晚期早产儿出生时25-羟基维生素D水平异常高危因素及疗效分析

目的 研究晚期早产儿出生时25羟基维生素D25-(OH)D]水平异常高危险因素,并观察常规治疗后的效果。方法 选取100例于2017年1月—2020年6月在石嘴山市第一人民医院新生儿病室住院的晚期早产儿,根据25-(OH)D水平分为缺乏组(66例)和充足组(34例),采用Logistic回归分析法明确影响晚期早产儿出生时25-(OH)D水平异常的危险因素,对缺乏组予以治疗,观察治疗后的临床效果。结果 缺乏组冬春季出生晚期早产儿为90.9%(60/66)高于充足组27.78%(10/34)(χ2=40.413,P＜0.001);母亲孕龄为(29.91±4.13)岁,大于充足组的(28.04±4.19)岁、(23.21±3.01)kg/m2,(χ2=2.134,P=0.035);母亲体质量指数(BMI)为(26.97±2.57)kg/m2,大于充足组的(23.21±3.01)kg/m2, (t=6.534,P＜0.001)。Logistic回归分析显示,冬春季出生(OR=2.659,95%CI 2.303～3.015,P＜0.001)、母亲孕龄(OR=3.425,95%CI 2.064～4.785,P=0.002)、母亲BMI(OR=2.136,95%CI 0.491～3.781,P=0.006)为晚期早产儿在出生时25-(OH)D缺乏的相关高危因素。缺乏组的晚期早产儿3个月龄时25-(OH)D水平为(51.25±3.87)nmol/L,高于出生24 h内(25.31±3.57)nmol/L(t=40.025,P＜0.001),且与充足组3个月龄时无明显差异(t=0.992,P=0.324)。结论 冬春季出生、母亲孕龄、母亲BMI是影响晚期早产儿25-(OH)D水平的危险因素,经过治疗,早产儿25-(OH)D水平能恢复正常。

Analysis of high risk factors and curative effect of abnormal 25-(OH) D levels at birth in late preterm infants

Objective To study the risk factors of abnormally high 25-hydroxyvitamin D levels at birth in late preterm infants, and observe the effects of the conventional treatment. Methods A total of 100 late preterm infants who were hospitalized in the neonatal ward of Shizuishan First People's Hospital from January 2017 to June 2020 were selected. According to their 25-(OH) D levels, they were divided into a deficiency group (66 cases) and an adequate group (34 cases). By using logistic regression analysis, the risk factors that affect the abnormal 25-(OH) D levels of late preterm infants at birth were clarified, and the deficiency group was treated with the conventional method and the clinical effect was observed after the treatment. Results The proportion (90.9%, 60/66) of late-born premature infants in winter and spring of the deficient group was higher than that (27.78%, 10/34) of the adequate group (χ2=40.413, P<0.001); the maternal gestational age of the deficient group was greater than that of the sufficient group (χ2=2.134, P=0.035); the maternal body mass index (BMI) of the deficient group was higher than that of the sufficient group (t=6.534, P<0.001). Logistic regression analysis showed that birth in winter and spring (OR=2.659, 95%CI 2.303-3.015, P<0.001), mother's gestational age (OR=3.425, 95%CI 2.064-4.785, P=0.002), mother's BMI (OR=2.136, 95%CI 0.491-3.781, P=0.006), and 25-(OH) D deficiency in late preterm infants were related high-risk factors. The 25-(OH) D level of late preterm infants in the deficiency group at 3 months of age was higher than that within 24 hours of birth (t=40.025, P<0.001), and compared with the adequate group at 3 months old, there was no significant difference (t=0.992, P=0.32). Conclusion Birth in winter and spring, mother's gestational age, and mother's BMI are risk factors that affect the 25-(OH) D level of late preterm infants. After the treatment, the 25-(OH) D level of preterm infants can return to normal.