Vitamin A Levels In Newborns And Its Correlation With Neonatal Pneumonia

Objective: To investigate the level of vitamin A in newborns and its correlation with the occurrence of neonatal pneumonia,to provide theoretical and experimental evidence for vitamin A supplementation in newborns,especially in children with pneumonia,and to provide help for clinical decision-making.Methods: A total of 1270 neonates,635 cases with pneumonia(pneumonia group)from Neonatal Center in the Affiliated Children's Hospital of Chongqing Medical University and 635 cases without pneumonia(normal control group)from the Qianjiang District Central Hospital of Chongqing between January 1,2016 and December 31,2018,were included in this study.The concentration of vitamin A was determined by high performance liquid chromatography-tandem mass spectrometry(HPLC-MS),and the difference of vitamin A level between the two groups was compared.Logistic analysis was used to analyze the independent risk factors of neonatal pneumonia and to explore the correlation between vitamin A level and pneumonia.Results:1.The concentration of vitamin A in pneumonia group and control group was 0.319±0.196 umol/L and 0.342±0.137 umol/L,respectively.There was significant difference between the two groups(p < 0.05).2.The incidence of vitamin A deficiency(VAD)was 95.91% in the pneumonia group and 97.48% in the control group,which was very high,suggesting that vitamin A deficiency is common in the newborn population.3.Among the 635 cases of pneumonia,there were 501 cases of mild pneumonia and 134 cases of severe pneumonia.The level of vitamin A in severe pneumonia group was lower than that in normal control group(0.296±0.192 ?mol/L vs 0.342±0.137 ?mol/L),and the difference was statistically significant(p < 0.05).4.Logistic regression analysis showed that Apgar-1 minute score(OR:0.133,95%CI:0.100,0.178,p < 0.05)was an independent protective factor for neonatal pneumonia,the higher the score,the less prone to pneumonia.The low Apgar score at 1 minute after birth indicates asphyxia,whether the fetus has intrauterine distress,and whether there is birth asphyxia and the degree of asphyxia is closely related to the occurrence of pneumonia.5.The ROC curve showed that vitamin A level alone had no significant predictive value for neonatal pneumonia.Conclusion:1.The rate of vitamin A deficiency in newborns is very high,and the level of VA in neonates with pneumonia is lower than that in normal newborns,suggesting that pneumonia increases vitamin A consumption.2.1-minute Apgar score is an independent protective factor for the occurrence of neonatal pneumonia.The higher the score is,the less likely it is to develop pneumonia.Whether the fetus has intrauterine distress,birth asphyxia and the degree of asphyxia are closely related to the occurrence of pneumonia.Strengthening maternal health care during pregnancy to avoid fetal distress and birth asphyxia is helpful to reduce the incidence of neonatal pneumonia.3.The incidence of neonatal pneumonia is closely related to many factors.Vitamin A level alone has no significant predictive value for neonatal pneumonia.4.More clinical problems such as neonatal vitamin A deficiency grading criteria,how to supplement vitamin A,and whether vitamin A supplementation can prevent pneumonia or shorten the course of pneumonia need to be further studied.