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衡水市妇幼保健院产科,河北 衡水 053000
副主任医师。研究方向:产科常见病防治。E-mail:shixiaoxia2001@163.com
副主任医师。研究方向:产科常见病防治。E-mail:707915117@qq.com
收稿:2025-09-28,
修回:2026-01-08,
录用:2026-01-08,
纸质出版:2026-05-15
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史晓霞,王维娜,李瑞,等.维生素D缺乏孕妇补充不同剂量维生素D对母婴结局影响的Meta分析 [J].中国药房,2026,37(09):1215-1221.
SHI Xiaoxia,WANG Weina,LI Rui,et al.Meta-analysis of the effects of different doses of vitamin D supplementation on maternal and infant outcomes in vitamin D-deficient pregnant women[J].ZHONGGUO YAOFANG,2026,37(09):1215-1221.
史晓霞,王维娜,李瑞,等.维生素D缺乏孕妇补充不同剂量维生素D对母婴结局影响的Meta分析 [J].中国药房,2026,37(09):1215-1221. DOI: 10.6039/j.issn.1001-0408.2026.09.19.
SHI Xiaoxia,WANG Weina,LI Rui,et al.Meta-analysis of the effects of different doses of vitamin D supplementation on maternal and infant outcomes in vitamin D-deficient pregnant women[J].ZHONGGUO YAOFANG,2026,37(09):1215-1221. DOI: 10.6039/j.issn.1001-0408.2026.09.19.
目的
2
系统评价维生素D缺乏孕妇补充不同剂量维生素D对母婴结局的影响。
方法
2
检索中国知网、万方、维普、PubMed、Medline、the Cochrane Library、Embase数据库中补充不同剂量维生素D对母婴结局影响的相关文献,检索时限为建库起至2025年6月30日。利用Cochrane系统评价员手册5.1评价纳入文献质量,采用RevMan 5.4软件对结局指标进行Meta分析。
结果
2
共纳入15篇文献,涉及4 664例孕妇,其中试验组(日剂量>2 000 IU)2 129例、对照组1(日剂量≤1 000 IU)2 058例、对照组2(日剂量>1 000~≤2 000 IU)477例。Meta分析结果显示,试验组与对照组1比较,子痫前期(PE)发生率[OR=0.71,95%CI(0.53,0.96),
P
=0.03
]
、妊娠期糖尿病(GDM)发生率[OR=0.60,95%CI(0.43,0.84),
P
=0.003
]
、新生儿低体重发生率[OR=0.72,95%CI(0.53,0.97),
P
=0.03
]
和巨大儿发生率[OR=0.53,95%CI(0.29,0.98),
P
=0.04
]
显著降低,早产发生率[OR=0.86,95%CI(0.65,1.13),
P
=0.28
]
、剖宫产率[OR=0.92,95%CI(0.74,1.15),
P
=0.48
]
、死胎发生率[OR=0.77,95%CI(0.48,1.24),
P
=0.29
]
的差异均无统计学意义。试验组与对照组2比较,新生儿低体重发生率[OR=0.64,95%CI(0.41,0.98),
P
=0.04
]
显著降低,PE发生率[OR=0.61,95%CI(0.25,1.49),
P
=0.28
]
、GDM发生率[OR=0.73,95%CI(0.42,1.24),
P
=0.24
]
、早产发生率[OR=0.90,95%CI(0.59,1.39),
P
=0.63
]
、剖宫产率[OR=0.92,95%CI(0.64,1.33),
P
=0.66
]
、死胎发生率[OR=0.68,95%CI(0.24,1.94),
P
=0.48
]
的差异无统计学意义。
结论
2
维生素D缺乏孕妇补充不同剂量维生素D对母婴结局有显著影响,日剂量>2 000 IU在降低PE、GDM和改善早产相关结局等方面具有显著优势。
OBJECTIVE
2
To systematically evaluate the effects of supplementation with different doses of vitamin D on maternal and infant outcomes in vitamin D-deficient pregnant women.
METHODS
2
Related literature on the effects of supplementing different doses of vitamin D on maternal and infant outcomes was searched in databases including CNKI, Wanfang Data, VIP, PubMed, Medline, the Cochrane Library, Embase from their inception to June 30, 2025. The risk of bias assessment tool from the Cochrane Handbook 5.1 was used to evaluate the quality of included literature. Meta-analysis of outcome indicators was performed by using RevMan 5.4 software.
RESULTS
2
A total of 15 studies were included, involving 4 664 patients [2 129 in the experimental group (daily dose >2 000 IU), 2 058 in control group 1 (daily dose ≤1 000 IU) and 477 in control group 2 (daily dose >1 000-≤2 000 IU)
]
. Meta-analysis results showed that the incidence of preeclampsia (PE) [OR=0.71, 95%CI (0.53, 0.96),
P
=0.03
]
, gestational diabetes mellitus (GDM) [OR=0.60, 95%CI (0.43, 0.84),
P
=0.003
]
, low birth weight of newborn [OR=0.72, 95%CI (0.53, 0.97),
P
=0.03
]
and macrosomia [OR=0.53, 95%CI (0.29, 0.98),
P
=0.04
]
in the experimental group were significant lower than control group 1; but there was no significant difference in the incidence of premature delivery [OR=0.86, 95%CI (0.65, 1.13),
P
=0.28
]
, cesarean delivery [OR=0.92, 95%CI (0.74, 1.15),
P
=0.48
]
or stillbirth rate [OR=0.77, 95%CI (0.48, 1.24),
P
=0.29
]
. The incidence of low birth weight of ne
wborn [OR=0.64, 95%CI (0.41, 0.98),
P
=0.04
]
in the experimental group was significant lower than control group 2; but there was no significant difference in the incidence of PE [OR=0.61, 95%CI (0.25, 1.49),
P
=0.28
]
, the incidence of GDM [OR=0.73, 95%CI (0.42, 1.24),
P
=0.24
]
, premature delivery rate [OR=0.90, 95%CI (0.59, 1.39),
P
=0.63
]
, cesarean delivery rate [OR=0.92, 95%CI (0.64, 1.33),
P
=0.66
]
, or stillbirth rate [OR=0.68, 95%CI (0.24, 1.94),
P
=0.48
]
.
CONCLUSIONS
2
Different doses of vitamin D supplementation in early pregnancy have a significant impact on maternal and infant pregnancy outcomes in vitamin D-deficient pregnant women; daily doses >2 000 IU have significant advantages in reducing the incidence of PE and GDM and improving the outcome of premature delivery.
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