| Objective:By detecting the serum vitamin D content of pregnant women in the third trimester and the vitamin D content of newborn umbilical cord blood,the relationship between hypertension in pregnancy and maternal and infant outc omes was explored,so as to provide reference for vitamin D supplementation du ring pregnancy and reduce the incidence of perinatal complications.Methods:A total of 102 pregnant women were randomly selected from the First Affiliated Hospital of Dali University(the Fourth People’s Hospital of Yun nan Province)from January 1,2022 to December 7,2022,and delivered in our hospital,including 102 single viable fetus.Grouping:normal pregnancy group,ges tational hypertension group,preeclampsia group,severe preeclampsia group,chron ic hypertension complicated with preeclampsia group.Basic information of pregnan t women during pregnancy was collected,3-5ml fasting venous blood of pregnan t women in late pregnancy and 3-5ml umbilical venous blood of newborn babies during delivery were collected,and serum vitamin D content was measured by liquid chromatography tandem mass spectrometry.SPSS25.0 software was used for statistical analysis,Chi-square test,Fisher test,bivariate correlation analysis,and one-way analysis of variance.LSD was used to compare the differences among multiple groups,and P<0.05 was considered statistically significant.Result:1.There was a significant positive correlation between vitamin D content and cord blood vitamin D content in pregnant women(r=0.620,P<0.05).There was a positive correlation between maternal blood calcium concentration and neonatal blood calcium concentration at admission(r=0.352,P<0.05).2.The rate of vitamin D deficiency in pregnant women was 47.1%,the rate of deficiency was 30.4%and the rate of sufficiency was 22.5%.The deficiency rate of vitamin D in cord blood was 61.8%,the insufficiency rate was 23.5%,and the sufficiency rate was 14.7%.The content of vitamin D in pregnant women with chronic hypertension complicated with preeclampsia was the highest(28.70±11.1ng/m L),while the content of vitamin D in pregnant women with preeclampsia was the lowest(19.19±7.88ng/m L).The content of vitamin D in pregnant women was significantly different between the normal pregnancy group and the gestational hypertension disease group(F=2.835,P=0.029),the group with chronic hypertension complicated with preeclampsia was higher than that with preeclampsia and severe preeclampsia(P=0.016,P severe preeclampsia=0.014),and the group with gestational hypertension was higher than that with preeclampsia and severe preeclampsia(P=0.029,P severe preeclampsia=0.026).The content of cord blood vitamin D was the highest in hypertensive group during pregnancy(15.57±6.46ng/m L),and the lowest in preeclampsia group(11.97±5.16ng/m L).There was no significant difference in cord blood vitamin D content between normal pregnancy group and hypertensive disease group during pregnancy(F=1.018,P=0.402).3.There were no significant differences in age,ethnicity and weight gain during pregnancy between normal pregnancy group and gestational hypertension group(P>0.05).There were statistically significant differences between the normal pregnancy group and the gestational hypertension group in delivery season,delivery mode,gestational week,BMI at the time of filing,and maternal blood calcium concentration at admission(P<0.05).Delivery season:normal pregnancy group accounted for the highest proportion of 33(68.8%)in spring,severe preeclampsia group accounted for the highest proportion of 4(17.4%)in summer,chronic hypertension complicated with preeclampsia group accounted for the highest proportion of 5(62.5%)in autumn,severe preeclampsia group accounted for the highest proportion of 6(26.1%)in winter.Delivery mode:The proportion of cesarean section in severe preeclampsia group and chronic hypertension complicated preeclampsia group was the highest,which were23(100.0%)and 8(100.0%),respectively.The proportion of natural birth in normal pregnancy group was the highest 22(45.8%).Gestational age at delivery:The mean gestational age at delivery was the lowest in severe preeclampsia group(34.27±2.91weeks).BMI at the time of filing:the highest BMI was found in the chronic hypertension complicated with preeclampsia group(29.05±6.01Kg/m~2),and the BMI in the gestational hypertension group,preeclampsia group and severe preeclampsia group was higher than that in the normal pregnancy group at the time of filing.Weight gain during pregnancy:The group with chronic hypertension complicated with preeclampsia gained the least weight during pregnancy(8.88±3.98Kg).Blood calcium at admission:The mean blood calcium concentration at admission was the lowest in the severe preeclampsia group(2.06±0.19mmol/L).4.There was no significant difference in maternal age,nationality,mode of delivery,gestational age and maternal and infant vitamin D content.The content of vitamin D in pregnant women was the lowest in winter(20.05±8.81ng/m L),but there was no significant difference between spring,summer,autumn and winter(P>0.05).The content of vitamin D in cord blood was the lowest in winter(10.26±4.12ng/m L),and the difference of vitamin D in cord blood in spring,summer,autumn and winter was statistically significant(F=3.312,P=0.023).The content of cord blood vitamin D in winter was significantly lower than that in spring(P spring=0.033),summer(P summer=0.048)and autumn(P autumn=0.003).The content of vitamin D and cord blood in the preterm delivery group was lower than that in the full-term delivery group.At the time of documentation,there was a statistically significant difference in the vitamin D content of pregnant women in the emaciated group,the normal group,the hypertrophic group and the obese group(F=2.423,P=0.037),the vitamin D content of pregnant women in the emaciated group was the lowest(19.97±5.38ng/m L),and the vitamin D content of pregnant women in the emaciated group was lower than that in the obese group(P=0.030).The vitamin D content of pregnant women increased with the increase of BMI at the time of registration.At the time of filing,there was no significant difference in the content of vitamin D in cord blood of BMI among emaciated group,normal group,superrecombinant group and obese group(P>0.05).5.There were no significant differences in vitamin D content and cord blood vitamin D content in pregnant women and fetal growth and development indexes among different groups(P>0.05).There was no statistical significance in vitamin D content of pregnant women at different levels,vitamin D content of umbilical cord blood and blood loss of different delivery modes between groups(P>0.05).There were no significant differences in 1-minute Apgar score,5-minute Apgar score and 10-minute Apgar score between normal pregnancy group and gestational hypertension group(P>0.05).In normal pregnancy group,the difference of 1-minute Apgar score between cord blood vitamin D deficiency group,insufficient group and sufficient group was statistically significant(P insufficient=0.000,P adequate=0.000).There was statistically significant difference in 1-minute Apgar score between the vitamin D deficiency group and the sufficient group(P=0.002),but there was no statistically significant difference in 5-minute Apgar score and 10-minute Apgar score between the normal pregnancy group and the hypertensive disease group(P>0.05).The 1-minute Apgar score,5-minute Apgar score and 10-minute Apgar score of neonates in the normal pregnancy group and the gestational hypertension group showed a gradually increasing trend at the levels of deficiency,insufficiency and sufficiency.There was no significant difference in vitamin D levels between the normal neonatal group and the group with neonatal diseases in the levels of deficiency,insufficiency and adequacy in the normal pregnancy group and the pregnancy-induced hypertension group(P=0.544,P=0.690).The incidence of neonatal pneumonia,neonatal respiratory distress complicated with pneumonia and neonatal death in the pregnant women with gestational hypertension group were higher than those in the normal pregnancy group at the level of deficiency,insufficient and sufficient vitamin D level.There was statistically significant difference in cord blood vitamin D content between the normal neonatal group and the group with neonatal diseases in the normal pregnancy group(P=0.046),but no statistically significant difference in cord blood vitamin D content between the normal neonatal group and the group with neonatal diseases in the pregnancy hypertension group(P=0.822).The incidence of neonatal pneumonia,neonatal respiratory distress complicated with pneumonia and neonatal death in hypertensive disease group was higher than that in normal pregnancy group at the level of deficiency,deficiency and sufficient vitamin D in cord blood.Conclusions:1.The phenomenon of vitamin D deficiency or deficiency in umbilical cord blood and pregnant women is relatively common in Dali and its surrounding areas.The lower the level of vitamin D in pregnant women,the lower the level of vitamin D in umbilical cord blood,the more severe the hypertensive disease during pregnancy,and the worse the maternal and neonatal prognosis.2.Cord blood vitamin D level affects neonatal prognosis. |
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