Objective To discuss the relationship between serum folic acid (Fa),homocysteine (Hcy),Vitamin B12 (VB12) in pregnent women as well as neonatal umbilical cord blood and fetal growth restriction.Methods We selected 44 delivery mothers and their infants inpatient from February to November in 2010.Serum Hcy,Fa,VB12 were measured by enzyme-linked immunosorbent assay.According to the birth weight neonates were classified into fetal growth restriction (FGR),appropriate for gestational age (AGA),large for gestational age (LGA).We recorded fetal birth weight,height,head circumference,abdomen circumference,placenta weight,body mass index (BMI),Rohrer index,delivery method,gender and evaluated neonatal growth state.Results ( 1 ) Serum Fa,VB12 of pregnant women in FGR group were less than those in AGA and LGA group (P ＜0.05).Hcy of pregnant women in FGR group was higher than that in AGA,LGA group (P ＜0.05).Serum VB12 of umbilical cord blood in FGR group was less than that in AGA,LGA group.Hcy in FGR group was higher than that in AGA,LGA group ( P ＜ 0.05).Serum Fa in pregnant women was correlated positively with Fa,VB12 in umbilical cord blood ( P ＜0.01 ),as well as serum VB12 in pregnant women was correlated positively with that in umbilical cord blood ( P ＜ 0.01 ).( 2 ) Serum Hey in pregnant women and umbilical cord blood was negatively correlated with neonatal growth parameters (P ＜0.01 ).Serum Fa in pregnant women was positively correlated with birth weight ( P ＜ 0.05 ).Serum VB12 in pregnant women was positively correlated with neonatal head circumference and abdomen circumference ( P ＜0.05).(3) Placenta weight in FGR group was less than that in AGA,LGA group (P ＜0.01).There wasn't correlation between placenta weight and birth weight,height,head circumference,abdomen circumference,BMI in FGR group (P ＞ 0.05 ).There is a significant positively correlation between placenta weight and birth weight,height,head circumference,abdomen circumference,BMI in AGA,LGA group (P ＜0.01 ).(4)Rohrer's body index: In FGR group the index was less than 2.00 at the gestational age of ≤37.The index was less than 2.20 at the gestational age of ＞ 37.The ratio of height and head circumference was more than 1.36 in three groups.Conclusion Lack of the Fa and VB12 may induce hyperhomocysteinemia in period of pregnancy.FGR may be corelated with the increasing Hcy level.Serum Fa,VB12 and Hcy had important influence on the fetal physical condition at the later period of pregnancy.Placenta weight may play an important role in the fetal growth and development.%目的 通过检测孕妇血与脐血同型半胱氨酸( homocysteine,Hcy)、叶酸(folic acid,Fa)及维生素B12( vitamin B12,VB12)水平,探讨其与胎儿生长受限的相关性及相互作用.方法 选取2010年2月至2010年11月间我院产科住院分娩的孕妇及其新生儿各44例,根据胎龄与出生体重百分位数的关系分为胎儿生长受限(fetal growth restriction,FGR)、适于胎龄儿(appropriate for gestational age,AGA)、大于胎龄儿(large for gestational age,LGA)三组.采用酶联免疫吸附法(ELISA)分别测定孕妇及其新生儿脐血Hcy、Fa、VB12水平.分别测量胎儿的出生体重、身长、头围、腹围及胎盘重量,计算体重指数(body mass index,BMI),Rohrer's身体指数,评估新生儿生长状态,记录新生儿分娩方式、性别.结果 (1)孕妇血清Fa、VB12水平FGR组小于AGA、LGA组,Hcy水平FGR组大于AGA、LGA组,差异均有统计学意义(P＜0.05)；脐血VB12水平FGR组小于AGA、LGA组,Hcy水平FGR组大于AGA、LGA组,差异均有统计学意义(P＜0.05).孕妇血Fa水平与脐血Fa、VB12水平均呈正相关(P均＜0.01),孕妇血VB12水平与脐血VB12水平呈正相关(P＜0.01).(2)孕妇血、脐血Hcy水平与新生儿各项生长参数均呈负相关(P均＜0.01)；孕妇血Fa水平与新生儿出生体重呈正相关(P均＜0.05)；孕妇血VB12水平与新生儿头围、腹围呈正相关(P均＜0.05).(3)胎盘重量FGR组均小于AGA、LGA组,差异有统计学意义(P＜0.01).FGR组新生儿出生体重、身长、头围、腹围、BMI与胎盘重量未见明显相关(P＞0.05),LGA、AGA组新生儿出生体重、身长、头围、腹围及BMI与胎盘重量呈正相关(P均＜0.01).(4) Rohrer's身体指数:FGR组胎龄≤37周小于2.00,胎龄＞37周小于2.20,LGA、AGA组均大于2.20;身长/头围比值三组均大于1.36.结论 妊娠期缺乏Fa及VB12可能发生高Hcy血症,FGR发病可能与血Hcy水平升高有关.妊娠晚期孕妇血清Fa、VB12、Hcy水平对胎儿体格状况有重要影响.胎盘重量在胎儿生长发育中具有重要作用.
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