孕产妇血清与新生儿脐带血中维生素A、E、D、K水平差异性研究OA

Objective This study aims to analyze the differences in the levels of fat-soluble vitamins(A,E,D,K)in the serum of pregnant women and the umbilical cord blood of newborns,as well as the related influencing factors.Methods A total of 5 240 healthy pregnant women who delivered at Dali prefecture people's hospital between June 2023 and November 2024 were enrolled as study subjects,including 4 677 singleton newborns and 304 twin newborns.Venous blood samples from the mothers during prenatal examinations or before labor,as well as umbilical cord blood samples from the newborns,were collected.Levels of vitamin A(VA),vitamin E(VE),25-hydroxyvitamin D(VD,VD2,VD3),vitamin K1(VK1),vitamin K2-MK-4(MK-4),and vitamin K2-MK-7(MK-7)were measured using high-performance liquid chromatography-tandem mass spectrometry(HPLC-MS/MS).The correlation between maternal and neonatal vitamin levels and their influencing factors were analyzed.Results The levels of VA,VD,VD2,VD3,VE,VK1,MK-4,and MK-7 in umbilical cord blood were significantly lower than those in the pregnant women's serum,and the differences were statistically significant(t=88.7,78.0,32.0,70.0,196.8,4.8,23.9,and 51.7,respectively,all P<0.05).Except for VD2,K1,and MK-4(t=-0.6,0.1,and-0.9,respectively,all P>0.05),the levels of other vitamins showed significant differences between single-birth and twin-born infants(t=4.7,-5.0,-5.0,-11.3,and-6.9,respectively,all P<0.05).The levels of VA,VD,(total VD,VD2,VD3),VE,VK1,MK-4,and MK-7 in umbilical cord blood were not significantly correlated with the corresponding levels in the pregnant women's serum(all P>0.05).Multivariate Logistic regression analysis showed that after adjusting for the mutual influence of vitamins,the levels of VA(OR=105.2,95%CI:32.34-339.13,P<0.001),VD2(OR=0.60,95%CI:0.55-0.66,P<0.001),VE(OR=0.47,95%CI:0.44-0.49,P<0.001),MK-4(OR=0.56,95%CI:0.37-0.85,P=0.001),and MK-7(OR=0.93,95%CI:0.87-0.99,P<0.05)in the pregnant women's serum were independently associated with the risk of vitamin D deficiency in the newborn's umbilical cord blood,but the OR value of VA was greatly amplified due to the unit effect(after conversion to 0.1 mg/L,the OR was approximately 1.59),and this association was inconsistent with the correlation analysis results,and should not be interpreted as a causal or independent predictive factor.Further verification is required.Conclusion The levels of fat-soluble vitamins in the umbilical cord blood of newborns were significantly lower than those in the pregnant women,or were related to placental selective transport and the nutritional status of pregnant women.There was no significant linear correlation between the vitamin levels of mothers and infants.This suggests that the vitamin levels in the umbilical cord blood of newborns cannot be directly predicted by the vitamin levels in the pregnant women's serum.This study provides a basis for maternal and infant nutrition management in the plateau region.