Original Article
Study on the relationship between pre-pregnancy vitamin D level and pregnancy outcome in unexplained recurrent spontaneous abortion
Li Guohua, Li Yangyang, Bao Shihua
Published 2021-05-20
Cite as J Chin Physician, 2021, 23(5): 702-706. DOI: 10.3760/cma.j.cn431274-20200421-00490
Abstract
ObjectiveTo investigate the pre-pregnancy vitamin D level and pregnancy outcome in patients with unexplained recurrent spontaneous abortion (URSA).
MethodsA prospective study was performed in 4 534 patients with URSA from May 2017 to April 2019 at Shanghai First Maternity and Infant Health Hospital Affiliated to Tongji University. The serum Vitamin D levels was obtained before pregnancy. Pregnancy complications and newborns outcomes were recorded after pregnancy.
ResultsThe serum vitamin D level of patients with URSA before pregnancy was (42.22±16.27)nmol/L, and the proportions of vitamin D deficiency, insufficiency and sufficiency were 72.3%, 24.0 %, and 3.7%, respectively. The Vitamin D level was positively correlated with age (P<0.05); The age of vitamin D<50 nmol/L group was lower than that of vitamin D≥50 nmol/L group (P<0.05); patients with vitamin D<50 nmol/L had higher proportion of spontaneous abortions ≥3 times than those with the vitamin D≥50 nmol/L (P<0.05); The level of vitamin D was negatively correlated with the ratio of CD3+ CD4+ T cells in peripheral blood (P<0.05); In multivariate logistic regression analysis, the final model adjusted for age, abortion frequency and season. The risk of pregnancy failure was increased in vitamin D <50 nmol/L group [30.6%(76/248) vs 17.9%(12/67), χ2=3.67, P=0.02], OR=2.02(95% CI: 1.02-3.9); In the group of vitamin D<50 nmol/L before pregnancy, the risk of newborns entering NICU was increased,OR=3.16(95% CI: 1.15-8.65).
ConclusionsVitamin D deficiency is prevalent in URSA patients before pregnancy, which correlates with the times of previous spontaneous abortions and recurrent pregnancy failure. Vitamin D deficiency before pregnancy is one of the high-risk factors for URSA.
Key words:
Abortion, habitual; Unexplained; Vitamin D; Pregnancy outcome
Contributor Information
Li Guohua
Department of Reproductive Immunology, Shanghai First Maternity and Infant Hospital Affiliated to Tongji University, Shanghai 201400, China
Li Yangyang
Department of Reproductive Immunology, Shanghai First Maternity and Infant Hospital Affiliated to Tongji University, Shanghai 201400, China
Bao Shihua
Department of Reproductive Immunology, Shanghai First Maternity and Infant Hospital Affiliated to Tongji University, Shanghai 201400, China
