Prevalence of calcium and vitamin D deficiency and their association with feto-maternal outcomes in a sample of Iranian pregnant women
Prevalence of calcium and vitamin D deficiency and their association with feto-maternal outcomes in a sample of Iranian pregnant women
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DOI：
10.3233/hab-200415
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发表时间：
2020-01-01
期刊：
影响因子：
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通讯作者：
Gargari, Soraya Saleh
中科院分区：
文献类型：
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作者：
Amouzegar, Atieh;Azizi, Freidoun;Gargari, Soraya Saleh
背景：钙和维生素D缺乏在伊朗育龄妇女中很常见，并对妊娠结局造成不利影响。本研究的目的是确定伊朗孕妇样本中维生素D和钙的患病率，并评估其与母婴结局的相关性。方法：在这项前瞻性横断面研究中，从德黑兰的多家医院招募了15至45岁的晚期妊娠妇女样本。采用自行设计的调查问卷、访谈、体格检查和测定血清钙、维生素D、甲状旁腺素(PTH)、磷(PI)等临床试验方法收集资料。问卷获得了年龄、教育水平、社会经济地位、产次、孕次、孕期钙摄入量以及母胎结局等信息。结果：共纳入233例单胎妊娠。大多数受试者(58.4%)患有维生素D缺乏，12.0%的人患有严重的维生素D缺乏。维生素D缺乏与受教育年限(p=0.007)、血清甲状旁腺素水平(p<；0.001)呈负相关。代谢相当于任务(p<；0.001)、每周锻炼顺序(p<；0.001)、日晒(p<；0.001)、更高的防晒霜使用率(p=0.011)和更高的体重指数(p=0.005)。维生素D缺乏与较高的剖宫产率(p=0.024)、较高的舒张压(p=0.019)、较高的新生儿黄疸(p=0.009)和较高的新生儿呼吸道感染率(p<；0.001)相关。血清甲状旁腺素水平是严重维生素D缺乏的重要危险因素，而补钙、MET和防晒霜是重要的保护因素。结论：伊朗妇女孕期维生素D缺乏症的患病率极高，并与剖宫产、新生儿黄疸和新生儿呼吸道感染等不良妊娠结局有关。维生素D补充量低、日晒少、缺乏体力活动和高BMI是其原因。在伊朗人群中，建议在孕期补充维生素D的同时增加知识。
BACKGROUND: Calcium and vitamin D deficiency is common among Iranian women of childbearing age and poses adverse effects on pregnancy outcomes. The aim of the current study was to determine the prevalence of vitamin D and calcium in a sample of Iranian pregnant women and to assess its correlation with the feto-maternal outcomes.METHODS: In this prospective cross-sectional study, a sample of pregnant women between 15 to 45 years who were in the third trimester were recruited from a number of hospitals in Tehran. Data were collected by the means of a self-developed questionnaire, interviews, physical examination, and paraclinical tests including measuring the serum level of calcium, vitamin D, parathormone (PTH) and phosphorous (Pi). The questionnaire obtained information on age, level of education, socio-economic status, parity, gravidity, calcium intake during pregnancy, as well as feto-maternal outcomes.RESULTS: We included a total number of 233 singleton pregnancies. Most of the subjects (58.4%) had vitamin D deficiency and 12.0% suffered from severe vitamin D deficiency. Vitamin D deficiency was adversely associated with the years of education (p = 0.007), serum level of parathormone (p < 0.001). The Metabolic Equivalent of Task (MET) (p < 0.001), the exercise sequence per week (p < 0.001), sun exposure (p < 0.001), higher rate of sunscreen usage (p = 0.011) and higher BMI (p = 0.005). Vitamin D deficiency was associated with higher rate of cesarean delivery (p = 0.024), higher rate of diastolic hypertension (p = 0.019), higher rate of neonatal jaundice (p = 0.009) and higher rate of neonatal respiratory infections (p < 0.001). Serum level of PTH was a significant risk factor for severe vitamin D deficiency while calcium D supplementation, MET and sunscreen were significant protective factors.CONCLUSION: The prevalence of vitamin D deficiency during pregnancy among Iranian women is extremely high and is associated with adverse pregnancy outcomes including cesarean delivery, neonatal jaundice and neonatal respiratory infections. Low vitamin D supplementation and sun exposure, lack of physical activity and high BMI are the etiologies. Increasing the knowledge along with vitamin D supplementation during the pregnancy is recommended in Iranian population.