significantly increase the pregnant women with premature rupture of membranes, gestational hypertension and gestational diabetes, the risk of pregnancy complications. |
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