Clinical Analysis Of Vitamin D Deficiency During Pregnancy And Gestational Diabetes Mellitus And Perinatal Outcomes

BackgroundVitamin D is an essential necessary element that regulates the balance of calcium and phosphorus and promotes growth and development.It is especially important for pregnant women and their fetuses.Vitamin D levels are assessed by measuring serum25 hydroxy vitamin D(25(OH)D)Gestational diabetes mellitus(GDM)is one of the common complications during pregnancy,the incidence of it is increasing year by year.There is increasing evidence that vitamin D can improve glucose metabolism indexes in pregnant women with GDM.There is a common and severe vitamin D deficiency in GDM patients,and low maternal vitamin D level is potentially correlated with the incidence of GDM and advers outcomes of mothers and newborns.However,the research results on the correlation between vitamin D levels in pregnancy and GDM are inconsistent.This paper studied the relationship between vitamin D deficiency during pregnancy and the incidence of GDM and advers outcomes of mothers and newborns,such as polyhydramnios,oligohydramnios,macrosomia,premature delivery,low birth weight,postpartum hemorrhage,neonatal asphyxia,neonatal hyperbilirubinemia,etc.Purpose1、To explore the relationship between vitamin D deficiency in the first trimester and gestational diabetes mellitus and perinatal outcome;2、To provide clinical basis for vitamin D supplementation during pregnancy and prevention and treatment of gestational diabetes mellitus。MethodsA retrospective cohort study was used to collect the number of singleton pregnant patients who visited the Department of Obstetrics and Gynecology Center of our hospital from January 1,2021 to February 14,2023,and had 25(OH)D test in the first trimester and delivered in our hospital.According to the inclusion and exclusion criteria,2173 patients were finally included in this study.The subjects were divided into the following three groups according to whether they were deficient or supplemented with 25-hydroxyvitamin D.494 patients with 25(OH)D < 30ng/ml and oral vitamin D preparation in the first trimester were the experimental group.The oral vitamin D supplement was taken at a daily dose between 400 and 2400 iu.1280patients with 25 hydroxyvitamin D < 30ng/ml but no oral vitamin D intake were the blank control group,and 399 patients with 25 hydroxyvitamin D ≥30ng/ml without oral vitamin D intake were the normal control group.The incidence of gestational diabetes mellitus,amniotic fluid volume abnormality,premature rupture of membranes,primiparity cesarean section rate,postpartum hemorrhage,fetal distress,premature delivery,macroia,low birth weight,neonatal asphyxia,neonatal hyperbilirubinemia and other adverse maternal outcomes were compared among the three groups.The incidence of gestational diabetes mellitus was used as the dependent variable.logistic regression was used to analyze 25 hydroxy vitamin D in the first trimester,the age,pre-pregnancy BMI and parity(primiparity or multiparity).Results1、Women with sufficient vitamin D in first trimester accounted for 18.36% of the study population,and the rate of vitamin D deficiency reached 81.63%.2、The incidence of gestational diabetes mellitus was higher in people with deficient vitamin D(17.63%)than in people with sufficient vitamin D(15.79%),but there was no significant difference between groups(P>0.05).The incidence of gestational diabetes was lower in the experimental group(17.41%)than in the blank control group(17.73%),and higher than that in the normal control group(15.79%),but there was no statistical significance in the incidence of gestational diabetes among the three groups(P > 0.05).3、The incidence of premature rupture of membranes in the normal control group(19.05%)was lower than that in the experimental group(22.47%),and the experimental group was lower than that in the blank control group(25.01%),and the differences between the comparison groups were statistically significant(P< 0.05).The incidence of neonatal hyperbilirubinemia in the experimental group(17.26%)was lower than that in the blank control group(21.57%)and the normal control group(20.54%),and the difference between the groups was statistically significant(P <0.05).The incidence of low birth weight infants in experimental group(4.20%)and the normal control group(4.86%)was higher than that in blank control group(1.94%),and the difference between groups was statistically significant(P < 0.05).4、There were no significant differences in the incidence of polyhydramnios,oligohydramnios,primiparous cesarean section,postpartum hemorrhage,fetal distress,premature delivery,macrosomia and neonatal asphyxia among groups(P > 0.05).Conclusions1、Vitamin D supplementation did not significantly reduce the incidence of GDM,suggesting that 25(OH)D in the first trimester may not be a major risk factor for GDM.2、Vitamin D supplementation can effectively reduce the incidence of premature rupture of membranes and neonatal hyperbilirubinemia in women with vitamin D deficiency in first trimester.