Correlation Between Vitamin D、Blood Lipids Levels Of The Third Trimester Pregnant And HDP、PE And Pregnancy Outcomes

Objective: To study the relationship between the levels of vitamin D,blood lipid and HDP and PE in the third trimester of pregnancy.The predictive value of HDP and PE was analyzed.To investigate the effects of vitamin D and blood lipid levels on different delivery outcomes.Methods: A total of 666 pregnant women in their third trimester who delivered in the Department of Obstetrics of the First Hospital of Jilin University from January 2018 to December 2019 were selected as the research subjects.Among them,210 patients with Hypertensive disorders of pregnancy were included in the observation group,and the patients without complications during pregnancy were included as vitamin D control group(329 cases)and blood lipid control group(127 cases),respectively.The differences of basic clinical data,vitamin D and blood lipid levels between the observation group and the control group were compared.Logistic regression analysis was used to investigate the correlation between the levels of vitamin D and blood lipid in pregnant women and the occurrence of HDP and PE.To evaluate the predictive value of HDP and PE and to obtain ideal cut-off value.The levels of vitamin D in pregnant women were divided into the deficiency group(< 20 ng/ml),the deficiency group(20-30 ng/ml)and the sufficiency group(≥30ng/ml).Meanwhile,the blood lipid was divided into two groups according to the median level,and the relationship between different pregnancy outcomes among vitamin D and blood lipid groups was compared.Results: 1、The level of vitamin D in HDP group and PE group was significantly lower than that of vitamin D control group(P < 0.01).The proportion of vitamin D deficiency in HDP group and PE group was the highest,which was significantly higher than that in control group(P < 0.01).2.Multivariate logistic regression analysis showed that the risk of HDP and PE decreased with the increase of vitamin D level(OR: 0.91,0.90;95%CI :0.89-0.93,0.88-0.92)(P < 0.01).The risk of HDP in the vitamin D deficient group was 9.19-fold higher than that in the vitamin adequate group(95%CI:5.44-15.51)(P < 0.01).The risk of PE was 10.40-fold higher in the vitamin adequate group(95%CI:5.76-18.79)(P < 0.01).3.Receiver operating characteristic curve(ROC curve)analysis showed that vitamin D level had a more accurate predictive value for the occurrence of HDP and PE.The area under the curve for predicting the occurrence of HDP was 0.750(95%CI:0.707-0.793).The area under the curve for predicting the occurrence of PE was 0.766(95%CI:0.721-0.810).4.Vitamin D level and different pregnancy outcomes: Vitamin D deficiency group had the highest incidence of premature birth and fetal growth restriction,which was significantly higher than vitamin D deficiency group and sufficient group(P < 0.05).5.The levels of Triglycerides(TG)in HDP and PE groups were significantly higher than those in the control group(P < 0.01).The High density lipoprotein(HDL)level was significantly lower than that of the control group(P < 0.01).6.Multivariate logistic regression analysis showed that the risk of HDP and PE increased with the increase of TG level(OR: 1.31,1.32;95%CI: 1.12-1.53;1.12-1.55)(P < 0.01).In contrast,as HDL levels increased,the risk of HDP decreased(OR: 0.42,0.36;95%CI :0.23-0.78;0.19-0.70)(P < 0.01).7.Receiver operating characteristic curve(ROC)analysis showed that TG and HDL had low predictive value for the occurrence of HDP and PE.The area under the HDP curve predicted by TG was 0.579(95%CI:0.518-0.641).The predicted area under the PE curve was 0.578(95%CI:0.513-0.643).The area under the HDP curve predicted by HDL was 0.589(95%CI:0.528-0.649).The predicted area under the PE curve was 0.605(95%CI:0.541-0.669).8.There was no significant difference between TG and HDL levels in pregnant women in the third trimester in terms of different pregnancy outcomes(P > 0.05).Conclusion: 1.The level of vitamin D in pregnant women in the third trimester is related to the occurrence of HDP and PE,and vitamin D is a protective factor for the occurrence of HDP and PE.Appropriate vitamin D supplementation during pregnancy may reduce the risk of hypertensive diseases during pregnancy.2.Vitamin D level in the third trimester has a more accurate predictive value for the occurrence of HDP and PE,suggesting that we should pay attention to the vitamin D level in pregnant women in the third trimester of pregnancy.3.Pregnant women with vitamin D deficiency are more likely to suffer from premature delivery and fetal growth restriction,so it is necessary to pay more attention and timely supplement vitamin D in clinical practice to reduce the occurrence of adverse pregnancy outcomes.4.The levels of TG and HDL in the third trimester were correlated with the occurrence of HDP and PE.HDL is a protective factor for the occurrence of HDP and PE,while TG is a risk factor for the occurrence of HDP and PE.Attention to the regulation of blood lipids during pregnancy may reduce the incidence of hypertensive diseases during pregnancy.5.The predictive value of TG and HDL in the occurrence of HDP and PE in the third trimester is low,but the importance of TG and HDL in the incidence of hypertension during pregnancy should not be ignored.