Effects Of Folic Acid,Vitamin B12,and Homocysteine Levels On The Functional Development Of The Nervous System In Late Preterm Infants

Objective:To investigate the correlation between serum folic acid,vitamin B12,and homocysteine levels of late premature infants and their neurodevelopmental outcomes.Furthermore,it provides a theoretical basis for the clinical prevention and treatment of the neurological dysfunction of late premature infants.Methods:To randomly select 120 cases of pure late preterm infants as observation subjects(gestational age at birth:34^0/7to 36^6/7weeks)admitted to the neonatal intensive care unit?NICU?of yijishan hospital affiliated to wannan medical college from October2017 to March 2018.These late preterm infants were born without any related complications,or congenital birth defects,and their pregnant mothers had no related severe pregnancy complications.The peripheral venous blood of all the observed subjects was collected about 3mL within the first day after birth and in the morning of the seventh day after birth.A total of 30 cases of normal term infants born at the same time in our hospital were selected as the normal control,and 3mL of umbilical cord blood was retained.All blood samples were centrifuged and the upper serum was taken.FolateandvitaminB12levelsweredeterminedbyradioimmunodirect chemiluminescence and homocysteine levels were determined by enzyme cycling.All late preterm infants and normal term infants were assessed with the“developmental screening test for 0-6 years”scale compiled by the affiliated pediatric hospital of fudan university in Shanghai at 40 to 44 weeks of correct gestational age.Development Quotient?DQ?and Mental Index?MI?scores greater than or equal to 85 were classified as normal,70⁸4 as suspicious,and lower than 70 as abnormal,then the late preterm infants were grouped.Folate,vitamin B12 and homocysteine levels were compared between the groups.At the same time,sex,delivery mode,whether or not twins,gestational age and birth weight were compared in each group.Results:1.A total of 104 observation subjects completed all the experimental procedures,and 7 cases were withdrawn due to complications or pregnant mothers with severe pregnancy complications,and 9 cases were lost to follow-up.A total of 6 cases were lost to follow-up in the control group.2.Among the 104 cases of late preterm infants,82 cases were in the DQ normal group,14 cases in the DQ suspicious group,and 8 cases in the DQ abnormal group.There were82 cases in the MI normal group,15 cases in the MI suspicious group,and 7 cases in the MI abnormal group.DQ and MI of 24 normal infants in the control group were normal.3.Serum folic acid and vitamin B12 levels of full-term infants were significantly higher than those of late preterm infants?P<0.01?,and Hcy levels of full-term infants were significantly lower than those of late preterm infants?P<0.01?.4.There were no statistical differences among the three groups in terms of gender,mode of delivery and whether the twinst?P>0.05?,and there were statistical differences in gestational age and birth weight?P<0.01?.The gestational age of the suspicious group and the abnormal group was smaller than that of the normal group?P<0.05?.The body weight of the DQ abnormal group was smaller than that of the suspicious group and the normal group,and that of the MI suspicious group and the abnormal group was smaller than that of the normal group?P<0.05?.5.There were statistically significant differences in serum folic acid,vitamin B12 and Hcy levels between the groups of DQ and MI on the 1st and 7th Postnatal Day?P1?and Postnatal Day 7?P7??P<0.05?.Folic acid and vitamin B12 levels in the DQ and MI abnormal group and suspect groups were lower than those in the normal group,and folic acid levels in the P7 abnormal group were lower than those in the suspect group?P<0.05?,while serum vitamin B12 levels in the MI suspect group were lower than those in the normal group.Serum Hcy levels in the P1 and P7 abnormal group and the suspicious group were lower than those in the normal group?P<0.05?.6.Serum Hcy level and birth weight on the first day after birth were independent risk factors for DQ and MI abnormalities?all P<0.05?.Serum folic acid,Hcy level and birth weight on the 7th day after birth were independent risk factors for DQ and MI abnormalities?all P<0.05?.Conclusion:1.Late preterm infants have a higher incidence of dysplasia of the nervous system.2.Folic acid and vitamin B12 levels were lower in late preterm infants than in term infants,and Hcy levels were higher in late preterm infants than in term infants just after the birth.3.Serum folic acid,vitamin B12 and Hcy levels are closely related to the outcome of neurological functional development in late preterm infants.4.The persistent high level of Hcy after birth may have a greater impact on the outcome of neurological functional development of late preterm infants.