宫内生长受限婴儿与出生体重正常婴儿脐带血和母血中维生素A、叶酸及铁的浓度

Vitamin A, folate, and iron concentrations in cord and maternal blood of intra-uterine growth retarded and appropriate birth weight babies.

作者信息

Rondo P H, Abbott R, Rodrigues L C, Tomkins A M

机构信息

Nutrition Department, Public Health School, University of Sao Paulo, Brazil.

出版信息

Eur J Clin Nutr. 1995 Jun;49(6):391-9.

PMID:7656882

Abstract

OBJECTIVES

(i) To evaluate the relationship between the levels of vitamin A, folate and iron in maternal blood and cord blood from mother-baby pairs who had intra-uterine growth retardation (IUGR) and appropriate birth weight (ABW) for gestational age. (ii) To assess low or marginal levels of vitamin A, folate and iron as risk factors for IUGR.

DESIGN

Retrospective unmatched case-control study.

SETTING

Maternidade de Campinas, Universidade Estadual de Campinas, Pontificia Universidade Catolica de Campinas, Hospital Albert Sabin.

SUBJECTS

356 mother-baby pairs who had IUGR and 356 mother-baby pairs who had ABW for gestational age.

INTERVENTIONS

Newborns were classified as being IUGR according to the Lubchenco classification. Gestational age of the newborns was evaluated by the Capurro method. Vitamin A, folate, ferritin, and haemoglobin were measured respectively by high performance liquid chromatography (HPLC), radioimmunoassay, immunoenzymetric assay and by the cyanmethaemoglobin method.

RESULTS

The percentages of IUGR babies with abnormal levels of nutritional indices compared with ABW babies were 33.1 vs 14.6 for vitamin A, 25.7 vs 19.9 for red blood cell (RBC) folate, 37.0 vs 21.4 for haemoglobin, but similar for ferritin. The percentages of IUGR mothers with abnormal levels of nutritional indices compared to ABW mothers were similar (1.1 vs 1.4) for vitamin A, and 36.8 vs 32.1 for RBC folate. IUGR mothers were less often anaemic (43.2 vs 50.8), but tended to have higher levels of ferritin (37.6 vs 23.9) compared to ABW mothers.

CONCLUSIONS

These results indicate marked differences in cord blood between IUGR and ABW with small differences in maternal levels. They suggest that micronutrient deficiency is the result of being born small rather than vice versa. The high levels of ferritin in IUGR mothers may reflect subclinical maternal infection contributing to IUGR. Maternal micronutrient deficiency is unlikely to be a causative factor for IUGR in this population.

SPONSORSHIP

ODA (Overseas Development Agency), United Kingdom; CNPq (Conselho Nacional de Desenvolvimento Cientifico e Tecnologico), Brazil.

摘要

目的

（i）评估患有宫内生长受限（IUGR）和适于胎龄出生体重（ABW）的母婴对中母血和脐血中维生素A、叶酸和铁水平之间的关系。（ii）评估维生素A、叶酸和铁的低水平或边缘水平作为IUGR的风险因素。

设计

回顾性非匹配病例对照研究。

地点

坎皮纳斯州立大学坎皮纳斯妇产医院、坎皮纳斯天主教大学、阿尔贝托·萨宾医院。

研究对象

356对患有IUGR的母婴对和356对适于胎龄出生体重的母婴对。

干预措施

根据卢申科分类法将新生儿分类为患有IUGR。通过卡普罗法评估新生儿的胎龄。分别采用高效液相色谱法（HPLC）、放射免疫分析法、免疫酶分析法和氰化高铁血红蛋白法测量维生素A、叶酸、铁蛋白和血红蛋白。

结果

与ABW婴儿相比，营养指标水平异常的IUGR婴儿的百分比，维生素A为33.1%对14.6%，红细胞（RBC）叶酸为25.7%对19.9%，血红蛋白为37.0%对21.4%，但铁蛋白相似。与ABW母亲相比，营养指标水平异常的IUGR母亲的百分比，维生素A相似（1.1%对1.4%），RBC叶酸为36.8%对32.1%。与ABW母亲相比，IUGR母亲贫血的情况较少（43.2%对50.8%），但铁蛋白水平往往较高（37.6对23.9）。