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摘要:
目的 了解上海市嘉定区妇女孕前、孕中期和孕晚期体内维生素D(Vitamin D, VD)水平的现状, 探讨孕中期和孕晚期VD水平的影响因素。 方法 选取2016年9月至2018年12月在上海市嘉定区妇幼保健院参加孕前检查并随访到分娩的94名妇女为研究对象, 采用化学发光法检测孕前、中期和晚期血清中的VD水平, 共检测282份血清。 结果 94名妇女的孕前、孕中期和晚期的VD缺乏率分别为:40.4%、57.4%和48.9%。混合线性模型结果显示, 近1年内有过染发/烫发的妇女孕期血清VD水平较低(P < 0.05), 孕期经常喝牛奶和吃深海鱼的妇女在孕期VD水平较高(P < 0.05)。 结论 上海嘉定区妇女孕前和孕期VD缺乏普遍, 应该重视在孕前和孕期VD的补充。 Abstract:Objective To investigate the levels of serum Vitamin D(VD) from preconception to pregnancy in Jiading district of Shanghai, and explore the risk factors of VD concentration deficiency in the second and third trimester of pregnancy. Methods A total of 94 women who planned to have antenatal care and delivery in Maternal and Child Health Hospital of Jiading district of Shanghai from September 2016 to December 2018 were recruited as the study participants. Chemiluminescent immunoassay(CLIA) was used to examine the concentration of women's serum VD from preconception to pregnancy. A total of 282 serum samples were detected. Results The prevalence of VD deficiency among 94 women from preconception to pregnancy were 40.4%, 57.4% and 48.9% respectively. Results of the mixed linear model showed that women who had dyed or permed hair within the past 1 year had significantly lower serum VD levels during pregnancy(P < 0.05), and women who often drank milk and ate deep-sea fish during pregnancy had higher VD levels during pregnancy(P < 0.05). Conclusions VD deficiency was common among women in Jiading district of Shanghai, and it should be emphasized to supplement VD before and during pregnancy. -
Key words:
- Preconception /
- Pregnant women /
- Vitamin D /
- Vitamin D deficiency
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表 1 94名妇女的基本情况
Table 1. Characteristics of women (n=94)
变量 n(%) 变量 n(%) 孕前年龄(岁) 孕期维生素补充 < 28 44(46.8) 是 72(76.6) ≥28 50(53.2) 否 22(23.4) 孕前BMI(kg/m2) 钙/铁/锌剂补充 偏瘦 < 18.5 16(17.0) 是 76(80.9) 正常18.5~ 68(72.3) 否 18(19.1) 超重≥24.0 10(10.6) 孕期叶酸补充 户籍所在地 是 72(76.6) 上海 55(58.9) 否 22(33.4) 非上海 39(41.1) 孕期新鲜蔬菜摄入(次/每周) 文化程度 ≥4 92(97.9) 大学以下 28(29.8) < 4 2(2.1) 大学及以上 66(70.2) 孕期牛奶摄入(次/每周) 家庭人均年收入(万元) ≥4 54(57.4) < 10 37(39.4) < 4 40(42.6) ≥10 57(60.6) 孕期畜肉摄入(次/每周) 孕前饮酒 ≥4 58(61.7) 是 14(14.9) < 4 36(38.3) 否 80(85.1) 孕期深海鱼摄入(次/每周) 孕前被动吸烟 ≥4 14(14.9) 是 30(31.9) < 4 80(85.1) 否 64(68.1) 孕期虾蟹贝类摄入(次/每周) 近1年内烫/染发 ≥4 77(81.9) 是 34(36.2) < 4 17(18.1) 否 60(63.8) 孕期蛋类摄入(次/每周) 孕期鱼肝油补充 ≥4 70(74.5) 是 52(55.3) < 4 24(25.5) 否 42(44.7) 表 2 妇女孕前、孕中期和孕晚期维生素D水平的分布[n(%)]
Table 2. Concentrations of VD in women's serum from preconception to third trimester [n(%)]
时期 总体M(P25, P75) VD水平分组 充足 不足 缺乏 孕前 20.97(17.55, 24.58) 8(8.5) 48(51.1) 38(40.4) 孕中期 18.68(15.99, 23.27) 6(6.4) 34(36.2) 54(57.4) 孕晚期 20.37(14.85, 26.16) 11(11.7) 37(39.4) 46(48.9) F/χ2值 5.998a 4.907b P值 0.050 0.086 注:ab采用Kruskal-Wallis H检验。 表 3 妇女孕中期和孕晚期VD水平影响因素的混合线性模型分析
Table 3. The analysis on influencing factors of Vitamin D concentration during the second and third trimester by mixed linear model
分组 β值 95%CI值 Sx t值 P值 孕期 中期 Ref. 晚期 1.22 -0.25~2.69 0.74 1.65 0.103 孕前VD浓度 0.07 -0.05~0.20 0.06 1.15 0.255 孕前年龄(岁) < 28 Ref. ≥28 0.67 -1.48~2.82 1.08 0.62 0.536 孕前BMI < 18.5 0.75 -1.97~3.47 1.37 0.55 0.586 18.5~ Ref. ≥24.0 -1.91 -5.17~1.34 1.64 -1.17 0.246 文化程度 大学以下 Ref. 大学及以上 -0.80 -3.19~1.59 1.20 -0.67 0.505 家庭人均年收入(万元) < 10 Ref. ≥10 1.79 -0.52~4.10 1.16 1.54 0.127 近1年内烫发/染发 是 -2.68 -4.89~-0.48 1.11 -2.43 0.018a 否 Ref. 孕期鱼肝油补充 是 1.57 -0.64~3.78 1.11 1.41 0.162 否 Ref. 孕期维生素补充 是 -0.48 -3.61~2.66 1.57 -0.30 0.764 否 Ref. 钙/铁/锌剂补充 是 0.97 -1.91~3.84 1.44 0.67 0.505 否 Ref. 孕期叶酸补充 是 2.03 -1.09~5.15 1.57 1.30 0.199 否 Ref. 孕期新鲜蔬菜摄入
(次/每周)≥4 5.20 -1.83~12.24 3.53 1.47 0.145 < 4 Ref. 孕期牛奶摄入(次/每周) ≥4 2.59 0.47~4.71 1.07 2.43 0.017a < 4 Ref. 孕期畜肉摄入(次/每周) ≥4 -1.19 -3.55~1.17 1.19 -1.01 0.317 < 4 Ref. 孕期深海鱼摄入(次/每周) ≥4 6.62 0.26~12.99 3.20 2.07 0.042a < 4 Ref. 孕期虾蟹贝类摄入(次/每周) ≥4 -4.89 -10.85~1.06 2.99 -1.64 0.106 < 4 Ref. 孕期蛋类摄入(次/每周) ≥4 1.85 -0.53~4.24 1.20 1.55 0.126 < 4 Ref. 注:a表示P<0.05。 -
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