母亲孕晚期膳食维生素A摄入对新生儿维生素A水平的影响及其相关因素分析

Effects of dietary vitamin A intake in late pregnancy on the neonatal vitamin A level and related factors

目的探讨母亲孕晚期膳食维生素A (vitamin A,VA)摄入情况对新生儿VA水平的影响。方法根据纳入标准,纳入2016年10—12月在重庆医科大学附属第二医院分娩的孕妇及其新生儿,采集脐血并收集相关病例资料,应用食物频率法调查孕母亲孕晚期膳食情况,采用高效液相色谱-串联质谱(high performance liquid chromatography tandem mass spectrometry,HPLC-MS/MS)法检测脐血视黄醇水平,采用t检验或方差分析分析其影响。结果共收集孕母亲-新生儿完整资料98对,其中母亲孕晚期膳食VA摄入过量的达12. 24%,充足率达75. 51%,不足率占12. 24%;而补充VA制剂的孕母亲中仍有8. 11%摄入不足。孕母亲孕晚期VA摄入充足组其新生儿脐血视黄醇水平明显高于不足组(P=0. 000),其中视黄醇水平随红黄色水果、肝脏摄入量的增多而升高(P=0. 000,0. 010);而鱼、虾、贝、蛋、牛奶和深色蔬菜摄入量以及是否补充VA制剂均未见与新生儿视黄醇水平相关(P均> 0. 05)。新生儿视黄醇水平≥0. 70μmol/L组,其出生体质量和头围显著高于视黄醇水平<0. 70μmol/L组(P=0. 000,0. 040),Pearson相关分析示视黄醇水平与体质量呈显著正相关(r=0. 245,P=0. 015)。结论孕母亲孕晚期VA摄入不足和过量者仍较多;新生儿VA水平受到孕母亲孕晚期膳食的影响,新生儿出生时体质量和头围与VA水平相关,提示加强孕期营养指导促进儿童早期发展很有必要。

Objective To explore the effects of dietary vitamin A （VA） intake in late pregnancy on VA level in neonates. Methods According to the inclusion criteria, the neonates born from October to November 2016 at the Second Affiliated Hospital of Chongqing Medical University and their mothers were included, and umbilical cord blood and related case data were collected. The dietary status of pregnant women at the late stage of pregnancy was investigated by food frequency method, the blood retinol levels were measured by high performance liquid chromatography tandem mass spectrometry （HPLC-MS/MS） method and t test or variance analysis were used to analyze the effects. Results Totally 98 mothers and their neonates were included. The excess intake of VA in the mother s late pregnancy reached 12.24%, with a sufficient rate of 75.51% and a deficient rate of 12.24%.And still, there was a deficient rate of 8.11% among pregnant mothers who took VA supplements. The neonatal umbilical cord blood retinol levels of group in which pregnant mothers took sufficient VA in late pregnancy were obviously higher than that of group in which pregnant mothers took insufficient VA （ P =0.000）, and the levels of retinol increased with the increase of the intake of red-yellow fruits and liver （ P =0.000, 0.010）. However, there was no correlation between the neonatal VA level and the intake of fish, shrimp, shell, eggs, milk, dark vegetables, and VA supplements （all P 〉0.05）. The birth weight and head circumference of group in which neonatal retinol levels ≥0.70 μmol/L were significantly higher than that of retinol levels 〈0.70 μmol/L （ P =0.000, 0.040）. Pearson correlation analysis showed that there was a significant positive correlation between retinol level and body weight （ r =0.245, P =0.245）. Conclusion There are still some pregnant mothers who took insufficient and excessive VA in late pregnancy. The neonatal VA level is affected by the diet of mothers in late pregnancy. The birth weight and head circumference of the newborn are related to the VA level. It is necessary to strengthen nutrition guidance during pregnancy to promote early development of children.