摘要
目的研究血清25羟维生素D[25(OH)D]及矿物质水平与产后出血(PPH)的关联性。方法选取2017年11月至2020年11月新疆生产建设兵团第十三师红星医院收治的297例孕妇为研究对象,依据分娩后24h内阴道出血量是否大于500mL分为产后出血组(n=21)与产后正常组(n=276),收集并比较两组一般资料、血清25(OH)D及矿物质(血清钙、血清磷、血清铁)水平。经受试者工作特征(ROC)曲线分析25(OH)D、血清钙、血清铁预测孕妇发生PPH的价值;多因素Logistic回归分析孕妇发生PPH的危险因素。结果产后出血组不良孕产史占比高于产后正常组,25(OH)D、血清钙、血清铁水平低于产后正常组,差异均有统计学意义(χ^(2)/t值分别为4.129、6.526、8.317、7.517,P<0.05);经ROC曲线分析,25(OH)D、血清钙、血清铁预测孕妇发生PPH的曲线下面积分别为0.905、0.853、0.860;多因素Logistic回归分析显示有不良孕产史、25(OH)D<41.905nmol/L、血清钙<2.165mmol/L、血清铁<12.265mmol/L是孕妇发生PPH的危险因素,其OR值及95%CI分别为3.261(1.298~8.193)、3.999(1.658~9.645)、3.654(1.449~9.214)、4.225(1.574~11.341),P<0.05。结论有不良孕产史及血清25(OH)D、钙、铁低水平均是影响孕妇发生PPH的危险因素,与发生PPH呈显著相关性,对降低产后出血发生率具有重要参考意义。
Objective To study correlations of serum levels of 25hydroxyvitamin D[25(OH)D]and trace elements with postpartum hemorrhage(PPH).Methods A total of 297pregnant women who delivered in Hongxing Hospital of The 13th Division of Xinjiang Production and Construction Corps from November 2017to November 2020were selected as research subjects.According to whether the vaginal bleeding volume within 24hours after delivery was greater than 500mL,they were divided into postpartum hemorrhage group(n=21)and normal postpartum group(n=276).General data,serum levels of 25(OH)D and minerals(calcium,phosphorus and iron)were collected and compared between the two groups.The receiver operating characteristic(ROC)curve was used to analyze values of serum 25(OH)D,calcium and iron levels for predicting occurrence of PPH in the pregnant women.Multivariate Logistic regression analysis was used to analyze risk factors for PPH of the pregnant women.Results The proportion of adverse pregnancy history in the postpartum hemorrhage group was higher than that in the normal postpartum group,and the serum levels of 25(OH)D,calcium and iron were lower than those in the normal postpartum group,the differences were statistically significant(χ^(2)/t=4.129,6.526,8.317and 7.517respectively,all P<0.05).ROC curve analysis shown that the areas under ROC curve of serum 25(OH)D,calcium and iron levels for predicting occurrence of PPH were 0.905,0.853and 0.860respectively.Multivariate Logistic regression analysis showed that adverse pregnancy history,serum level of 25(OH)D<41.905nmol/L,serum level of calcium<2.165mmol/L and serum level of iron<12.265mmol/L were risk factors for PPH in the pregnant women.ORvalues and 95%CIs were 3.261(1.298-8.193),3.999(1.658-9.645),3.654(1.449-9.214)and 4.225(1.574-11.341)respectively,all P<0.05.Conclusion Adverse pregnancy history and low serum levels of 25(OH)D,calcium and iron are risk factors for PPH of the pregnant women,and they are significantly correlated with occurrence of PPH,which is of important guiding significa
作者
张颖
马艳
尼牙孜汗·依明
刘海
陈梅
ZHANG Ying;MA Yan;MIYAZIHAN·Yiming;LIU Hai;CHEN Mei(Department of Obstetrics,Hongxing Hospital of The 13th Division of Xinjiang Production and Construction Corps,Xinjiang Hami 839000,China;Department of Obstetrics,Hami Municipal Central Hospital,Yizhou District,Hami City,Xinjiang Uygur Autonomous Region,Xinjiang Hami 839000,China)
出处
《中国妇幼健康研究》
2022年第10期80-84,共5页
Chinese Journal of Woman and Child Health Research
基金
新疆维吾尔自治区自然科学基金资助项目(2017D01C317)。
关键词
25羟维生素D
微量元素
血清钙
血清铁
产后出血
25hydroxyvitamin D[25(OH)D]
trace element
serum calcium
serum iron
postpartum hemorrhage(PPH)
