目的 调查我国北方地区三个城市产妇母血、脐带血及其后不同泌乳阶段母乳中维生素A（vitamin A,VA）含量,分析母乳中VA含量的变化趋势并探讨母血与脐带血以及与母乳中VA含量的相关性。方法 在天津、长春、兰州三个北方城市招募健康足月产孕妇,收集其分娩时的静脉血（即母血）、脐带血以及其泌乳期的初乳、过渡乳和成熟乳,使用高效液相色谱仪对其中VA水平进行检测。结果 三城市产妇产时母血、脐带血中的VA含量[中位数（P25,P75）]分别为310.45（243.19,389.60）μg/L、151.30（128.49,175.09）μg/L ;初乳、过渡乳、成熟乳中的含量分别为695.97（509.92,854.90）μg/L、224.27（155.17,300.10）μg/L、100.75（63.50,162.00）μg/L,乳中的VA含量随泌乳期的延长而逐渐下降（P<0.05）;产妇维生素A缺乏（vitamin A deficiency, VAD）的患病率为15.12%,仅在患有VAD的孕妇中发现初乳与母血中的VA含量存在正相关性（r=0.676,P=0.011）。结论 母乳中VA含量随泌乳期延长而逐渐下降;当母体VA处于较低水平时,初乳中的VA含量随母血中VA的降低而降低;我国北方地区孕妇的VAD情况值得重视。
Abstract
Objective To investigate the contents of vitamin A (VA) in maternal plasma, umbilical cord plasma and human milk at different lactation stages in three cities of northern China, analyze the changing trend of VA content in human milk, and explore the association between maternal plasma and umbilical cord plasma as well as human milk. Methods Healthy full-term pregnant women were recruited in three northern cities including Tianjin, Changchun and Lanzhou. Their venous plasma (i.e., maternal plasma), umbilical cord plasma during delivery, and colostrum, transitional as well as mature milk samples during lactation were collected. The contents of VA in samples were analyzed by high-performance liquid chromatography. Results The contents of VA [median (P25, P75)] in maternal plasma and umbilical cord plasma at delivery in the three cities were 310.45 (243.19, 389.60) μg/L, 151.30 (128.49, 175.09) μg/L, respectively. The contents of VA in colostrum, transitional milk and mature milk were 695.97 (509.92, 854.90) μg/L, 224.27 (155.17, 300.10) μg/L, 100.75 (63.50, 162.00) μg/L, respectively. The contents of VA in breast milk decreased gradually with the extension of the lactation period (P<0.05). The prevalence of vitamin A deficiency (VAD) was 15.12%. In pregnant women with VAD, a positive association was found between the contents of VA in human colostrum milk and maternal plasma (r=0.676, P=0.011). Conclusion The contents of VA in human milk decrease gradually with the prolongation of the lactation period. When the content of maternal VA is at a low level, the content of VA in human colostrum milk decreases with the decrease of VA in maternal plasma. The findings in this study address the significance of VAD status in northern China.
关键词
维生素A /
母血 /
脐带血 /
母乳 /
中国北方
Key words
vitamin A /
maternal plasma /
umbilical cord plasma /
human milk /
northern China
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