妊娠期维生素A缺乏现状及对新生儿体格指标的影响

周倩珺　蒋敏桥　李仲均　殷婉萍　黄巧如

[关键词] 维生素A;妊娠;变化;出生体重;体重指数

[中图分类号] R725.6          [文献标识码] B          [文章编号] 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）

妊娠期是妇女的一个特殊时期，孕妇需要同时满足自身和胎儿的营养需求，因此需要的营养素更多，更容易出现营养素缺乏的情况。维生素A（Vitamin A，VA）是一种重要的脂溶性维生素，妊娠期维生素A缺乏（Vitamin A deficiency，VAD），不仅会损害到母体的健康，还会影响胎儿的正常发育，出现发育迟缓，甚至畸形等后果[1]。本研究拟通过分析健康孕妇不同妊娠期VA营养状况与新生儿体格发育指标之间的关系，评估VA在胎儿体格发育中的作用，为孕期合理补充VA提供建议，现报道如下。

1 资料与方法

1.1 一般資料

本研究为回顾性研究，选择2018年1月至2019年6月来我院产检和分娩的孕产妇作为研究对象。纳入标准：①单胎妊娠;②妊娠早期和晚期均检测血清维生素A浓度;③新生儿出生时无畸形，并记录身长和体重;④产妇及其家属同意将相关数据纳入该研究，并书面签署知情同意书。排除标准：①多胎妊娠;②存在妊娠相关的脏器功能能障碍，或慢性的脏器功能障碍者;③任何一次检测结果提示维生素A过量者（血清维生素A浓度≥0.7 mg/L）;④有妊娠期糖尿病或妊娠高血压综合征等妊娠期合并症者;⑤采集的数据不全或存在明显偏倚者。经上述纳入及排除标准严格的筛选后，共有855例孕产妇及新生儿的数据纳入统计分析，产妇年龄19～45岁，平均（30.12±4.55）岁。该研究经东莞市人民医院医学伦理委员会审核并批准实施。维生素A浓度参考文献[2]进行分组，血清VA浓度<0.30 mg/L为VA缺乏组;血清VA浓度范围为0.30～0.69 mg/L为VA正常组。VA浓度变化分组根据妊娠晚期VA浓度减去妊娠早期VA浓度的差值来分组，差值≥0为VA升高组;差值<0为VA降低组。两种孕妇年龄、两次采样的孕龄比较，差异无统计学意义（P>0.05），具有可比性。