早产儿出生时25羟基维生素D水平与呼吸窘迫综合征关系分析

Relationship between serum 25(OH)D levels at birth and respiratory distress syndrome in preterm infants

摘要:

目的 研究早产儿出生时血清25羟基维生素D[25（OH）D]水平与呼吸窘迫综合征（RDS）的关系。方法 将2014年1月至2016年12月于新生儿病房住院的符合入组标准和排除标准的早产儿112例分为RDS组（n=72）和对照组（n=40）。收集两组患儿的一般临床资料，包括胎龄、出生体重、性别、分娩方式、1 min及5 min Apgar评分，以及母妊娠期糖尿病和产前激素使用情况。采集患儿的外周静脉血，分离血清，采用化学发光免疫分析法检测血清25（OH）D水平；采用二元logistic回归模型分析25（OH）D水平与RDS发生的关系。结果 RDS组1 min及5 min Apgar评分、血清25（OH）D水平显著低于对照组（P < 0.05），新生儿窒息及维生素D缺乏发生率显著高于对照组（P < 0.05）。经二元logistic回归分析结果显示，新生儿窒息（OR=2.633，95%CI：1.139~6.085）、维生素D缺乏（OR=4.064，95%CI：1.625~10.165）是导致早产儿RDS发生的危险因素（P < 0.05）。结论 早产儿出生时维生素D缺乏可能与RDS发病风险增加有关，母孕期合理补充维生素D可能降低早产儿RDS发病率。

Abstract:

Objective To investigate the relationship between serum 25-hydroxyvitamin D[25 (OH)D] levels at birth and respiratory distress syndrome (RDS) in preterm infants. Methods This retrospective study recruited preterm infants with gestational age of below 34 weeks who were born between January 2014 and December 2016. These preterm infants were divided into two groups:RDS (n=72) and control (n=40). Clinical data of the two groups were collected, including gestational age, birth weight, gender, delivery mode, Apgar scores at 1 minute and 5 minutes, incidence of maternal gestational diabetes mellitus, and use of prenatal steroid hormone. Peripheral blood samples were collected and 25 (OH)D levels were measured by chemiluminescence immunoassay. The association between serum 25 (OH)D levels at birth and RDS was analyzed by multivariate logistic regression. Results Apgar scores at 1 minute and 5 minutes and serum 25 (OH)D levels in the RDS group were significantly lower than those in the control group (P < 0.05), while the rates of neonatal asphyxia and vitamin D deficiency were significantly higher than those in the control group (P < 0.05). Multivariate logistic regression analysis showed that neonatal asphyxia (OR=2.633, 95%CI:1.139-6.085) and vitamin D deficiency (OR=4.064, 95%CI:1.625-10.165) were risk factors for RDS in preterm infants. Conclusions Vitamin D deficiency might be associated with increased risk of RDS in preterm infants. Reasonable vitamin D supplementation during pregnancy might reduce the incidence of RDS in preterm infants.