2022 年第 12 期 第 17 卷

妊娠中期血清维生素水平与子痫前期及不良妊娠结局的关系

Relationship of serum vitamin levels in the second trimester of pregnancy with preeclampsia and adverse pregnancy outcomes

作者：郑福利 杨静 张娜 陈蓓 张小菜 连李斌

英文作者：Zheng Fuli Yang Jing Zhang Na Chen Bei Zhang Xiaocai Lian Libin

单位：陕西中医药大学第二附属医院产科，咸阳712000

英文单位：Department of Obstetrics the Second Affiliated Hospital of Shaanxi University of Chinese Medicine Xianyang 712000 China

关键词：子痫前期；妊娠中期；维生素；妊娠结局

英文关键词：Preeclampsia;Thesecondtrimesterofpregnancy;Vitamin;Pregnancyoutcome

• 摘要：

• 目的  探讨妊娠中期血清维生素水平与子痫前期及不良妊娠结局的关系。方法  收集2017年2月至2021年7月16 328例于陕西中医药大学第二附属医院进行定期产检并住院分娩孕妇的病历资料进行回顾性分析。根据妊娠期间是否发生子痫前期将孕妇分为子痫前期组（461例）和对照组（15 867例）。记录孕妇一般资料，比较2组妊娠中期血清维生素A、维生素E、维生素D及血脂指标水平，记录妊娠结局。采用单因素和多因素Logistic回归模型分析子痫前期的危险因素。采用Spearman相关性模型分析妊娠中期血清维生素水平与不良妊娠结局的相关性。结果  子痫前期组血清维生素A、维生素E、维生素D不足比例以及三酰甘油、低密度脂蛋白胆固醇、载脂蛋白B水平均高于对照组，高密度脂蛋白胆固醇水平低于对照组，差异均有统计学意义（均P<0.001）。孕前体重指数异常以及妊娠中期血清维生素A、维生素E、维生素D不足是发生子痫前期的独立危险因素（均P<0.05）。461例子痫前期孕妇中，共155例（33.6%）出现不良妊娠结局。妊娠中期血清维生素A（r=-0.256，P=0.001）、维生素E（r=-0.231，P=0.005）、维生素D（r=-0.218，P=0.010）水平均与子痫前期孕妇的不良妊娠结局相关，维生素A、维生素E、维生素D水平越低，出现不良妊娠结局的风险越高。结论  妊娠中期维生素A、维生素E、维生素D不足是子痫前期的独立危险因素，且与不良妊娠结局明显相关。

• Objective  To investigate the relationship of serum vitamin levels in the second trimester of pregnancy with preeclampsia (PE) and adverse pregnancy outcomes. Methods  From February 2017 to July 2021, totally 16 328 pregnant women′s clinical data were collected for retrospective analysis. The women underwent regular check-ups and gave birth in the Second Affiliated Hospital of Shaanxi University of Chinese Medicine. According to whether pregnant women had PE, they were divided into the PE group (461 cases) and the control group (15 867 cases). The general data of pregnant women were recorded, the levels of serum vitamin A, vitamin E, vitamin D and lipid indexes in the second trimester of pregnancy were compared between the two groups, and pregnancy outcomes were recorded. Univariate and multivariate Logistic regression models were used to analyze the risk factors affecting the PE. Spearman correlation analysis was used to analyze the correlation between levels of serum vitamin in the second trimester of pregnancy and adverse pregnancy outcomes. Results  The proportions of vitamin A, vitamin E, vitamin D deficiency and levels of triacylglycerol, low-density lipoprotein cholesterol, apolipoprotein B in the PE group were higher than those in the control group, while the level of high-density lipoprotein cholesterol was lower than that in the control group (all P<0.001). The abnormal pre-pregnancy body mass index and serum vitamin A, vitamin E, vitamin D deficiency in the second trimester of pregnancy were independent risk factors affecting the PE (all P<0.05). Among 461 pregnant women with PE, 155(33.6%) of them had adverse pregnancy outcomes. The levels of serum vitamin A (r=-0.256, P=0.001), vitamin E (r=-0.231, P=0.005), and Vitamin D (r=-0.218, P=0.010) in the second trimester of pregnancy were correlated with adverse pregnancy outcomes of pregnant women with PE, the lower levels of vitamin A, vitamin E and vitamin D, the higher risk of adverse pregnancy outcomes. Conclusions  Vitamin A, vitamin E and vitamin D deficiency in the second trimester of pregnancy are independent risk factors for the onset of PE, and those are significantly correlated with adverse pregnancy outcomes.