| Objective:The study was performed on pregnant women in mid-and late-pregnancy Dietary vitamin K intake,food sources and their influencing factors were investigated.Through dietary surveys,serum levels of vitamin K were also detected.We aimed to analyze the association between dietary and serum vitamin K levels with pregnancy complications and neonatal outcomes The finding would provide reference for guiding pregnant women to consume vitamin K reasonably and setting recommended dietary intakes of vitamin K.Methods:In this cross-sectional study,a total of 831 pregnant women with informed consent who attended a tertiary care hospital in Binzhou City from April 2021 to December 2022 in the middle and late stages of pregnancy were selected as the study population The basic information of the patients was collected by questionnaire.A semi-quantitative food frequency questionnaire(SFFQ)was used to acquire the information of food intakes of the pregnant women.The levels of daily dietary vitamin K intake were calculated referenced to the data of vitamin K1 content in the US food composition table and the data of MK-4 and MK-7 content from Chinese Center for Disease and Control Prevention The main food sources of each vitamin K subtype were calculated,and the factors influencing dietary vitamin K intake were analyzed.SPSS 26 0 software was used for statistically analysis.Analysis of variance or Kruskal-Wallis nonparametric test was used to compare the quantitative data among groups,Chi-square test was used to compare the qualitative data among groups Association between serum vitamin K levels and dietary vitamin K intake in pregnant women were performed using Spearman correlation analysis.Figures were drew by Graphpad prism 8.0 and Excel.Venous blood was collected from pregnant women to separate serum and serum levels of vitamin K1 and MK-4 measured by LC/MS/MS(High performance liquid chromatography-tandem mass spectrometry).We also collect information of the onset of gestational diabetes and other complications in pregnant women,and clinical information of newborns.Multifactorial logistic regression was used to analyze the correlation between dietary vitamin K intake and serum vitamin K levels in pregnant women with pregnancy complications and neonatal outcomes.Result:A total of 831 pregnant women completed the dietary survey,and the median(P25,P75)intake of vitamin K1 was 192.8(132.5,250.1)μg/d,of which 33(3.4%)women were below the recommended intake(80μg/d).Vitamin K1 intake accounted for 79.4%of the total vitamin K.The median(P25,P75)intake of MK-4 was 31.2(22.8,34.4)μg/d,accounting for 11.8%of the total vitamin K intake.The median intake of MK-7(P25,P75)was 16.7(2.4,25.0)μg/d,accounting for 8.8%of the total vitamin K intake The main source of dietary vitamin K1 for pregnant women in this study was vegetables.The main source of MK-4 was meat,poultry,and eggs,and that of MK-7 was yogurt.Results of the analysis for the factors influencing dietary vitamin K intake of pregnant women showed that the total dietary vitamin K intake,vitamin K1,and MK-7 intake of pregnant women living in urban areas were significantly higher than those living in rural areas(all P<0.05).The total dietary vitamin K intake,vitamin K1,and MK-7 intake of pregnant women with higher education and monthly income were notably higher The dietary intake of total vitamin K and vitamin K1 of pregnant women were markedly higher in winter and spring seasons than in summer and autumn(P<0.001),while that of MK-4 intake was lower than in summer and autumn(P=0 001).The MK-7 intake in pregnant women with two or more pregnancies was lower compared with those with one pregnancy(P=0.021).Correlation analysis showed a positive correlation between serum vitamin K1 levels and vitamin K1 intake(r=0.130,P<0.001).After controlling for potential confounders,compared with the lowest quartile,a negative association between total vitamin K intake and excess weight gain was found only in the third quartile,with an OR(95%CI)of 0 53(0.30,0.94).In the highest quartile,vitamin K1 intake was negatively associated with the risk of PIH,with an OR(95%CI)of 0.46(0.24,0 88).A negative association between MK-4 intake and the risk of PIH was found only in the second quartile with an OR(95%CI)of 0.51(0.26,0 98).A positive association between MK-4 intake and the risk of GDM and excess weight gain was identified in the third quartile with an OR(95%CI)of 2.19(1.31,3.66)and 1.83(1.05,3.16)respectively After correcting for potential confounders,total maternal serum vitamin K levels were negatively associated with the risk of developing PIH,GDM,and excess weight gain.Serum vitamin K1 levels were negatively associated with the risk of PIH and GDM.Serum MK-4 levels was negatively associated with the risk of PIH.In addition,serum total vitamin K levels and serum vitamin K1 levels were negatively associated with preterm birth,with OR(95%CI)of 0.25(0.14,0 43)and 0.29(0.17,0.50)in the highest compared to the lowest quartile.Maternal serum vitamin K1 levels were negatively associated with the risk of neonatal bilirubinemia,with OR(95%CI)of 0.45(0 27,0 76),compared with the lowest quartile.A negative correlation between maternal serum vitamin K1 and the risk of macrosomia was found in the second quartile,with an OR(95%Cl)of 0.29(0.10,0 83).Conclusion:1.The vitamin K1 intake of pregnant women basically reached the adequate intake(AI)in China.Factors influencing dietary vitamin K intake included maternal education,monthly income,place of residence,and season of investigation.Dietary vitamin K1 was positively correlated with serum vitamin K1 levels.2.Maternal vitamin K1 intake was negatively associated with the risk of PIH,MK-4 intake was positively associated with the occurrence of GDM and excess weight gain,total serum vitamin K levels were negatively associated with the risk of PIH,GDM and preterm birth,serum vitamin K1 was negatively associated with the risk of PIH,GDM,preterm birth,neonatal bilirubinemia and macrosomia,and serum MK-4 levels were negatively associated with the risk of PIH and preterm birth. |
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