CAJ | 학술논문

目的了解孕妇妊娠末期及新生儿（脐带血）维生素D水平，探讨妊娠期补充维生素D的必要性。方法在2009年12月至2010年2月间对辽宁省凌源市中心医院住院分娩的94例孕妇，于分娩开始前取孕妇静脉血2mL，胎盘娩出后取脐带血2mL，测定25-羟维生素D，并加以分析。结果孕妇血与脐带血25-羟维生素D[25（OH）D]水平呈显著正相关（r＝0．607， P＝0．001），孕妇血25（OH）D均值（20．3±6．1nmol/L）低于脐带血均值（22．3±5．9nmol/L），经比较差异存在统计学意义（t＝3．976，P＝0．001）。孕妇与新生儿维生素D均处于缺乏状态，受检对象中无25（ OH） D达到50nmol/L者，其中，小于25nmol/L的中、重度维生素D缺乏孕妇和新生儿分别占85．1％和72．8％。孕妇在妊娠中晚期补充钙剂72例，没有补者22例，补充与未补充钙剂孕妇血25（OH）分别为21．4±6．1nmol/L和16．6±4．5nmol/L（Z＝3．505，P＜0．001）；脐带血25（OH）D分别为23．3±6．0nmol/L和19．0±3．8nmol/L（Z＝2．935，P＝0．003）。结论孕妇妊娠末期及新生儿冬季维生素D缺乏严重，应对孕妇实施干预，以提高孕妇、胎儿及新生儿维生素D水平。
목적료해잉부임신말기급신생인（제대혈）유생소D수평，탐토임신기보충유생소D적필요성。방법재2009년12월지2010년2월간대요녕성릉원시중심의원주원분면적94례잉부，우분면개시전취잉부정맥혈2mL，태반면출후취제대혈2mL，측정25-간유생소D，병가이분석。결과잉부혈여제대혈25-간유생소D[25（OH）D]수평정현저정상관（r＝0．607， P＝0．001），잉부혈25（OH）D균치（20．3±6．1nmol/L）저우제대혈균치（22．3±5．9nmol/L），경비교차이존재통계학의의（t＝3．976，P＝0．001）。잉부여신생인유생소D균처우결핍상태，수검대상중무25（ OH） D체도50nmol/L자，기중，소우25nmol/L적중、중도유생소D결핍잉부화신생인분별점85．1％화72．8％。잉부재임신중만기보충개제72례，몰유보자22례，보충여미보충개제잉부혈25（OH）분별위21．4±6．1nmol/L화16．6±4．5nmol/L（Z＝3．505，P＜0．001）；제대혈25（OH）D분별위23．3±6．0nmol/L화19．0±3．8nmol/L（Z＝2．935，P＝0．003）。결론잉부임신말기급신생인동계유생소D결핍엄중，응대잉부실시간예，이제고잉부、태인급신생인유생소D수평。
Objective To understand the vitamin D level in late pregnancy and newborns ( umbilical cord blood ) and to explore the necessity of vitamin D supplement during pregnancy .Methods From December 2009 to February 2010, 94 pregnant women delivered in Liaoning Lingyuan Central Hospital were recruited .Blood samples (2mL) were obtained both from each of the pregnant women before delivery and from umbilical cord blood immediately after delivery respectively , and then serum 25-hydroxyvitamin D[25(OH)D] levels were tested and analyzed.Results A significant positive correlation was observed in D [25(OH)D] level between maternal blood and umbilical cord blood(r=0.607, P=0.001).The average level of 25(OH)D in maternal serum(20.3 ±6.1nmol/L) was lower than that in umbilical cord blood(22.3 ±5.9nmol/L), and the difference was significant(t=3.976,P=0.001).Both mothers and newborns were in the state of vitamin D deficiency .Neither the level of 25( OH) D in maternal blood nor in umbilical cord serum reached 50nmol/L.The proportion of pregnant women and newborns with mild or severe vitamin D deficiency ( lower than 25nmol/L) was 85.1% and 72.8%, respectively .There were 72 pregnant women taking calcium supplement at middle and late pregnancy , while 22 cases without taking .The level of 25(OH) D in pregnant women with and without calcium supplement was 21.4 ±6.1nmol/L and 16.6 ±4.5nmol/L, respectively (Z=3.505,P<0.001), and that in umbilical cord blood was 23.3 ±6.0nmol/L and 19.0 ±3.8nmol/L, respectively(Z=2.935, P=0.003).Conclusion Vitamin D deficiency is severe at late gestation of pregnancy , and the situation of vitamin D deficiency of newborns is severe in winter .Intervention during pregnancy should be taken to improve the level of vitamin D in pregnant women , fetus and newborns .