Vitamin D Eksikliği ve Gebelik: Preeklempsi Etyolojisinde Rolü Var Mıdır?

Öz

Amaç: Vitamin D eksikliği gebelikte data sık görülmektedir ve çeşitli obstetrik rahatsızlıklarla ilişkisi olduğuna yönelik kanıtlar mevcuttur. Bu çalışmanın amacı gebelerde vitamin D düzeyi ile preeklempsi arasındaki ilişkiyi araştırmaktır. Yöntem: Çalışmaya 1209 kadın dahil edilmiştir. Genel karakteristikler, laboratuar sonuçları ve obstetrik sonuçlar değerlendirilmiştir. Global olarak da kabul edilmiş olan <20ng/mL, vitamin D eksikliği (VDE) olarak tanımlanmıştır. ROC analizinde eksiklik için kritik düzey 8.335 ng/mL olarak tespit edilmiştir. Sonuçlar: Hastaların ortanca yaşı 28 (17-45) idi. Hastaların %11.9'unda doğum indüksiyonu gerekmiştir. Sezaryen seksiyo oranı %32.5 idi. Hastaların %81'inde (n:979) VDE tespit edilmiştir. Gestasyonel hafta (38.6 vs. 38.5), doğum ağırlığı (3291gr vs. 3248gr) ve baş çevresi (34.98cm vs. 34.9cm) VDE olmayan ve olan gruplarda benzerdi (p: 0.145, p:0.184 ve p:0.358, sırasıyla). Bunun yanı sıra, tek değişkenli analizde VDE'li grupta doğum indüksiyonu ve erken membran rupture daha yüksek oranda tespit edilmiştir. Otuz sekiz hasta preeklempsi tanısı almıştır. Vitamin D düzeyinin 8.335 ng/mL olarak tanısal doğruluk oranı %76.1 idi. Çok değişkenli analizde 8.335 ng/mL 25-OH vitamin D düzeyi (HR: 2.94; %95 GA: 2.04-4.22; p:<0.001) ve nulliparite (HR: 2.05; %95 GA: 1.43-2.93; P < 0.001) preeklempsi için istatistiksel olarak anlamlı bağımsız risk faktörleri olarak tespit edilmiştir. Sonuç: Çalışmamızda azalmış vitamin D düzeyi preeklempsi ice ilişkili olarak bulunmuştur. İlişkinin vitamin D düzeyi düştükçe, arttığı gözlenmiştir. VDE oldukça sık izlenmektedir ve ileride yapılacak çalışmalar dünya genelinde izlenen bu sağlık sorununa destekleyici sonuçlar ortaya koyacaktır.

Anahtar Kelimeler

• 25-hidroksi vitamin D,
• preeklempsi
• gebelik
• vitamin d eksikliği
• sonuçlar

Vitamin D deficiency and pregnancy outcome: Does it have a role in preeclampsia etiology?

Öz

Purpose: Vitamin D deficiency is higher in pregnancy and there is evidence on its relationship with various obstetric disorders. The aim of this study was to investigate the association between preeclampsia and vitamin D levels in pregnant women. Methods: This study included 1209 women. General characteristics, laboratory results and obstetric outcomes were evaluated. As globally accepted vitamin D deficiency was defined as <20 ng/mL and we determined a critical level of for deficiency that is 8.335 ng/mL in ROC analyses. Results: The median age of the patients was 28 (17-45). The percentage of need of labor induction was 11.9%. Cesarean section rate was 32.5%. The incidence of VDD was 81% (n:979). Gestational week (38.6 vs. 38.5), birth weight (3291gr vs. 3248gr) and head circumference (34.98cm vs. 34.9cm) were not different groups with regard to VDD (p: 0.145, p:0.184 and p:0.358, respectively). Besides; VDD was significantly associated with risk of labor induction and PROM in univariant analyses. 38 patients were diagnosed with preeclampsia. The diagnostic accuracy rate of level vitamin D level as 8.335 ng/mL was 76.1 %. According to multivariate analysis 25-OH vit D level of 8.335 ng/mL (HR: 2.94; 95%CI: 2.04-4.22; P < 0.001) and nulliparity (HR: 2.05; 95%CI: 1.43-2.93; P < 0.001) were independent factors significantly associated with preeclampsia. Conclusion: Low levels of vitamin D was associated with preeclampsia in our study. The association was stronger in lower levels. VDD is very frequent and further studies may also support advances in a health problem worldwide.

Anahtar Kelimeler

• 25-hydroxy vitamin D
• Outcome
• Preeclampsia
• Pregnancy
• Vitamin D deficiency.

Kaynakça

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