Umbilical Cord Blood Vitamin A Level At Birth And Association With Neonatal Morbidity

Objective:To detect the level of vitamin A(VA)in umbilical cord blood at birth and follow-up the incidence of neonatal diseases,then to explore the relationship between umbilical cord blood vitamin A levels and the disease of newborn infants.Methods:This experiment was a prospective observational study,the research object was 506 cases of neonatal deliveried in Maternal and Child Health Hospital of Wenling city from January 2014 to June 2015,including 249 cases of premature infants and 257 cases of full-term infants.Umbilical cord blood(UCB)was collected immediately after the umbilical cord cutted off from parent end,detected vitamin A(VA)level,compared the difference vitamin A levels of umbilical cord blood between preterm infants and full-term infants,compared the difference vitamin A levels of umbilical cord blood between different gestational age and different birth weight.And for all newborns were followed up to discharge,and recorded relevant clinical data,observed the incidence of neonatal diseases,including Neonatal Hyperbilirubinemia(NHB),Sepsis(SP),Neonatal Respiratory Distress Syndrome(NRDS),BronchoPulmonary Dysplasia(BPD),Necrotizing Enterocolitis(NEC),and the incidence of mortality rate,thus to investigate the relationship between umbilical cord blood vitamin A levels and neonatal diseases.Using SPSS19.0 statistical software,analyzed of condition of UCBVA in the neonatal population,compared differences of UCBVA between preterm infants group and full-term infants group,Compared the effects of different gender,different delivery mode,different gestational age,different birth weight on level of UCBVA.Analysed differences of UCBVA levels between neonatal disease groups and non neonatal disease groups;Analysed of different levels of UCBVA,the difference of neonatal morbidity,number of hospitalizations,hospitalization time and oxygen therapy time;Analysed of the relationship between the level of UCBVA and neonatal diseases.Results:Umbilical cord blood vitamin A level of preterm infants group was lower than that of full-term infants group;Umbilical cord blood vitamin A level of male was higher than that of female,but the difference was not statistically significant,level of vitamin A in umbilical cord blood of vaginal delivery was higher than that of cesarean section,the difference was statistically significant.Vitamin A levels in umbilical cord blood were different in different gestational age group,the difference were statistically significant.Pairwise comparison,Compared with the group of gestational age<32 week,umbilical cord blood VA level of 32～34 week and>34～36 week group were higher,but the differences were not statistically significantcompared with the 32～34 week group,umbilical cord blood VA level of 34～36 week group and>37 week group were higher,but the differences was not VI statistically significant;Compared with<32 week group,umbilical cord blood VA concentration of gestational age ≥37 week and>34～36 week was more higher,the difference was statistically significant.Umbilical cord blood VA level of>37 weeks group was higher than that of<32 week group,and that of>34-36 week,the differences was statistically significant.Umbilical cord blood VA level of different birth weight groups were different,the differences were statistically significant(H=28.2,P<0.001).Pairwise comparison,the umbilical cord blood VA level in>2500g group was higher than that in the<1500g group and that in the 1500～2500g group,the difference were statistically significant,and the 1500～2500g group was higher than that of the<1500g group,but the difference was not statistically significant.Umbilical cord blood VA level in Hospitalization group was lower than that in none Hospitalization group,the difference was statistically significant.The vitamin A level of umbilical cord blood in oxygen therapy group was lower than that in non oxygen therapy group,the difference was statistically significant.The level of vitamin A in umbilical cord blood of neonatal hyperbilirubinemia group was lower than non neonatal hyperbilirubinemia group,the difference was statistically significant.Umbilical cord blood vitamin A level of NRDS group was lower than non NRDS group,the difference was statistically significant.The level of vitamin A in umbilical cord blood of sepsis group was lower than that of non sepsis group,but the difference was not statistically significant.The vitamin A level of umbilical cord blood in the death group was lower than that in the survival group,but the difference was not statistically significant.Umbilical cord blood vitamin A level were negatively correlated with Neonatal Hyperbilirubinemia(r=-0.190,P<0.01),NRDS(r=-0.193,P<0.01),BPD(r=-0.098,P<0.05),the number of hospitalizations(r=-0.215,P<0.01),hospitalizations time(r=-0.203,P<0.01),and number of oxygen therapy(r=-0.190,P<0.01),duration of oxygen therapy(r=-0.190,P<0.01),but had no correlated with sepsis(r=-0.04,P>0.05)and death(r=-0.035,P>0.05).Umbilical cord blood level of vitamin A were divided into four groups according to the median and four percentile interval:<P25group,P25-P50group,>P50-P75group and>P75 group.The incidences of HBE and NRDS were the highest in<P25 group,were 32%and 16%,respectively.With the increase of cord blood VA level,both incidences were lower,and in>P75 group,the incidences were lowest,were 9.5%and 1.6%,respectively.The incidences of Sepsis,BPD and NEC had no statistically significant difference between different level of cord blood VA groups,P values>0.05.The mortality rate in P25-P50 group was the highest,compared with other groups,the difference was statistically significant(P<0.05).Conclusion1.The level of umbilical cord blood vitamin A was generally low in Neonatal,preterm infants is lower than that in full-term infants.The mother during pregnancy,neonatal,particularly preterm infants all needed to supplement vitamin A in time.2.Umbilical cord blood vitamin A level were positively association with birth weight and gestational age.The smaller birth weight,the smaller gestational age,the more prone to be deficiency of umbilical cord blood vitamin A.The level of umbilical cord blood vitamin A of Vaginal delivery neonatal was higher than that of Cesarean section.3.Umbilical cord blood vitamin A concentration were negatively association with neonatal hyperbilirubinemia,neonatal respiratory distress syndrome,bronchopulmonary dysplasia,hospitalization time,and duration of oxygen therapy,but no correlation with sepsis and death.