Ma Ai-Guo, Chen Xue-Cun, Wang Yu, Xu Rong-Xian, Zheng Ming-Ci, Li Jue-Sheng
Institute of Human Nutrition, Medical College of Qingdao University, 38# Dengzhou Road, 266021 Qingdao, China.
J Nutr Sci Vitaminol (Tokyo). 2004 Apr;50(2):87-92. doi: 10.3177/jnsv.50.87.
Iron-deficiency or anemia in pregnancy is a major public health problem in China. This cross-sectional study was carried out to observe the association between iron status and multiple vitamin levels of Chinese pregnant women in the third trimester. We measured iron, ascorbic acid, retinol, folate and vitamin B12 in serum, and riboflavin in urine specimens of 1,163 pregnant women in four sites throughout rural and city areas in China. Based on hemoglobin concentrations (Hb), the subjects were divided into an anemia group with Hb < 110 g/L or Hb < or = 100 g/L as severe anemia group, and nonanemia group with Hb > or = 110 g/L. Results showed that 41.58% of the population with serum iron < 700 microg/L and 51.04% of the population with ferritin < 12 microg/L in the anemia group, percentages that were much higher than those in the nonanemia group. Relationships between five vitamins and hemoglobin concentrations of all subjects were observed. There was a lower level of serum ascorbic acid (291.05 microg/dL) in the Hb < or = 100 g/L group than in the Hb > or = 120 g/L group (487.79 microg/dL) (p < 0.001). Serum levels of vitamin B12 and folate were 445.67 pg/mL and 5.94 ng/mL in the Hb < or = 100 g/L group, whose levels were much lower than the levels of 502.01 pg/mL (p < 0.012) and 8.07 ng/mL (p < 0.010) respectively in the Hb > or = 120 g/L group. Further, cross-sectional analysis showed positive correlations between abnormal hematological results and prevalences of vitamin deficiencies. The subjects with iron-deficiency anemia had much higher rates of vitamin C, folate and vitamin B12 deficiencies than those in the nonanemic subjects, and especially in the deficient rates of ascorbic acid and folate in the anemia (Hb < 110 g/L) group, which reached 64.04% and 22.70% respectively. Moreover, we observed that the decreasing trends of hemoglobin concentrations were accompanied by the decreases of serum levels of vitamin A, ascorbic acid, folate and vitamin B12. In conclusion, multiple vitamin deficiencies, especially ascorbic acid, retinol and folic acid, may be associated with anemia or iron deficiency in pregnant women in the last trimester. The study suggested that anemic pregnant women in China should be supplemented with iron and multiple vitamins simultaneously.
孕期缺铁或缺铁性贫血是中国一个主要的公共卫生问题。本横断面研究旨在观察中国孕晚期妇女铁营养状况与多种维生素水平之间的关联。我们测定了中国农村和城市四个地区1163名孕妇血清中的铁、抗坏血酸、视黄醇、叶酸和维生素B12，以及尿样中的核黄素。根据血红蛋白浓度（Hb），将研究对象分为贫血组（Hb < 110 g/L）或重度贫血组（Hb <或= 100 g/L），以及非贫血组（Hb≥110 g/L）。结果显示，贫血组中血清铁<700μg/L的人群占41.58%，铁蛋白<12μg/L的人群占51.04%，这些比例远高于非贫血组。观察了所有研究对象的五种维生素与血红蛋白浓度之间的关系。Hb≤100 g/L组的血清抗坏血酸水平（291.05μg/dL）低于Hb≥120 g/L组（487.79μg/dL）（p < 0.001）。Hb≤100 g/L组的血清维生素B₁₂和叶酸水平分别为445.67 pg/mL和5.94 ng/mL，远低于Hb≥120 g/L组的502.01 pg/mL（p < 0.012）和8.07 ng/mL（p < 0.010）。此外，横断面分析显示血液学异常结果与维生素缺乏患病率之间呈正相关。缺铁性贫血患者的维生素C、叶酸和维生素B₁₂缺乏率远高于非贫血患者，尤其是贫血（Hb < 110 g/L）组的抗坏血酸和叶酸缺乏率分别达到64.04%和22.70%。此外，我们观察到血红蛋白浓度的下降趋势伴随着血清维生素A、抗坏血酸、叶酸和维生素B₁₂水平的下降。总之，多种维生素缺乏，尤其是抗坏血酸、视黄醇和叶酸缺乏，可能与孕晚期妇女的贫血或缺铁有关。该研究表明，中国贫血孕妇应同时补充铁剂和多种维生素。
