Association Of Nutrients Status Of Pregnant Women With The Risk Of Anembryonic Pregnancy

Recently,with the improvemnent of eugenics consciousness and wide use of ultrasound scan,more and more anembryonic pregnancies have been found.Many pregnant women and their family were burdened with anembryonic pregnancy.There are some issues in studies about anembryonic pregnancy:first,the objects of many studies were consisted of women with anembryonic pregnancy and dead embryo pregnancy,which caused diagnosis bias.Second,there are few studies on the association of nutrients status of pregnant women with anembryonic pregnancy. Third,the pathomorphology of anembryonic pregnancy were hardly reported.Objective:1) To study the epidemiology characteristic of anembryonic pregnancy and give some advice to future prevention of anembryonic pregnancy.2) To study the association of nutrients status of pregnant women with the risk of anembryonic pregnancy and establish the discirminant function,which can be helpful for future diagnosis and prevention of anembryonic pregnancy.3) To provide information for future intervention of diet behavior by qualitative investigation which was used to investigate the diet behavior of the local villager.Methods:Four hospitals in four districts with high prevalence of birth defects in Shanxi were selected by standard selection principal.Case control study was used in our study.Eighty pairs of pregnant women with anembryonic and normal pregnancy were paired by gestation weeks and were administered epidemiological questionaire. Thirty pairs of pregnant women from whole sample were selected and their level of folate,VB12,homocysteine,S-adenosylhomocysteine(SAH) and 55 elements were measured.Serum folate level of the objects was analyzed by a method of paramagnetic-particle,the level of homocysteine was by a fluorescence Polarization immunoassay(FPIA),the level of SAH was by Enzyme Linked ImmunoSorbent Assay(Elisa),and 55 elements were measured simultaneously by inductively coupled plasma mass spectrometry(ICP-MS).The test results were analyzed by X² analysis, paired T-test,Multivariate data analysis and discirminant analysis.The objects of intervention investigation of diet behavior were 80 women selected from four counties in two districts selected from the four fields mentioned above.According to the standard principle,two counties were selected from every district and 10 women were selected from every country.Structure investigation, structure personal interview,focus group discussion,Particular Rural Appraisal(PRA) and field research were used to collection information.The tools of intervention investigation of diet behavior were questionnaire of food frequency introduced from Center of disease control and prevention and interview outline.Results:1) There is no embryonic tissue in gestation sac without or with little villous tissue in anembryonic pregnancy.And villous cells were sparsity in villous tissue of anembryonic pregnancy through staining technique of haematoxylin and eosin and were serious mucinous degeneration.2) The proportion of anembryonic pregnancy in the total of adverse pregnancy outcome was averagely 40%,the ratio of the number of women with anembryonic pregnancy to the number of women with other kinds of spontaneous abortion was 6 to 1;the ratio of women with anembryonic pregnancy to the number of women with neural tube defects was 1.5 to 1;and the ratio ofanembryonic pregnancy to other birth defects was 1.7 to 1.3) There is no significant difference between anembryonic and normal pregnancy in aspect of age of women and husband,education level of women and husband,exposure of all kinds of poison,smoking,drinking,and diet behavior. However,the frequency of pregnancy,abortion,stillbirth and the proportion of nonresident women in women with anembryonic pregnancy were more than those in women with normal pregnancy.Further analysis showed that the history of birth defect in relative were no difference between anembryonic and normal pregnancy.4) The test results showed that the level of folate,V,Ti,Li,Cd,Sr,Rb,P,Na, K,and B in women with anembryonic pregnancy were significantly lower than those of normal pregnancy women;the level of VB₁₂ and homocysteine in women with anembryonic pregnancy were significantly higher than those of the normal,and the women with anembryonic and normal pregnancy women were not different in the level of SAH.5) The results of intervention investigation of diet behavior showed that the majority of food of local village was flour,potato and Chinese cabbage.In local country,the intake of flour of women of child-bearing age was higher than the recommendation in dietary pagoda by the Nutrition Society of China.The intake of fresh vegetables,fruit and meat in local village were lower than the recommendation, and especially,the intake of animal food,pulses and milk were equal to or lower than one third of the recommendation,respectively.The reasons for unscientific diet behavior in local women were not only that they are too poor to afford buying many kinds of food,but also that the local women didn't know how to be balanced diet.Conclusion:The lower level of folate,V,Ti,Li,Cd,Sr,Rb,P,Na,K,and B together with the higher level of homocysteine and Ge were associated the risk of anembryonic pregnancy.The intervention investigation of diet behavior showed the diet behavior of the local child-bearing women was unscientific and the local women look forward to the practical intervention measure of diet behavior.