| Objectives:This study is designed to investigate the effects of prepregnancy body mass index(BMI)and gestational weight gain(GWG)on serum vitamin A、E content in late pregnancy,the correlation between serum vitamin A、E content and pregnancy outcomes and complications in late pregnancy,in turn to provide a guide for antenatal care.Methods:A prospective study was conducted during the whole investigation.Pregnant women who had undergone antenatal checkups and hospitalized deliveries at the obstetric department of the First Affiliated Hospital of Hunan Normal University from December 2016 to January 2018 were enrollen in this study.The height and weight were recorded by standard operating procedures.The pregestational weight(within one month before pregnancy),the prenatal weight(the weight of pregnant woman at delivery)and gestational week(according to the last menstrual period of pregnant women and ultrasonography during the first trimester to correct gestational weeks),pregnancy complications(pregnancy hypertension disease and gestational diabetes mellitus),delivery methods and pregnancy outcomes were all recorded respectively.The pre-pregnancy body mass index(BMI)-pre-pregnancy weight(kg)/height(m)2(kg/m2).The gestational weight gain(GWG)= prenatal weight(kg)-pre-pregnancy weight(kg).According to the Chinese adult body mass index(BMI)standard,pregnant women were divided into four groups:the underweight group(BMI<18.5kg/m2),the normal weight group(18.5kg/m2 ≤BMI<24kg/m2),the overweight group(24kg/m2 ≤BMI<28 kg/m2),the obese group(BMI>28kg/m2).All the four groups were divided into three sub-groups:the low GWG group(12.5kg ≤pregnancy weight gain<18kg),the normal GWG group(11.5kg<pregnancy weight gain<16.0kg),the excessive GWG group(7kg<pregnancy weight gain<11.5kg),the obesity group(5 kgpregnancy weight gain<9kg),and then each pre-pregnancy BMI group was divided into three groups as Low pregnancy weight gain group、normal pregnancy weight gain group、excessive pregnancy weight gain group.Blood collection pregnancy week,High performance liquid chromatography was used to quantify the serum vitamin A and E concentrations of late pregnant phase women(pregnancy week>37 week).The effects of prepregnancy BMI and pregnancy weight gain on late pregnant serum vitamin A、E levels were studied.Results:(1)The serum vitamin A content in late pregnancy of the obese group was(0.26±0.10)mg/L lower than that in other pre-pregnancy BMI group(P<0.05).The mean serum vitamin A content in late pregnancy of obese group was lower than the normal range of serum vitamin A;The serum vitamin E content in late pregnancy of the obese group was(21.39 ± 5.58)mg/L higher than that in other pre-pregnancy BMI groups(P<0.05).The mean serum vitamin E content of the obese group was higher than the normal range of serum vitamin E.(2)The level of GWG in obesity group was lower than other pre-pregnancy BMI group(P<0.05),but the mean GWG in obesity group was higher than IOM recommended range,the mean GWG in other groups were within IOM recommendation range;The level of GWG in each pre-pregnancy BMI groups were compared statistically significant difference(P<0.05).Overweight groups and obesity groups had a high proportion of GWG than other groups.(3)The serum vitamin A content in late pregnancy of the excessive pregnancy weight gain group(0.3010.10)mg/L were lower than the low pregnancy weight gain group(0.37±0.11)mg/L and the normal pregnancy weight gain group(0.36±0.10)mg/L.The serum vitamin E content in late pregnancy of the excessive pregnancy weight gain group(19.06±5.25)mg/L were higher than the low pregnancy weight gain group(17.731±4.27)mg/L and the normal pregnancy weight gain group(17.26±4.35)mg/L,the differences were statistically significant(P<0.05).the mean serum vitamin A、E content of each GWG group were within the normal range,but the mean serum vitamin A、E content in late pregnancy of the excessive pregnancy weight gain group in each pre-pregnancy BMI groups was lower than other GWG groups.(4)The content of serum vitamin A.E content in late pregnancy of each GWG group in the thin group,normal weight group and the overweight group were within normal range(except for in the normal weight group,the serum vitamin A content in late pregnancy of the excessive pregnancy weight gain group(0.28±0.10)mg/L were lower than the normal range);(5)In the obese group,the serum vitamin A content in late pregnancy of the excessive pregnancy weight gain group(0.34±0.10)mg/L were lower than the low pregnancy weight gain group(0.45±0.14)mg/L and the normal pregnancy weight gain group(0.39±0.12)mg/L(P<0.05);the serum vitamin A content in late pregnancy of the excessive pregnancy weight gain group and the normal pregnancy weight gain group were were lower than the normal range;The serum vitamin E content in the late pregnancy of each weight gain group were higher than the normal range.the low pregnancy weight gain group(20.54±7.01)mg/L、the normal pregnancy weight gain group(20.52±5.59)mg/L、the excessive pregnancy weight gain group(21.75±5.42)mg/L,There was no significant difference in serum vitamin E content in the late pregnancy of each GWG(P>0.05).(6)There was no significant difference of serum vitamin A、E content in the late pregnancy between GWG groups of the thin group and the obese group(P>0.05).There was a statistically significant difference of serum vitamin A、E content in the late pregnancy between the normal weight group and the overweight group(P<0.05).The proportion of serum vitamin A content deficiency and vitamin E content excess in the late pregnancy was higher in the excessive pregnancy weight gain of the normal weight groups、overweight groups and obesity groups.(7)The serum vitamin A content deficiency in the late pregnancyis increased the risk of pregnancy hypertension disease,gestational diabetes mellitus,premature rupture of membranes and low birth weight infants were 2.3-fold,1.4-fold,2.5-fold,and 1.8-fold than the normal serum vitamin A content in late pregnancy,respectively;the serum vitamin E excess in the late pregnancy is increased the risk of pregnancy hypertension disease,gestational diabetes mellitus and macrosomia were 2.9-fold,2.4-fold,2.5-fold higher than the normal serum vitamin E content in late pregnancy,respectively.Conclusions:(1)The obesity group’s weight gain during pregnancy is higher than the recommended range of IOM.Obesity maternity’s weight management during pregnancy is still an important task;(2)The highest proportion of the overweight group,obesity group and the excessive pregnancy weight gain is serum vitamin A content deficiency and vitamin E content excess in the late pregnancy.(3)At present,the mainly abnormalities in this region are the insufficient of serum vitamin A and the excessive of serum vitamin E in the late pregnancy.These groups need to pay more attention to monitoring vitamins A and E content.nutrition guidance should be according to the needs of individual and avoid excessive vitamin E supplements;(4)The insufficient of serum vitamin A and the excessive of serum vitamin E in the late pregnancy is associated with the risk of pregnancy hypertension disease,gestational diabetes mellitus;The insufficient of serum vitamin A is associated with the risk of premature rupture of the membrane and low birth weight infants;the excessive of serum vitamin E in the late pregnancy is associated with the risk of macrosomia.Therefore,vitamin A and E supplements should be monitored regularly during pregnancy to minimize the risk of serum vitamin A and E abnormalities leading to adverse pregnancy outcomes. |
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