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解锁维生素 D 在产前女性缺铁性贫血中作用的奥秘:新德里一家三级保健医院的病例对照研究。

Unlocking the mystery of the role of Vitamin D in iron deficiency anemia in antenatal women: a case control study in a tertiary care hospital in New Delhi.

机构信息

Dr. Baba Saheb Ambedkar Medical College and Hospital, Delhi, 110085, India.

Department of Obstetrics and Gynaecology, Dr. Baba Saheb Ambedkar Medical College and Hospital, Delhi, 110085, India.

出版信息

BMC Pregnancy Childbirth. 2023 Oct 24;23(1):749. doi: 10.1186/s12884-023-06047-w.

Abstract

BACKGROUND

Vitamin D deficiency and anemia are clinical conditions that coexist during pregnancy. A high prevalence of Vitamin D deficiency ranging from 50 to 94% is seen throughout the country. The aim of the study was to discover the association between Vitamin D status and iron deficiency anemia during pregnancy. Improving the vitamin D status of pregnant women is crucial to prevent iron deficiency anemia and can improve maternal and fetal outcomes.

METHODS

A case-control study including 94 primigravida women of age within the age group 18 to 30 years, divided into two groups: a Case Group of 48 patients with already diagnosed iron deficiency anemia (mild to moderate) and a Control Group of 46 antenatal women with normal hemoglobin levels. Data on sociodemographic, clinical characteristics, and the levels of 25(OH) Vitamin D was estimated in both the groups. The association of 25(OH)D levels and anemia was then determined using suitable statistical analysis.

RESULTS

Among pregnant women affected with anemia, 75% of women had serum Vitamin D concentrations < 20 ng/ml compared to 52.2% of women in the controls. Maternal serum vitamin D level was significantly lower in pregnant women affected with anemia (19.61 ± 13.12) as compared to control (29.43 ± 24.05); (p = 0.024). A positive correlation was found between hemoglobin and vitamin D levels in pregnant women (Pearson's r = 0.200, p = 0.05).

CONCLUSIONS

These findings provide evidence suggesting that Vitamin D deficiency or insufficiency during pregnancy may be a risk factor for anemia and correction of Vitamin D levels can improve hemoglobin levels. Educational efforts should be made to include safe vitamin D intake in antenatal care.

摘要

背景

维生素 D 缺乏和贫血是妊娠期间同时存在的临床情况。全国范围内,维生素 D 缺乏的患病率高达 50%至 94%。本研究旨在探讨妊娠期间维生素 D 状态与缺铁性贫血之间的关系。改善孕妇的维生素 D 状态对于预防缺铁性贫血至关重要,并可以改善母婴结局。

方法

这是一项包括 94 名年龄在 18 至 30 岁之间的初产妇的病例对照研究,将其分为两组:一组为 48 例已确诊的缺铁性贫血(轻度至中度)患者的病例组,另一组为 46 例血红蛋白水平正常的产前妇女的对照组。对两组的社会人口统计学、临床特征和 25(OH)维生素 D 水平进行了评估。然后使用适当的统计分析来确定 25(OH)D 水平与贫血之间的关联。

结果

在患有贫血的孕妇中,75%的孕妇血清维生素 D 浓度<20ng/ml,而对照组中这一比例为 52.2%。与对照组(29.43±24.05)相比,患有贫血的孕妇的血清维生素 D 水平明显更低(19.61±13.12)(p=0.024)。在孕妇中,血红蛋白与维生素 D 水平之间存在正相关关系(Pearson r=0.200,p=0.05)。

结论

这些发现表明,妊娠期间维生素 D 缺乏或不足可能是贫血的一个危险因素,纠正维生素 D 水平可以提高血红蛋白水平。应该努力在产前保健中纳入安全的维生素 D 摄入。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1a9/10594760/681ba4c7c03e/12884_2023_6047_Fig1_HTML.jpg

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