妊娠期維生素A缺乏現狀及對新生兒體格指標的影響

周倩珺　蔣敏橋　李仲均　殷婉萍　黃巧如

[關鍵詞] 維生素A;妊娠;變化;出生體重;體重指數

[中圖分類號] R725.6? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 1673-9701（2021）22-0066-03

Status of vitamin A deficiency during gestation periods and its effect on neonatal physical indexes

ZHOU Qianjun? ?JIANG Minqiao? ?LI Zhongjun? ?YIN Wanping? ?HUANG Qiaoru

Department of Gynecology and Obstetrics， Dongguan People′s Hospital in Guangdong Province， Dongguan? ?523000， China

[Abstract] Objective To evaluate the effects of maternal vitamin A nutritional status on neonatal physical development indexes during different gestation periods. Methods A retrospective study was conducted on 855 healthy single pregnant women who were admitted to our hospital for obstetric examination and delivery from January 2018 to June 2019. Data of two vitamin A tests in the first and third trimesters of pregnancy， as well as the neonatal body length and weight of all subjects were collected， and their BMI were calculated. The SPSS software was used to analyze the difference of vitamin A concentration between the two times and the effect on neonatal physical development indexes. Results The serum vitamin A concentration of pregnant women in the third trimester， （0.38±0.11）mg/L， was lower than that in the first trimester， （0.45±0.09）mg/L， and the difference was statistically significant（P<0.05）. The neonatal body length， body weight and BMI were negatively correlated with VA in the first trimester（r=-0.117，-0.134 and -0.114， P<0.05）， and positively correlated with VA in the first trimester （r=0.068， 0.097 and 0.101， P<0.05）. The birth weight （3240.33±415.92） g and BMI （12.78±1.05） kg/m2 in pregnant women with elevated vitamin A during pregnancy were higher than those in pregnant women with reduced vitamin A [（3164.04±448.24）g and （12.57±1.16）kg/m2， P<0.05]. Conclusion The maternal vitamin A level and its changes during pregnancy can affect the body weight and body mass index of the newborn.

[Key words] Vitamin A; Pregnancy; Change; Birth weight; Body mass index （BMI）

妊娠期是婦女的一個特殊時期，孕婦需要同時滿足自身和胎兒的營養需求，因此需要的營養素更多，更容易出現營養素缺乏的情況。維生素A（Vitamin A，VA）是一種重要的脂溶性維生素，妊娠期維生素A缺乏（Vitamin A deficiency，VAD），不僅會損害到母體的健康，還會影響胎兒的正常發育，出現發育遲緩，甚至畸形等后果[1]。本研究擬通過分析健康孕婦不同妊娠期VA營養狀況與新生兒體格發育指標之間的關系，評估VA在胎兒體格發育中的作用，為孕期合理補充VA提供建議，現報道如下。

1 資料與方法

1.1 一般資料

本研究為回顧性研究，選擇2018年1月至2019年6月來我院產檢和分娩的孕產婦作為研究對象。納入標準：①單胎妊娠;②妊娠早期和晚期均檢測血清維生素A濃度;③新生兒出生時無畸形，并記錄身長和體重;④產婦及其家屬同意將相關數據納入該研究，并書面簽署知情同意書。排除標準：①多胎妊娠;②存在妊娠相關的臟器功能能障礙，或慢性的臟器功能障礙者;③任何一次檢測結果提示維生素A過量者（血清維生素A濃度≥0.7 mg/L）;④有妊娠期糖尿病或妊娠高血壓綜合征等妊娠期合并癥者;⑤采集的數據不全或存在明顯偏倚者。經上述納入及排除標準嚴格的篩選后，共有855例孕產婦及新生兒的數據納入統計分析，產婦年齡19～45歲，平均（30.12±4.55）歲。該研究經東莞市人民醫院醫學倫理委員會審核并批準實施。維生素A濃度參考文獻[2]進行分組，血清VA濃度<0.30 mg/L為VA缺乏組;血清VA濃度范圍為0.30～0.69 mg/L為VA正常組。VA濃度變化分組根據妊娠晚期VA濃度減去妊娠早期VA濃度的差值來分組，差值≥0為VA升高組;差值<0為VA降低組。兩種孕婦年齡、兩次采樣的孕齡比較，差異無統計學意義（P>0.05），具有可比性。