VitB12、叶酸、同型半胱氨酸和血管内皮生长因子水平与胎儿生长受限的相关性

Correlation between levels of VitB12,folic acid,homocysteine and vascular endothelial growth factor with fetal growth restriction

目的探讨妊娠晚期孕妇空腹静脉血及脐带静脉血中维生素B12(VitB12)、叶酸、同型半胱氨酸(HCY)及血管内皮生长因子(VEGF)的水平与胎儿生长受限(FGR)的关系。方法选取2019年1月1日至2021年12月31日在郑州市妇幼保健院住院分娩的138例妊娠合并FGR孕妇为FGR组,同期住院分娩的无妊娠并发症且新生儿体重正常的138例孕妇为对照组,比较两组间孕妇空腹静脉血及脐带静脉血中VitB12、叶酸、HCY和VEGF水平,采用Pearson相关分析以上指标与FGR新生儿出生体重之间的关系。结果FGR组孕妇年龄、妊娠合并子痫前期的比例高于对照组,孕期增重低于对照组,差异均有统计学意义(t/χ^(2)值分别为2.027、43.371、-4.513,P<0.05);FGR组孕妇空腹静脉血及脐带静脉血中VitB12、叶酸及VEGF的水平低于对照组,而孕HCY的水平高于对照组,差异均有统计学意义(t值介于-4.757~6.968之间,P<0.05);FGR组孕妇空腹静脉血及脐带静脉血VitB12、叶酸及VEGF水平与新生儿出生体重正相关(r值介于0.540~0.668之间,P<0.05),而HCY水平与新生儿出生体重负相关(r值分别为-0.640、-0.617,P<0.05)。结论妊娠晚期孕妇血中低VitB12、叶酸、VEGF水平或高HCY水平与FGR发生率的增加有关。妊娠晚期监测并及时补充孕妇的VitB12和叶酸,可能有利于防治FGR的发生。

Objective To investigate the relationship between the levels of vitamin B12(VitB12),folic acid,homocysteine(HCY)and vascular endothelial growth factor(VEGF)in fasting and umbilical venous blood of pregnant woman in the third trimester complicated with fetal growth restriction(FGR).Methods 138 pregnant women with FGR who were delivered in Women and Infants Hospital of Zhengzhou from January 1,2019 to December 31,2021 were selected as the FGR group,and 138 pregnant women without pregnancy complications and with normal newborn weight who were delivered in hospital at the same time were selected as the control group.The levels of VitB12,folic acid,HCY and VEGF in fasting and umbilical venous blood of pregnant women were compared between the two groups.Pearson correlation analysis was used to analyze the relationship between the above indicators and birth weight of FGR newborn.Results The age of pregnant women,the proportion of pregnancy with preeclampsia in the FGR group were higher than those in the control group,and the weight gain in pregnancy was lower than that in the control group,the difference was statistically significant(t/χ^(2)values were 2.027,43.371 and-4.513,respectively,P<0.05).The levels of VitB12,folic acid and VEGF in fasting venous blood and umbilical cord venous blood of pregnant women in the FGR group were lower than those in the control group,while the level of HCY in pregnant women were higher than that in the control group,with significant differences(t values ranged from-4.757 to 6.968,P<0.05).The levels of VitB12,folic acid and VEGF in fasting venous blood and umbilical venous blood of pregnant women in the FGR group were positively correlated with birth weight of newborn(r values ranged from 0.540 to 0.668,P<0.05),while HCY level was negatively correlated with birth weight of newborn(r values were 0.640 and-0.617,respectively,P<0.05).Conclusion Low levels of VitB12,folic acid,VEGF or high levels of HCY in the blood of pregnant women in the third trimester of pregnancy are associated with the increased incidence of FGR.Monitoring and timely supplementation of VitB12 and folic acid in late pregnancy women may be beneficial to the prevention and treatment of FGR.