孕妇血清叶酸浓度对新生儿出生体重的影响

Effect of pregnant serum folate concentration on newborn’s birth weight

目的研究孕妇血清叶酸浓度对新生儿出生体重的影响。方法采用前瞻性队列研究,选取2016年6月-2018年8月在河北省某县产检、分娩的490名18~45岁孕妇及其新生儿纳入研究。孕妇均于孕20周前纳入并采集静脉血,收集基本情况及叶酸补充剂服用情况;分娩时收集新生儿性别、分娩孕周、出生体重等基本信息。测定孕妇血清叶酸值,以孕妇血清叶酸四分位数为切点,将孕妇分为4组,采用一般线性模型及多因素非条件Logistic回归分析研究4组孕妇血清叶酸对新生儿出生体重的影响。结果孕妇年龄为(27.9±4.1)岁,血清叶酸P50(P25,P75)为12.3(9.0,14.5)ng/mL;叶酸检测时间为孕(13.7±2.6)周;49.3%(242/490)的新生儿为男性,婴儿分娩孕周为(39.1±1.0)周,出生体重为(3403±425)g。4组孕妇的新生儿出生体重分别为(3408±456)、(3405±450)、(3427±418)和(3374±378)g。一般线性模型分析发现,血清叶酸浓度对新生儿出生体重影响差异无统计学意义[血清叶酸值<9.0 ng/mL(β=32.24,P=0.55),血清叶酸值9.0~12.2 ng/mL(β=18.01,P=0.74),血清叶酸值12.3~14.4 ng/mL(β=42.27,P=0.43)]。多因素非条件Logistic回归分析结果显示,相较于血清叶酸9.0~12.4 ng/mL的孕妇,血清叶酸≥14.5 ng/mL可降低小于胎龄儿发生风险(P=0.02,OR=0.08,95%CI 0.01~0.61),但是血清叶酸浓度与大于胎龄儿发生风险差异无统计学意义。结论孕妇血清叶酸浓度与新生儿出生体重不存在显著关联,但较高浓度叶酸可以降低小于胎龄儿发生风险。

OBJECTIVE To study the effect of pregnant serum folate concentrations on the birth weight.METHODS This study was a prospective cohort study.Pregnant women aged 18-45 who were examined and delivered in a county in Hebei Province from June 2016 to August 2018 and their newborns were included in the study.A total of 490 women were recruited and collected venous blood before the 20 th week of pregnancy.Basic information of women as well as their use of folic acid supplements was collected at the same time.Newborns’basic information,such as sex and birth weight,had been collected after delivery.The chemiluminescence method was used to determine the serum folate concentrations.Folate concentrations quartile were used as the cut-off point to divide subjects into four groups.The general linear model and multivariate unconditional Logistic regression analysis were used to study the effect of different serum folate concentrations on the infant birthweight.RESULTS The age of 490 pregnant women was(27.9±4.1)years.The serum folate value P50(P25,P75)was 12.3(9.0,14.5)ng/mL and its’detection time was(13.7±2.6)weeks.49.3%(242/490)newborns were male.The average gestational age of the newborns was(39.1±1.0)weeks and the average birth weight was(3403±425)g.The birth weight of four groups’newborns were(3408±456)g,(3405±450)g,(3427±418)g and(3374±378)g,respectively.General linear model analysis showed that there was no significant difference in the effect of serum folate levels before the 20 th week of gestation on the birth weight(serum folate concentration<9.0 ng/mL(β=32.24,P=0.55),serum folate concentration 9.0-12.2(β=18.01,P=0.74),serum folate concentration 12.3-14.4(β=42.27,P=0.43)].Multivariate unconditional Logistic regression analysis showed that the group with folate concentration above 14.5 ng/mL can reduce the risk of small for gestational age(SGA)[(P=0.02,OR=0.08(95%CI 0.01-0.61)].Comparing with ghe pregnant women whose serum folate concentration was in 9.0-12.4 ng/mL.Hovever,there was no significant difference between the pregnant serum folate levels and large for gestational age(LGA).CONCLUSION There was no significant correlation between serum folate concentrations and the birth weight.But higher folate level may reduce the risk of SGA.