标题：孕妇及脐带静脉血中VitB12、叶酸和HCY含量与胎儿生长受限的相关性研究

      作者：高颖，杨俊娟，柳蕊    郑州市妇幼保健院产科，河南 郑州 450000

      卷次： 2023年34卷17期

      【摘要】 目的 探讨孕妇及脐带静脉血中VitB12、叶酸及同型半胱氨酸(HCY)的含量与胎儿生长受限(FGR)的相关性。方法 选取 2019年 1月 1日至 2022年 12月 31日在郑州市妇幼保健院产科分娩的 84例FGR患儿作为FGR组，另选择同期在我院分娩的84例正常新生儿作为对照组。比较两组新生儿生长指标、孕妇及脐带静脉血中VitB12、叶酸及HCY含量，采用Pearson相关性检验分析孕妇及脐带静脉血血清VitB12、叶酸及HCY含量与新生儿生长指标的相关性。结果 FGR组出生体质量、出生身长、出生头围分分别为(2.18±0.46) kg、(45.89±1.14) cm、(27.65±0.87) cm，均明显低于对照组的(3.42±0.51) kg、(50.37±1.59) cm、(33.06±0.96) cm，差异均有统计学意义(P<0.05)；FGR组孕妇静脉血血清VitB12、叶酸的含量分别为(54.28±11.69) ng/L、(3.69±1.43) μg/L，脐带静脉血分别为(45.32±10.71) ng/L、(5.22±1.65) μg/L，均明显低于对照组孕妇静脉血的(417.24±57.25) ng/L、(16.77±3.74) μg/L和脐带静脉血的(278.38±58.35) ng/L、(18.35±3.80) μg/L，差异均有统计学意义(P<0.05)；FGR组孕妇静脉血中血清HCY含量为(47.98±7.99) μmol/L，脐带静脉血中血清HCY含量为(28.29±4.87) μmol/L，均高于对照组孕妇静脉血的(8.58±2.51) μmol/L和脐带静脉血的(8.95±2.55) μmol/L，差异均有统计学意义(P<0.05)；经Pearson相关性检验分析结果显示，孕妇静脉血中血清VitB12、叶酸、HCY含量与脐带静脉血中的含量呈正相关(P<0.05)；孕妇及脐带静脉血中血清VitB12、叶酸含量与新生儿出生体质量、出生身长和出生头围呈正相关(P<0.05)，而孕妇及脐带静脉血HCY含量与新生儿出生体质量、出生身长和出生头围呈负相关(P<0.05)。结论 孕妇及脐带静脉血低VitB12、叶酸含量及高HCY含量可能引起FGR发生，临床可根据孕妇静脉血血清VitB12、叶酸及HCY含量推测胎儿是否缺乏VitB12、叶酸，以及HCY含量是否过高，并及时采取干预措施，减少FGR的发生。
      【关键词】 胎儿生长受限；维生素B12；叶酸；同型半胱氨酸；相关性
      【中图分类号】 R714.12 【文献标识码】 A 【文章编号】 1003—6350（2023）17—2540—04

Relationship of the contents of VitB12, folic acid, and HCY in pregnant women and umbilical cord venous bloodwith fetal growth restriction.
GAO Ying, YANG Jun-juan, LIU Rui. Department of Obstetrics, Zhengzhou Maternity andChild Health Hospital, Zhengzhou 450000, Henan, CHINA
【Abstract】 Objective To explore the correlation of the contents of VitB12, folate acid, homocysteine (HCY) inpregnant women and umbilical cord venous blood with fetal growth restriction (FGR). Methods Eighty-four newbornswith FGR born in Zhengzhou Maternity and Child Health Hospital from January 1, 2019 to December 31, 2022 were se-lected as the FGR group, and 84 normal newborns born in the hospital at the same period were selected as the controlgroup. The neonatal growth indicators, the contents of VitB12, folic acid, and HCY in pregnant women and umbilical cordvenous blood were compared between the two groups. The correlation of the contents of VitB12, folic acid, and HCY inpregnant women and umbilical cord venous blood with neonatal growth indicators was analyzed by Pearson correlationtest. Results The birth weight, birth length, and birth head circumference of the FGR group were (2.18±0.46) kg, (45.89±1.14) cm, and (27.65±0.87) cm, respectively, which were significantly lower than (3.42±0.51) kg, (50.37±1.59) cm,and (33.06±0.96) cm of the control group (P<0.05). The contents of VitB12, folic acid were (54.28±11.69) ng/L, (3.69±1.43) μg/L in venous blood of pregnant women and (45.32±10.71) ng/L, (5.22±1.65) μg/L in umbilical cord venousblood in FGR group, which were significantly lower than (417.24±57.25) ng/L, (16.77±3.74) μg/L in venous blood of preg-nant women and (278.38±58.35) ng/L, (18.35±3.80) μg/L in umbilical cord venous blood in the control group (P<0.05).The content of HCY was (47.98±7.99) μmol/L in venous blood of pregnant women and (28.29±4.87) μmol/L in umbilicalcord venous blood in the FGR group, which was significantly higher than (8.58±2.51) μmol/L and (8.95±2.55) μmol/L inthe control group (P<0.05). Pearson correlation results showed that the contents of serum VitB12, folic acid, and HCY invenous blood of pregnant women were positively correlated with those in umbilical cord venous blood (P<0.05); the se-rum VitB12 and folic acid content of pregnant women and umbilical cord venous blood were positively correlated withthe birth weight, birth length, and birth head circumference of the newborn (P<0.05), while the HCY content of pregnantwomen and umbilical venous blood was negatively correlated with the birth weight, birth length, and birth head circum-ference of the newborn (P<0.05). Conclusion FGR may be caused by low contents of VitB12, folic acid and high con-tent of HCY in pregnant women and umbilical venous blood. Clinically, whether the fetus lacks VitB12, folic acid and hasabnormally high HCY can be inferred according to the contents of VitB12, folic acid, and HCY in venous blood of preg-nant women, and timely intervention measures should be taken to reduce the occurrence of FGR.
      【Key words】 Fetal growth restriction; Vitamin B12; Folic acid; Homocysteine; Correlation