妊娠早期血清同型半胱氨酸水平在个体化叶酸补服中的应用

目的结合孕妇叶酸代谢能力基因检测结果,研究不同方式叶酸补服后不同妊娠时期血清同型半胱氨酸的水平,探讨妊娠早期血清同型半胱氨酸水平在个体化叶酸补服中的指导价值。方法纳入430名符合条件的孕妇,根据叶酸代谢能力基因检测结果分为观察组(中度风险者、高度风险者)130例和对照组(低风险者、未发现风险者)300例,分别给予孕妇不同方式口服叶酸,跟踪监测并记录分析两组妊娠早、中、晚期血清同型半胱氨酸的水平和妊娠期并发症及妊娠结局情况。结果妊娠早期观察组的血清同型半胱氨酸水平高于对照组,差异有统计学意义(P0.05),个体化叶酸补服后妊娠中、晚期两组血清同型半胱氨酸水平差异无统计学意义(P0.05)。组内妊娠中期与妊娠晚期血清同型半胱氨酸水平比较,无论是观察组还是对照组,差异均无统计学意义(P0.05)。两组间妊娠期并发症(妊娠期糖尿病、妊娠期高血压疾病、妊娠晚期贫血)及不良妊娠结局(低体质量儿、巨大儿、神经管畸形、唐氏综合征)差异无统计学意义(P0.05)。结论妊娠早期血清同型半胱氨酸水平异常增高时,提示孕妇有存在叶酸代谢障碍的风险。血清同型半胱氨酸水平可以作为反映孕妇叶酸代谢能力风险等级的参考指标,用于指导孕妇个体化叶酸补服,以减少妊娠期并发症及不良妊娠结局。     

妊娠期妇女的人体测量及脂肪贮存

本文对30名居住北京城近郊区的健康初产孕妇,于妊娠早期、中期及末期连续进行人体测量,包括身长,体重,皮下脂肪厚度和肢体围,以观察孕期体重增长,身体脂肪含量及肌肉情况。测量结果,受试者从妊娠6周至37周平均体重增长13.0kg。三头肌、二头肌部位皮脂厚度在孕期无明显变化。肩胛下皮脂厚度至孕末期时明显较早期增加。髂骨上皮脂厚度在孕中期及末期均有明显增长,与早期相比差別显著。据皮脂厚度计算身体密度及脂肪含量络果,至孕末期身体脂肪含量占体重的百分比共增加3.7％。肢体围测量结果,仅臀围在妊娠中期后至末期明显较早期增大。大腿上部围略有增加,但与早期差别无显著意义。大腿中部、小腿腓肠肌部及上臂围孕期均无明显变化。     

孕妇血清叶酸浓度对新生儿出生体重的影响

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。     

胎儿生长受限孕妇妊娠晚期血清同型半胱氨酸表达水平及意义

目的分析胎儿生长受限孕妇妊娠晚期血清同型半胱氨酸(Hcy)表达水平。方法选择胎儿生长受限妊娠晚期孕妇61例,作为观察组,另外选择同期健康妊娠晚期孕妇65例,作为对照组,两组孕妇及新生儿均接受血清Hcy检测,检查两组孕妇体内叶酸、维生素B_(12)水平,观察两组新生儿出生体重及分娩孕周。结果观察组孕妇及新生儿血清Hcy高于对照组(P0.05),叶酸、维生素B_(12)水平、新生儿出生体重、分娩孕周低于对照组(P0.05)。结论孕妇妊娠晚期血清Hcy表达水平升高时,易导致胎儿生长受限,影响分娩结局。     

妊娠期服用《母宝改良品》的临床和实验观察

本研究以118名正常孕中期妇女为研究对象,将其随机分成两组,母宝组和对照组,分别加服母宝改良品和钙尔奇—D片,连续服用12周以上直到分娩。服用期观察孕妇体重、并记录排便情况、有无并发症、产后泌乳情况及胎儿的出生体重。于实验前(孕中期)及分娩时(孕后期)取两组孕妇静脉血,并于产后取脐血,检测血红蛋白、血清铁蛋白、血清白蛋白、血清叶酸、红细胞叶酸及血清钙。结果表明母宝改良品的补充对孕妇的排便、产后的泌乳情况、新生儿体重无不良影响。孕期每日服用14％母宝改良品调乳液400ml,可促进孕妇对铁、叶酸的贮存,维持蛋白质和钙的良好营养状态。     

孕期妇女体重增加的探讨

上海市中福会国际和平妇幼保健院１９９３～１９９４年门诊产前检查确定为怀孕的２０００名妇女，从妊娠开始进行追踪调查，到分娩正常出生体重的活婴为止。观察项目包括，膳食调查３ｄ记录法，孕妇孕前及孕期体格检查，新生儿体格检查，并根据孕前体重、身高，计算孕前身体质量指数（ＢＭＩ）。根据ＢＭＩ不同，将孕妇分为４组。结果分娩正常出生体重婴儿的孕妇，孕期总增重平均为１５ｋｇ，较以往１２ｋｇ有较大的提高。孕早期体重增加很少，至孕１５ｗ不足２ｋｇ，从孕１７ｗ起，增重明显。孕中期平均每周增重０．２～０．９ｋｇ，孕晚期为０．４～０．８ｋｇ，孕中与孕晚期各周增重均无明显差别，与孕晚期增重高于孕中期的看法尚不一致。不同的ＢＭＩ４组孕妇间，孕期增重水平并无显著性差别，而婴儿出生体重随孕前ＢＭＩ的增大而增加，有统计学意义。此外本次调查发现，ＢＭＩ＜１９．８，１９．８～２６．０，２６．０～２９．０间的３组孕妇，其孕期营养素摄入水平并无明显差别。     

妊娠神经管畸形孕妇血清叶酸与同型半胱氨酸水平分析

目的:比较妊娠早期神经管畸形(neural tube defects,NTDs)孕妇及正常孕妇血清叶酸和同型半胱氨酸(ho-mocysteine,Hcy)水平,分析两种物质的代谢水平与妊娠NTDs的关系。方法:采用病例对照研究方法,以NTDs高发的山西省5个县作为研究现场,选择9所医院收集研究对象,对所有研究对象采集肘静脉血5ml,检测其血清叶酸和Hcy水平,比较病例组和对照组血清叶酸和Hcy的差异。分别以对照组血清叶酸和Hcy浓度的第10和第90百分位数作为界值,划分为2个水平组,比较不同水平组NTDs的发病风险。结果:妊娠NTDs孕妇血清平均叶酸水平显著低于对照组(10.4nmol/Lvs14.7nmol/L,P0.05),同时血清Hcy高于对照组,差异无统计学意义。低叶酸水平孕妇妊娠NTDs的危险性显著增加(AOR=3.0,95%CI为1.2～7.7)。结论:孕期血清叶酸低水平是研究人群NTDs发生的危险因素。     

妊娠早期血清叶酸水平与婴儿体格及智能发育的关联研究

目的 探讨妊娠早期孕妇血清叶酸水平与婴儿体格及智能发育的关系。方法 依据合肥市行政区域经济发展水平和地理位置情况选取四个区,2018年12月至2019年8月在各区随机抽取1个孕产妇保健手册办理单位,选取妊娠早期(12～12⁺⁶周)496例孕妇作为研究对象,采集3～5mL肘静脉血检测血清叶酸含量,分别于6、12月龄进行体格测量及智能发育的评估。结果 6月龄时低叶酸水平组头围发育低下率高于正常叶酸组和高叶酸组(χ²=9.585,P<0.05),身长和体重发育无统计学差异(P>0.05);12月龄时低叶酸水平组体重和头围发育低下率均高于正常叶酸组和高叶酸组(χ²值分别为12.858、18.449,P<0.05),身长发育各组之间差异无统计学意义(P>0.05);多因素Logistic回归分析显示,6月龄叶酸在(16.66～19.30)ng/mL范围时,智力发育异常率较低,其OR值及95%CI为0.103(0.011～0.961);12月龄时未发现叶酸水平与婴儿智力及精神发育的关联(P>0.05)。...     

孕妇血清抗心磷脂抗体水平与妊娠结局的关系

目的：阐述孕妇血清抗心磷脂抗体（ACA）水平与妊娠结局的关系。方法：采用ELISA测定309名妊娠晚期妇女的血清ACA－IgM、IgA、IgG综合指数，观察孕妇血清ACA水平与妊娠并发症，新生儿低出生体重及围产儿缺氧的关系。结果：妊娠并发症组、低出生体重组和围产儿缺氧组ACA结合指数的变化以IgM、IgA为主，与对照组比较，各组ACA－IgM、IgA结合指数均显著增高（P＜0．001－0．05）；妊娠并发症组ACA－IgG结合指数显著增高（P＜0．001），轻度和中、重度妊高征患者间ACA结合指数无显著性差异（P均＞0．05）；低体重儿组新生儿本重与ACA结合指数无显著相关性（P均＞0．1），1种并发症和2种并发症患者间比较，ACA－IgM、IgG无明显性差异（P＞0．1，P＞0．05，ACA－IgA有显著性差异（P＜0．001）。结论：孕妇血清ACA水平增高可能与妊娠并症、低出生体重、围产儿缺氧等不良妊娠结局的发生有关。     

孕妇血清Hcy水平对婴儿认知-运动发育的影响

目的 探讨孕妇血清同型半胱氨酸(Hcy)水平与婴儿认知-运动发育的关系。方法 选取2020年4月～5月合肥市区594名孕中期孕妇作为研究对象,孕妇年龄20～35岁,孕周15～20⁺⁶周,同时测定孕妇血清Hcy水平。采用年龄与发育进程问卷(ASQ-3)进行评估,主要包括沟通、粗大动作、精细动作、问题解决、个人-社交技能5个方面的发育状况。收集妊娠结局和婴儿6月龄、12月龄认知-运动发育评估结果,采用Pearson相关性分析孕期血清Hcy水平与婴儿认知-运动发育情况的相关性;采用线性回归分析孕期血清Hcy水平与婴儿认知-运动发育水平间关系。结果 单因素分析结果显示,婴儿6月龄ASQ-3各方面得分在出生体重、是否早产、血清Hcy水平的差异均无统计学意义。婴儿12月龄ASQ-3各方面得分在出生体重、是否早产的差异均无统计学意义。不同血清Hcy水平婴儿12月龄婴儿精细动作发育得分比较,差异有统计学意义。相关性分析结果显示,孕期血清Hcy水平与婴儿12月龄精细动作发育得分呈负相关,且差异有统计学意义(r=-0.123,P<0.05)。线性回归分析结果显示,孕期血清Hcy...     

Maternal serum folate and zinc concentrations and their relationships to pregnancy outcome.

To evaluate the relationship between folate and zinc, and its effect on pregnancy outcome, maternal serum folate and zinc concentrations were determined at 18 and 30 wk gestation in a defined population of 285 pregnant women as part of a large-scale study to identify risk factors for fetal growth retardation (FGR). These results were correlated with birth weight and Apgar scores of newborn infants and with maternal infections during the perinatal period. A weak linear relationship was observed between maternal serum folate and zinc concentrations at 30 wk gestation. Folic acid supplementation had favorable effects on birth weight and Apgar scores of newborns, and reduced prevalence of FGR and maternal infections. No significant correlation was found between serum zinc concentration and birth weight of infants. The concept that folic acid supplementation has an adverse effect on maternal zinc nutriture and pregnancy outcome was not supported.     

Dietary folate intake during pregnancy and birth weight in Japan

BACKGROUND: Inadequate folate status has been associated with many negative reproductive outcomes, such as neural tube defects (NTD), low birth weight and placental abruption. AIM OF THE STUDY: The objectives of this study were to evaluate the levels of dietary folate intake during pregnancy in Japanese women and the subsequent birth weight of their babies. METHODS: A longitudinal prospective study was conducted with 197 women with a singleton pregnancy in 2005. Dietary folate was investigated 3 times: in the first trimester at 12 weeks, in the second trimester at 20 weeks and in third trimester at 32 weeks using a diet history questionnaire (DHQ). Non fasting blood samples were collected from the women for measurement of homocysteine, hemoglobin, ferritin, unbound iron-binding capacity (UIBC) and total iron-binding capacity (TIBC). RESULTS: Energy intake increased as pregnancy advanced, but not significantly. The daily intake of folate increased from 248.5 +/- 113.1 microg/d in the first trimester to 275.4 +/- 100.2 microg/d in the third trimester (P = 0.04). This was well below the recommended level of 440 microg/d and only 10% of mothers were above the levels. In the third trimester, plasma homocysteine concentration was significantly higher in the low folate group of less than 250 microg/d (P = 0.02), but not the first and second trimesters. Dietary folate intake and plasma homocysteine concentrations were not likely to be predictors of birth weight in our subjects. CONCLUSIONS: Our study shows that Japanese women's energy and folate intakes do not meet their energy needs during pregnancy and are at an extremely low recommended dietary allowance level throughout pregnancy.     

Evidence from the National Survey of Family Growth. Work during pregnancy and subsequent hospitalization of mothers and infants.

Large and increasing proportions of women work late into pregnancy and resume work soon after delivery. If work in those periods injures their health or that of their infants, this trend would be of public health concern. Data on ever-married primaparas from the National Survey of Family Growth conducted by the National Center for Health Statistics were used to investigate the relationship between working in the last trimester of pregnancy and two indicators of illness--hospitalization of women for complications of pregnancy and hospitalization of their infants during the first year of life. Hospitalization of the mother or child occurred for 15.0 percent of the primaparas. For primaparas who worked in the last trimester of pregnancy, the percentage was slightly higher--17.1 percent. In two groups, black women and women without hospital insurance for delivery, the percentage of mothers or infants hospitalized was much higher among the mothers who worked in the third trimester than among those who did not. The association of working late in pregnancy with higher rates of hospitalization does not mean, necessarily, that working is a cause of hospitalization. It does indicate, however, the need for epidemiologic and medical research on the relationship.     

Hematologic and vitamin status of african american women and their relationships to pregnancy outcome

A prospective observational study was conducted to investigate the effects of nutrition and related factors on the outcome of pregnancy in nulliparous African American women 16–35 years of age. Blood samples from a subset of these subjects were taken during the first (1st), second (2nd) and third (3rd) trimesters of pregnancy and at delivery. Cord blood samples were also collected at delivery. Levels of selected biochemical variables including serum ferritin, vitamin B₁₂ and folate as well as whole blood folate, and selected hematologic indices were determined and correlated with pregnancy outcome variables. During the second trimester of pregnancy, values for hematocrit and hemoglobin were less than 30% and 11 g/dL, respectively, in 16% and 30% of the participants, respectively. Serum and whole blood (WB) folate increased sequentially during pregnancy. Cord concentrations of serum folate were significantly higher than maternal concentrations at delivery (P<0.05). Serum ferritin declined significantly from 36±5.6 ng/ml in the first trimester to 17±1.5 ng/ml during the 3rd trimester (P<0.05), and returned to the 2nd trimester level (26±2.0 ng/ml) at delivery. Second trimester WB folate was positively related to birth weight (R²=0.21), while gestational age was inversely correlated with 3rd trimester vitamin B₁₂ (R²=0.34). These data suggest that vitamin B₁₂ and folate play an important role in the outcome of pregnancy in this population.     

Relationship between dietary folate intakes,maternal plasma total homocysteine and B-vitamins during pregnancy and fetal growth in Japan

Background Adequate folate status in pregnancy is important for satisfactory pregnancy outcome. Aim of the Study The objective of the present study was to evaluate folate status in healthy pregnant women by assessing dietary folate intakes and measuring changes in folate-related biomarkers including plasma tHcy, serum vitamin B₁₂ (B₁₂), and serum and RBC folate concentrations in each trimester and to examine their relation to fetal growth. Methods From 94 pregnant women, 3-day-dietary records were obtained and blood was collected for plasma total homocysteine (tHcy), serum B₁₂, and serum and red-blood cell (RBC) folate measurements. Infant anthropometric measurements were made immediately after birth. Results Average folate intake was less than 300 μg/day with a mean energy intake of about 1800 kcal. Mean serum and RBC folate concentrations declined significantly during gestation (p < 0.05). Mean serum B₁₂ also significantly decreased (p < 0.01), whereas plasma tHcy increased from 5.1 in the first trimester to 5.9 μmol/l in the third trimester (p < 0.01). Multiple regression analyses, after controlling for maternal age, parity and pre-pregnancy body-mass index indicated that a 1.0 μmol/l increase in plasma tHcy in the third trimester corresponded to a 151 g decrease in birth weight (p < 0.01). Neither B₁₂ nor folate concentrations in all three trimesters showed any significant associations with birthweight. Plasma pyridoxal-5′-phosphate concentrations were markedly low, and were consistent with low intake of vitamin B₆ in our population. Conclusion Our data suggest that higher plasma tHcy in the third trimester is a predictor of lower birth weight. In general, the dietary intake of B-vitamins and energy may be inadequate in our population, suggesting intervention is necessary.     

Iron, zinc, folate and vitamin B12 nutritional status and milk composition of low-income Brazilian mothers

The purpose of this study was to assess the nutritional status of low-income Brazilian mothers, who were supplemented with iron and vitamin B12 during pregnancy, in terms of iron, zinc, folate and vitamin B12, in different stages of lactation and to determine the influence of the maternal nutritional status on milk composition. The effect of folate supplementation during pregnancy on folate status of the nursing mothers and milk composition was investigated. The effect of partial weaning on maternal status and milk composition was also studied. In general, the nutritional status of iron, zinc, folate and vitamin B12 of the mothers appears adequate. However, some of the mothers had indices of status lower than normal limits for non-pregnant women. These values, particularly after 30 d post-partum, indicate that these mothers might be at nutritional risk and that the nutrient supplementation received during pregnancy was insufficient to meet demands. There was an increase with the stage of lactation for haematocrit, serum vitamin B12, serum zinc, serum albumin, milk folate and saturation of its binding protein, but there was a decrease for milk protein, total and whey-bound iron and zinc, and lactoferrin. Mothers who took folate supplements during pregnancy had higher serum folate levels immediately after birth than those not taking the supplements but no differences were found at later stages of lactation. Milk composition was not affected. Partial weaning did not affect the maternal nutritional status or the milk composition except for iron which was higher in milk from mothers who were partially breastfeeding.(ABSTRACT TRUNCATED AT 250 WORDS)     

A national survey of iron and folate status in pregnant women in Switzerland.

Women often do not meet the increased iron and folate needs of pregnancy. Maternal iron-deficiency anemia is associated with poor maternal and infant outcomes, including preterm delivery and low birth weight. Poor folate status increases risk for maternal anemia, spontaneous abortion, and congenital defects. Because of this, supplemental iron and folate are often recommended during pregnancy. There are few data on iron and folate status in pregnant women in Switzerland. We measured iron and folate status in a national sample of Swiss pregnant women, estimated the prevalence of anemia, and determined if supplement use is associated with iron and/or folate status in this group. A 3-stage probability to size cluster sampling method was used to obtain a representative national sample of pregnant women (n = 381) in the second and third trimester. We measured hemoglobin, hematocrit, mean corpuscular volume, and serum folate and ferritin concentrations. Serum transferrin receptor concentration was determined in anemic subjects. The use of iron and folate supplements was evaluated by questionnaire. Mean hemoglobin (+/- SD) in the sample was 123 g/L (+/- 1.0). The prevalence of anemia was 6%. Of the 21 anemic women, 11 were iron-deficient, giving an iron-deficiency anemia prevalence of 3%. Nineteen percent of women had low serum ferritin concentrations (< 12 micrograms/L) and 4% had low serum folate concentration (< 2.5 micrograms/L). Supplements containing iron were taken by 65% of women, and 63% were taking folate-containing supplements. Women in the second and third trimester taking folate-containing supplements had significantly higher serum folate concentrations compared to those not taking a folate supplement (p < 0.001). In the third trimester, women taking iron-containing supplements had significantly higher serum ferritin concentrations compared to those not taking an iron-containing supplement (p < 0.01). Our findings indicate that iron and folate status appears to be adequate in the majority of pregnant women in Switzerland, and that use of iron and folate supplements may have a positive impact on status.     

Biochemical indexes of the B vitamins in cord serum are predicted by maternal B vitamin status

BACKGROUND: The concentration of total homocysteine (tHcy) is higher in newborns than in older children. Vitamin B-12 is the major determinant of tHcy in newborns. Maternal status of folate, vitamin B-12, and vitamin B-6 during pregnancy may affect the biochemical markers of these micronutrients in newborns. OBJECTIVE: Our objective was to study the relation between concentrations of the metabolites and B vitamins in maternal sera and concentrations in the umbilical venous blood of the corresponding newborns. DESIGN: We studied healthy pregnant women at the time of labor who were expecting healthy, full-term, appropriate-birth-weight babies. Samples were available from 82 mother-infant pairs. RESULTS: Concentrations of B vitamins were higher in cord samples than in maternal blood (folate, 2-fold; vitamin B-12, 1.5-fold; and vitamin B-6, 6-fold). Concentrations of cystathionine and methylmalonic acid (MMA) were also higher in the infants than in the mothers (x +/- SD: cystathionine, 462 +/- 189 and 343 +/- 143 nmol/L; MMA, 353 +/- 144 and 233 +/- 110 nmol/L). No significant differences in tHcy concentrations were observed between fetal and maternal samples. Concentrations of vitamin B-12 did not differ significantly between mothers of infants from different quartiles of cord MMA. Higher fetal MMA concentrations were related to higher maternal MMA and vitamin B-12 concentrations and lower fetal concentrations of vitamin B-12. Fetal concentrations of cystathionine were predicted by maternal cystathionine, gestational age, fetal vitamin B-6, and fetal tHcy. CONCLUSIONS: Maternal concentrations of the metabolic markers of B vitamins predict values in fetal blood at delivery. Fetal tHcy concentrations were low but were predicted by the vitamin status of the mother. The effect of increasing maternal intake of vitamins B-12 and B-6 during pregnancy on the fetal concentrations of the metabolites should be investigated.     

孕前及孕期贫血与新生儿体格发育的关系

目的:探讨孕前及孕期贫血与新生儿体格发育的关系。方法:研究对象为浙江、江苏、河北27个县市1993年1月～1996年12月分娩妇女及其生育的新生儿,共535137例。采用张路指数(ZLI)衡量新生儿体格发育状况。将新生儿按性别和胎龄分层,分析母亲孕前及孕期贫血程度与新生儿ZLI的关系。采用多元逐步回归分析影响新生儿ZLI的相关因素。结果:母亲孕前轻度和中度贫血组新生儿ZLI均值低于母亲孕前非贫血组新生儿ZLI均值。除母亲孕晚期轻度和中度贫血组新生儿ZLI均值高于非贫血组外,母亲孕期轻度、中度和重度贫血组新生儿ZLI均值均低于非贫血组;新生儿ZLI均值随母亲血红蛋白值降低而降低。母亲孕前、孕早期和孕中期贫血与早产儿ZLI均值降低有关,妊娠各期贫血均与足月儿ZLI均值降低有关。在控制了母亲孕早期体重、胎龄、母亲孕期增重及胎数等因素后,孕前血红蛋白值与ZLI呈现正相关关系。结论:孕前及孕期贫血对新生儿体格发育有不利影响。     

Folate intakes and folate biomarker profiles of pregnant Japanese women in the first trimester

OBJECTIVE: To assess the status of dietary folate intake, serum and red blood cell (RBC) folate, and related nutritional biomarkers in healthy Japanese women in early pregnancy. DESIGN: A cross-sectional, observational study. SUBJECTS: Pregnant women in the first trimester, at 7-15 weeks gestation (n=70), who were not consuming any folate supplements or folate fortified foods. METHODS: Three-day dietary records were obtained from each subject to assess dietary folate intake. Blood samples were collected for measurement of biomarkers. Biomarkers and nutrient intake were analyzed in two groups defined by their serum folate concentrations: the low folate group (serum folate < 9 ng/ml) and the high folate group (serum folate > or = 9 ng/ml). RESULT: Mean serum and RBC folate concentrations in all subjects were 10.3 and 519 ng/ml, respectively. These levels were remarkably higher than the reported values from many other countries despite our subjects receiving no folic acids supplements. However, mean folate intake by our subjects from natural foods was 289 microg/day, which is thought to be low according to the Japanese dietary recommendation specified for pregnant women. The intake of spinach and fruits was significantly greater in the high folate group than in the low folate group. CONCLUSION: Folate intake was thought to be adequate to maintain a desirable level of serum folate concentration in Japanese pregnant women in the first trimester, although the intake of folate from natural food was not high enough to meet the recommended daily intake.