目的 探讨母源性吸烟对新生儿出生体重、头围、身长及储存铁的影响,为提高我国围产保健水平提供理论依据。方法 以150名产妇及其新生儿为研究对象,按WHO推荐的吸烟频率分类将产妇分为不吸烟组,偶尔吸烟组以及每日吸烟组,于孕晚期进行膳食调查,计算其每日铁摄入量。测量新生儿的出生体重、身长、头围,并采集产妇外周血及新生儿脐带血,检测血清铁蛋白(SF)及血清可溶性转铁蛋白受体(sTfR)水平,计算全身铁(TBI)水平。结果 产妇在孕晚期的每日铁摄入量差异无统计学意义;不吸烟组新生儿出生体重明显高于两个吸烟组(P均<0.05);两个吸烟组新生儿的头围及身长差异无统计学意义(P均>0.05);不吸烟组产妇sTfR水平明显高于两个吸烟组(P均<0.001),SF和TBI水平均低于两个吸烟组(P均<0.05);不吸烟组新生儿sTfR水平明显低于两个吸烟组(P均<0.001),SF和TBI水平明显高于两个吸烟组(P均<0.001)。结论 母源性吸烟可引起产妇自身储存铁升高,而使新生儿出生体重以及储存铁降低。
Abstract
Objective To investigate the effect of maternal cigarette smoking on birth weight,head circumference birth length and iron stores in newborn to confirm the harm of smoking behavior in pregnancy,and to provide theoretical basis for improving the level of perinatal health care in China. Methods Totally 150 puerperas and their newborns were recruited.According to the WHO definition of cigarette smoking frequency,puerperas were divided into no smoking group,occasional smoking group and daily smoking group.Daily iron intake was assessed by dietary survey in every puerpera at late pregnancy.Birth weight,head circumference and birth length of newborns were measured.Serum ferritin (SF) and soluble transferrin receptor (sTfR) levels were analyzed in maternal peripheral blood and infant cord blood at the time of delivery.Then the levels of total body iron (TBI) were calculated. Results Birth weight of newborns in no smoking group was significantly higher than that of both two smoking group (all P<0.05).There was no significant difference in average head circumference and birth length of newborns in three groups (all P>0.05).The level of sTfR was significantly higher in puerperas of no smoking group than that of two smoking groups (all P<0.001).The levels of SF and TBI were significantly lower in puerperas of no smoking group than those of two smoking groups (all P<0.05).The sTfR of newborns in no smoking group was significantly lower than that of two smoking groups (all P<0.001).The levels of SF and TBI were significantly higher in newborns of no smoking group than those of two smoking groups (all P<0.001). Conclusion Maternal cigarette smoking is associated with higher iron stores in puerperal,as well as lower birth weight and iron stores in newborn.
关键词
母源性吸烟 /
新生儿 /
铁缺乏 /
全身铁
Key words
maternal cigarette smoking /
newborn /
iron deficiency /
total body iron
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] McLean E,Cogswell M,Egli I,et al.Worldwide prevalence of anaemia,WHO vitamin and mineral nutrition information system,1993-2005[J].Public Health Nutr,2009,12(4):444-454.
[2] Milman N.Iron and pregnancy a delicate balance[J].Ann Hematol,2006,85(9):559-565.
[3] 程贵辉,崔其亮,邱其周,等.被动吸烟孕母血浆白细胞介素-6和白细胞介素-10与早产关系的临床研究[J].中国儿童保健杂志,2015,23(11):1175-1177.
[4] 胡俊,李玉平.孕期被动吸烟对新生儿出生体重影响的临床研究[J].中国儿童保健杂志,2013,21(5):946-947.
[5] Machado Jde B,Plinio Filho VM,Petersen GO,et al.Quantitative effects of tobacco smoking exposure on the maternal-fetal circulation[J].BMC Pregnancy Childbirth,2011,11:24.
[6] Guilbert JJ.The world health report 2002 - reducing risks,promoting healthy life[J].Educ Health (Abingdon),2003,16(2):230.
[7] Lee J,Lee DR,Lee DH,et al.Influence of maternal environmental tobacco smoke exposure assessed by hair nicotine levels on birth weight[J].Asian Pac J Cancer Prev,2015,16(7):3029-3034.
[8] McKinnon B,Auger N,Kaufman JS.The impact of smoke-free legislation on educational differences in birth outcomes[J].J Epidemiol Community Health,2015,69(10):937-943.
[9] Pateva IB,Kerling EH,Reddy M,et al.Effect of maternal cigarette smoking on newborn iron stores[J].Clin Res Trials,2015,1(1):4-7.
[10] Chen X,Scholl TO,Stein TP.Association of elevated serum ferritin levels and the risk of gestational diabetes mellitus in pregnant women:The Camden study[J].Diabetes Care,2006,29(5):1077-1082.
[11] Cooksey RC,Jouihan HA,Ajioka RS,et al.Oxidative stress,beta-cell apoptosis,and decreased insulin secretory capacity in mouse models of hemochromatosis[J].Endocrinology,2004,145(11):5305-5312.
[12] Bouthoorn SH,van Lenthe FJ,Gaillard R,et al.Socioeconomic inequalities in placental vascular resistance:a prospective cohort study[J].Fertil Steril,2014,101(5):1367-1374.
[13] Rao R,Georgieff MK.Iron in fetal and neonatal nutrition[J].Semin Fetal Neonatal Med,2007,12(1):54-63.
[14] Geng F,Mai X,Zhan J,et al.Impact of fetal-neonatal iron deficiency on recognition Memory at 2 months of age[J].J Pediatr,2015,167(6):1226-1232.
[15] 董胜雯,曹璐佳,韩姹.母乳喂养效能及乳汁成分含量与产妇体重指数的相关性研究[J].中国妇幼保健,2015,30(1):30-33.
[16] Greer FR.How much iron is needed for breastfeeding infants [J].Curr Pediatr Rev,2015,11(4):298-304.
[17] Lubach GR,Coe CL.Preconception maternal iron status is a risk factor for iron deficiency in infant rhesus monkeys (Macaca mulatta)[J].J Nutr,2006,136(9):2345-2349.
[18] Koura GK,Ouedraogo S,Le Port A,et al.Anaemia during pregnancy:impact on birth outcome and infant haemoglobin level during the first 18 months of life[J].Trop Med Int Health,2012,17(3):283-291.
基金
哈尔滨市儿研所种子基金(HEY201401)
PDF(738 KB)
