Relationship Between Serum Vitamin A?E Level And Pregnancy Outcome In Pregnant Women In Yunnan Province

Objective:To investigate the serum vitamin A and E levels of pregnant wo men in second trimester of pregnancy in Yunnan Province,analyze the related influencing factors of the levels of vitamin A and E and their relationship with pregnancy outcome,and provide reasonable guidance for pregnant women's he alth care in pregnant women in Yunnan Province.Methods:A prospective cohort study was conducted on pregnant women w ho met the inclusion criteria from August 2015 to August 2018 in the obstetric al out-patient clinic of the second affiliated Hospital of Kunming Medical Univ ersity and who were scheduled to give birth in our hospital.In the second tri mester of gestation(14-27+6weeks),informed consent was signed in the obstetr ical clinic and peripheral blood was collected from the laboratory.The levels o f vitanin A and E were quantitatively determined by high performance liquid c hromatography(HPLC),and the outcomes of delivery were recorded.The level s of vitamin A and E of pregnant women with different characteristics were co mpared by Chi-square test,and the pregnancy outcomes of pregnant women wi th different levels of vitamin A and E were different.The correlation factors o f vitamin A and E levels and the relationship between vitamin A and E levels and pregnancy outcome were analyzed by logistic regression.Results:1.There were 6723 pregnant women(0.05%)who had vitamin A and E levels measured and followed up to delivery in the obstetrical clinic of the second Hospital of Kunming Medical treatment and affiliated Hospital during the three-year period,and 6723(0.05%)of pregnant women who were deficient in vitamin A were followed up.Vitamin A excess was found in 83 cases(0.010),the abnormal rate was(0.07%),and the others were normal.There were 36(0.005%)pregnant women with vitamin E deficiency and 161(0.02%)with vitamin E overdose.The abnormal rate was(0.02%)and the rest were normal.2.there was no significant difference in vitamin A deficiency rate among pregnant women of different ages,nationalities,times of pregnancy and second trimester of pregnancy;The vitamin A deficiency rate of farmers(8.8%)and freelancers(7.4%)was higher than that of other workers(3.9%and 7.0%),the difference was statistically significant(P<0.05).There was no significant difference in vitamin A excess rate among pregnant women of different ages,nationalities,times of pregnancy and second trimester of pregnancy.The vitamin A excess rate(5.9%)in pregnant women with occupational managers was higher than that in other occupational groups(0.7%vs 1.4%),with a statistically significant difference(P<0.05).Multivariate logistic regression analysis showed that women's occupation was an important factor in abnormal serum vitamin A levels in the second trimester of pregnancy.Compared with workers,farmers were 1.92 times more likely to develop serum vitamin A deficiency in the second trimester of pregnancy(OR=1.92,95%CI:1.03-3.61).Freelance workers were 1.60 times more likely to develop serum vitamin A deficiency in the second trimester of pregnancy(OR=1.60,95%Cl:1.16-2.20).Compared with workers,managers were 7.90 times more likely to have elevated serum vitamin a levels in their second trimester of pregnancy(OR=7.90,95%CI:2.06-30.33).3.There was no significant difference in vitamin E deficiency rate among pregnant women of different ages,nationalities,occupations,gestation times and second trimester of pregnancy.There was no significant difference in the rate of vitamin E excess among pregnant women of different nationalities,occupations,gestational times and second trimester of pregnancy.The vitamin E overdose rate of older pregnant women(3.7%)was higher than that of normal pregnant women(2.2%),the difference was statistically significant(P<0.05).Multivariate logistic regression analysis showed that age was an important factor for excessive serum vitamin E levels in the second trimester of pregnancy.Compared with pregnant women under 35 years old,pregnant women with age?35 years were 1.85 times more likely to have excessive serum vitamin E levels in the second trimester of pregnancy(OR=1.85,95%Cl:1.22-2.82)than those who were younger than 35 years old.4.Multi-factor logistic regression analysis showed that high vitamin A level was an independent risk factor of GDM after controlling the factors of age,nationality,occupation and pregnancy history.The hypervitamin A group was 1.46 times more likely to develop gestational diabetes than the normal group(OR=1.46,95%Cl:1.04-2.62).There was no significant correlation between serum vitamin A concentration and premature rupture of membranes,premature delivery,low birth weight and macrosomia,and there was no significant difference(P>0.05)between serum vitamin A concentration and premature rupture of membranes,premature delivery,low birth weight and macrosomia(P>0.05).5.No correlation was found between serum vitamin E concentration and hypertensive disorder complicating pregnancy,premature rupture of membranes,premature delivery,low birth weight,macrosomia and cesarean section(P>0.05)Conclusions:1.Vitamin A deficiency and excess vitamin e were the main abnormalities of vitamin A and vitamin E in pregnant women of second trimester in Yunnan Province.2.The vitamin A level of pregnant women in the second trimester of pregnancy in Yunnan Province vas affected by occupation.The risk of vitamin A deficiency among farmers and freelancers was higher,and the risk of vitamin A overdose among managers was higher.Vitamin E levels were correlated with age.Older women(age?35)had a higher risk of vitamin E overdose.3.The vitamin A level of pregnant women in the second trimester of pregnancy was correlated with gestational diabetes mellitus(GDM),and the excess of vitamin A in the second trimester was a high risk population of gestational diabetes mellitus(GDM).There was no significant correlation between vitamin A level and premature rupture of membranes,premature delivery,low birth weight and macrosomia.There was no significant correlation between vitamin E level and above diseases.4.The levels of vitamin A and E in pregnant women are disturbed by many factors,and they are prone to abnormal vitamin A and E levels.The levels of vitamin A and E were closely related to the outcome of pregnancy.The dynamic monitoring of vitamin A and E levels during pregnancy and the timely treatment of the abnormalities of vitamin A and E were of great significance to the improvement of maternal and infant outcomes.