叶酸代谢基因多态性及血浆同型半胱氨酸水平与新生儿早产、出生体重的关系

The relationship between folic acid metabolism gene polymorphism, plasma homocysteine level and premature birth and birth weight of newborns

目的探讨叶酸代谢基因多态性及血浆同型半胱氨酸(Hcy)水平与新生儿早产、出生体重的关系。方法选取2016年1月～2017年12月在我院产检并最终在我院分娩的孕妇344例作为研究对象,于孕早期采集口腔黏膜标本进行检测,根据基因检测结果,对叶酸代谢障碍遗传风险进行分级,将其分为中/高风险组182例,无/低风险组162例,同时采血检测其Hcy水平。分析Hcy水平与新生儿早产、出生体重的相关性,比较两组的早产发生率等。结果 Hcy水平与新生儿出生体重成正相关(r=0.143,P=0.008);MTRR A66G基因型与新生儿早产成正相关(r=0.126,P=0.019);基因型总风险与新生儿早产成正相关(r=0.120,P=0.026)。中/高风险组的早产率高于无/低风险组,差异有统计学意义(P=0.027)。分娩巨大儿的孕妇Hcy水平高于分娩正常出生体重儿及低出生体重儿的孕妇,差异有统计学意义(P<0.05);叶酸代谢障碍不同风险程度出生体重分布比较,差异无统计学意义(P=0.483)。结论叶酸利用能力与早产具有相关性,叶酸代谢障碍中/高风险组的早产发生率显著升高;新生儿出生体重受孕母Hcy水平影响,孕母Hcy水平与新生儿出生体重成正相关。

Objective To discuss the relationship between folic acid metabolism gene polymorphism,plasma homocysteine(Hcy)level and premature birth and birth weight of newborns.Methods A total of 344 pregnant women having prenatal examinations and finally giving birth to their children in our hospital from January 2016 to December 2017 were selected as study objects and their oral mucosa specimens at the early pregnancy stage were collected.According to the results of genetic testing,the genetic risk of folic acid metabolic disorder was graded,and they were divided into the middle/high risk group(182 cases)and non/low risk group(162 cases).Blood samples were taken to detect the level of Hcy.The correlation between Hcy level and neonatal preterm birth and birth weight was analyzed,and the incidence of premature birth was compared between the two groups.Results Hcy level was positively correlated with neonatal birth weight(r=0.143,P=0.008);MTRR A66G genotype was positively correlated with neonatal preterm birth(r=0.126,P=0.019);total genotype risk was positively correlated with neonatal preterm birth(r=0.120,P=0.026).The preterm birth rate in the middle/high risk group was higher than that in the non/low risk group(P=0.027).The Hcy level of pregnant women with macrosomia was higher than that of pregnant women with normal birth weight and low birth weight(P<0.05).There was no significant difference in body redistribution among different risk level of folic acid metabolic disorder(P=0.483).Conclusion The utilization of folic acid was correlated with preterm birth.The incidence of preterm birth is significantly increased in the middle/high risk group of folic acid metabolic disorder.Neonatal birth weight is affected by maternal Hcy level,and maternal Hcy level is positively correlated with neonatal birth weight.