目标:在过去的几年中,研究人员一直关注维生素D对孕妇健康的重要性,以及减少胎儿发育障碍发生的机会。此外,在妊娠期间发生的高血压疾病中,胎儿发育与动脉僵硬之间已经建立了联系。因此,这项研究的目的是检查血清25-羟基维生素D(25(OH)D)作为维生素D状态的主要标志物与内皮功能障碍之间的关系,通过子痫前期(PE)和妊娠高血压(HTN)孕妇的脉搏波速度(PWV)测量,以及它对胎儿发育的影响。
方法:这项研究包括187名符合研究纳入标准的孕妇。孕妇分为两组:妊娠高血压综合征(HTN组),其中包括100名患者(53.48%),和先兆子痫(PE组),其中包括87例患者(46.52%)。
结果:关于臂增强指数(Aix)的显着差异,PWVao,心率,和收缩压或舒张压更高的值观察到HTN组与本研究中子痫前期组(p<0.001)。此外,与HTN组相比,子痫前期组的Aix肱指数显着降低(HTN组的1.76±0.71与子痫前期组0.62±0.5,p<0.001)。严重的孕妇血清25(OH)D水平缺乏与更严重的早产亚类(p<0.001)和新生儿早产机会增加有关(p<0.05)。此外,研究了重度孕妇血清25(OH)D水平缺乏对血压值的负面影响,艾克斯肱,第二和第三个三个月的PWVao值,和胎儿体重。Kruskal-Wallis测试应用于此,在所有情况下获得显着差异:开放P小于0.05和封闭。当血清25(OH)D水平严重缺乏时,动脉僵硬度参数显著恶化.
结论:这项研究的结果揭示了维生素D缺乏与先兆子痫和妊娠高血压孕妇动脉僵硬度增加之间的显著联系。这些结果强调了进行两种检查以对这些患者进行更全面评估的重要性。利用脉搏波分析作为一种实用的方法来评估妊娠期高血压疾病的母体动脉僵硬度可能是有益的,特别是在血清25(OH)D水平缺乏的情况下。它可以在识别疾病严重程度恶化风险较高的患者方面发挥关键作用,因此,防止对胎儿发育的任何影响。
OBJECTIVE: Over the past few years, researchers have focused on the importance of vitamin D in the health of pregnant women and in reducing the chances of developmental disorders occurring in fetuses. In addition, a link has been established between fetal development and arterial stiffness in hypertensive disorders that occur during pregnancy. Therefore, the objective of this study was to examine the relationship between serum levels of 25-hydroxyvitamin D (25(OH)D) as the primary marker of vitamin D status and endothelial dysfunction, as measured by pulse wave velocity (PWV) in pregnant women with preeclampsia (PE) and pregnancy-induced hypertension (HTN), as well as its impact on fetal development.
METHODS: This study included 187 pregnant women who met the study inclusion criteria. Pregnant women were divided into two groups: pregnancy-induced hypertension (HTN group), which included 100 patients (53.48%), and preeclampsia (PE group), which included 87 patients (46.52%).
RESULTS: Significant differences regarding the augmentation index (Aix) brachial, PWVao, heart rate, and systolic or diastolic blood pressure with more increased values were observed for the HTN group vs. the preeclampsia group in the current research (p < 0.001). Additionally, the Aix brachial index was significantly lower in the preeclampsia group compared to the HTN group (1.76 ± 0.71 for the HTN group vs. 0.62 ± 0.5 for the preeclampsia group, p < 0.001). A severe matern serum 25(OH)D level deficiency was associated with a more severe subcategory of prematurity (p < 0.001) and with increased chances of newborn preterm birth (p < 0.05). Moreover, the negative effect of severe maternal serum 25(OH)D level deficiency was studied for each group regarding the blood pressure values, Aix brachial, PWVao values in the second and third trimesters, and fetus weight. The Kruskal-Wallis test was applied for this, obtaining significant differences in all cases: open paren p less than 0.05 and closed. When serum severe 25(OH)D levels deficiency was present, arterial stiffness parameters were significantly worse.
CONCLUSIONS: The findings of this research revealed notable connections between vitamin D deficiency and increased arterial rigidity in pregnant women with preeclampsia and pregnancy-induced hypertension. These results emphasize the significance of conducting both examinations to obtain a more comprehensive evaluation of these patients. Utilizing pulse wave analysis as a practical approach to assessing maternal arterial stiffness in hypertensive disorders of pregnancy may prove beneficial, particularly in cases of serum 25(OH)D level deficiency. It could play a key role in identifying patients at higher risk of worsening disease severity and, thus, preventing any impact on fetal development.