Correlation Of Vitamin A Levels In Umbilical Cord Blood With Neonatal Pulmonary Diseases

BackgroundPrevious studies reported that among the life-threatening diseases of newborns,neonatal lung diseases account for a large proportion.Vitamin A(Vitamin A,VA)is an essential micronutrient that plays a vital role in many physiological processes.Vitamin A deficiency(VAD)is closely related to anemia,recurrent respiratory tract infections,and diarrhea.VAD can lead to increased infant morbidity and mortality.However,the specific role of VA in disease progression is still unclear for different types of neonatal lung diseases.By using clinical samples,this study explored the correlation between the vitamin A level of umbilical cord blood and the occurrence of neonatal lung disease.ObjectiveBy detecting VA levels of umbilical cord blood(UCB),we observed the effect of umbilical cord blood vitamin A level on the prevalence of neonatal lung disease and calculated the relationship between umbilical cord blood vitamin A level and neonatal lung disease prevalence rates.This study aims to provide a theoretical basis for early clinical prediction of the risk of neonatal pulmonary disease and VA supplementation to reduce the prevalence of the neonatal pulmonary disease.Methods1.Subjects:Neonates born in Anyang People’s Hospital from January 2020 to March2022 were included.A total of 252 neonatal cord blood samples were collected,and 233were enrolled according to the inclusion and exclusion criteria.Based on the umbilical cord blood VA level,they were divided into the VA deficiency group(<0.10mg/L)(47cases),VA borderline deficiency group(0.10～0.20mg/L)(161 cases),and VA normal group(≥0.20mg/L)(25 cases).Three groups of neonates were followed up until 28 days after birth,and the prevalence of neonatal lung disease was compared between groups with different umbilical cord blood vitamin A levels.2.Analysis indicators:We explored umbilical cord blood VA levels in newborns with different weights,ages,regions,gender,and delivery mode.Also,we studied the relationship between umbilical cord blood VA level and neonatal pulmonary diseases,including respiratory distress syndrome,pneumonia,asphyxia,bronchopulmonary dysplasia,and apnea.3.Statistical analysis:Data analysis was performed using Excel,IBM SPSS 23.0 and other software,and mean±standard deviation(±S)was used for normally distributed data,t-test was used for comparison between the two groups,and one-way analysis of variance was used for comparison between multiple groups.Nonnormal measurements were presented using median(interquartile range)[M(P25,P75)],Mann-Whitney U test for intergroup comparisons,and Kruskal-Wallis H(K)test for multiple group comparisons.Enumeration data were expressed as number of cases(n)and percentage(%),andχ~2test was used for comparison between the two groups.Correlation analysis was performed using Spearman correlation coefficient.Logistic regression was used to analyze the influencing factors of pulmonary diseases in neonatal period.P<0.05 was considered statistically significant,and P<0.01 was considered statistically significant.Results1.There were no significant differences in newborns’VA levels in umbilical cord blood in terms of gender differences,mode of production,gestational age,and term status.2.Compared with the<1500g group,the umbilical cord blood VA level was slightly higher in the 1500g-2500g group and the≧2500g group,although the difference was not statistically significant(P>0.05).3.The umbilical cord blood VA of the rural neonates was slightly higher than that of the urban neonates,but the difference was not statistically significant(P>0.05).4.There was no significant difference in umbilical cord blood VA levels among the groups in the 1-min Apgar score(P>0.05).The level of vitamin A was slightly lower than that in groups scoring 1-3 and 4-7,but the difference was not statistically significant(P>0.05).5.Through spearman correlation analysis,it was found that the level of vitamin A in umbilical cord blood was significantly negatively correlated with respiratory tract infection in neonates(-0.4<r<-0.2,P<0.001).However,there was no correlation between umbilical cord blood vitamin A level and neonatal asphyxia,respiratory distress syndrome,bronchial dysplasia,and apnea(0<|r|<0.2,P>0.05).6.Logistic regression analysis discovered that VA level and term status were independent risk factors for respiratory diseases(P<0.01).ConclusionNeonatal cord blood vitamin A deficiency and premature delivery are independent risk factors for neonatal lung disease.Lower cord blood vitamin A levels are more susceptible to neonatal respiratory tract infections in the neonatal period.VA level in neonatal umbilical cord blood and term status are two independent risk factors for respiratory diseases.