Wang Shujia, Shi Minghua, Zhou Li, Huang Hui, Mo Shien
Reproductive Medicine Department, The Reproductive Hospital of Guangxi Zhuang Autonomous Region Nanning 530029, Guangxi, PR China.
Am J Transl Res. 2023 Jun 15;15(6):3838-3845. eCollection 2023.
To investigate maternal vitamin E (tocopherol) levels during pregnancy and maternal and neonatal health (MNH) outcomes by using meta-analysis and systematic review of literature.
PubMed, Web of Science and Medline database were searched from database establishment to December 2022 to collect studies on the level of vitamin E (tocopherol) and pregnancy outcomes. Seven studies were finally included, after screening based on pre-specified eligibility and exclusion criteria. Included studies must have data on maternal vitamin E levels and maternal and infant pregnancy outcomes. Literature quality assessment was made using the Newcastle-Ottawa-Scale scoring standard, and meta-analysis was performed with the use of RevMan5.3.
Seven studies (involving 6247 normal women and 658 adverse pregnancy outcomes women, 6905 total), all with a quality evaluation score ≥6 points, were included. The meta-analysis of the 7 studies revealed the presence of statistical heterogeneity in vitamin E data (<0.1 and >50%), so a random-effects analysis was further carried out. Statistically lower serum vitamin E levels were determined in the adverse pregnancy outcome group compared with the normal group [SMD=4.44, 95% CI (2.44,6.43), <0.001]. Descriptive analysis of the correlation of vitamin E levels with maternal and neonatal general information showed no statistical difference in vitamin E levels among mothers of different ages (<27 years, ≥27 years), =0.214; however, women with BMI<18.5 kg/m showed a higher incidence of vitamin E deficiency than those with BMI ≥18.5 kg/m (χ=15.173, <0.05). Maternal vitamin E level with neonatal weight Z-Score >-2 was [1.793 (0.08, 4.514) mg/L], which was significantly lower than that of maternal vitamin E level with neonatal weight Z-Score ≤-2 [2.223 (0.899,6.958) mg/L], =0.009. Maternal vitamin E levels with neonatal length Z-Score >-2 [1.746 (0.08, 4.514) mg/L] were significantly lower than those with neonatal length Z-Score ≤-2 [2.362 (1.380, 6.958) mg/L], =0.006.
Maternal vitamin E level is lower in those with adverse pregnancy outcomes than that in those with non-adverse pregnancy outcomes. Still, given the limited research on the correlation of vitamin E during pregnancy with maternal BMI and neonatal body length and weight, a large-scale and well-designed cohort study is needed for further analysis.
通过对文献进行荟萃分析和系统评价，研究孕期母体维生素E（生育酚）水平与母婴健康（MNH）结局。
检索PubMed、Web of Science和Medline数据库，从数据库建立至2022年12月，收集关于维生素E（生育酚）水平与妊娠结局的研究。根据预先设定的纳入和排除标准进行筛选后，最终纳入7项研究。纳入的研究必须有母体维生素E水平及母婴妊娠结局的数据。采用纽卡斯尔-渥太华量表评分标准进行文献质量评估，并使用RevMan5.3进行荟萃分析。
纳入7项研究（涉及6247名正常女性和658名不良妊娠结局女性，共6905名），所有研究质量评估得分均≥6分。对这7项研究的荟萃分析显示，维生素E数据存在统计学异质性（<0.1且>50%），因此进一步进行随机效应分析。与正常组相比，不良妊娠结局组的血清维生素E水平在统计学上更低[标准化均数差（SMD）=4.44，95%置信区间（CI）（2.44，6.43），<0.001]。对维生素E水平与母婴一般信息相关性的描述性分析显示，不同年龄（<27岁、≥27岁）母亲的维生素E水平无统计学差异，P=0.214；然而，体重指数（BMI）<18.5 kg/m²的女性维生素E缺乏发生率高于BMI≥18.5 kg/m²的女性（χ²=15.173，<0.05）。新生儿体重Z评分>-2的母体维生素E水平为[1.793（0.08，4.514）mg/L]，显著低于新生儿体重Z评分≤-2的母体维生素E水平[2.223（0.899，6.958）mg/L]，P=0.009。新生儿身长Z评分>-2的母体维生素E水平[1.746（0.08，4.514）mg/L]显著低于新生儿身长Z评分≤-2的母体维生素E水平[2.362（1.380，6.958）mg/L]，P=0.006。
不良妊娠结局者的母体维生素E水平低于非不良妊娠结局者。不过，鉴于孕期维生素E与母体BMI以及新生儿身长和体重相关性的研究有限，需要开展大规模、设计良好的队列研究进行进一步分析。
