Journal of Nutrition and Health

  • 제35권3호
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  • Pages.322-331
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  • 2002
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  • 2288-3886(pISSN)
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  • 2288-3959(eISSN)
한국영양학회 (The Korean Nutrition Society)
권호 표지

임신부의 비타민 $B_{6}$ 섭취와 모체와 제대혈 및 태반 조직의 비타민 $B_{6}$농도

Maternal Vitamin $B_{6}$ Intake and Vitamin $B_{6}$ Level in Maternal, Umbilical Cord Plasma and Placenta

  • 안홍석 (성신여자대학교 식품영양학과) ;
  • 이금주 (성신여자대학교 식품영양학과) ;
  • 정환욱 (성균관대학교 의과대학 삼성제일병원 산부인과교실)
  • 발행 : 2002.04.01
⟨ 이전 논문 다음 논문 ⟩

초록

본 연구는 정상만기분만 임신부 (30명)와 그들의 신생아를 대상으로 임신부와 비타민$B_{6}$ 섭취양상과 모체와 신생아 제대혈장 및 태반조직내의 비타민$B_{6}$ 농도를 측정하고 이들 농도와 임신결과와의 상관성을 조사하며, 모체에서 태아로 비타민$B_{6}$가 이동될 때, 태반의 역할을 규명하고자 하였다. 임신부의 평균 연령과 임신 전 체중 및 신장은 각각 25.9세, 53.8kg 및 161 cm 였으며, 임신 전 체중 및 신장은 각각 25.9세, 53.8 kg 및 161cm 였으며, 임신 전 BMI는 20.7kg/$m^2$로 정상 범위였다. 수축기와 이완기 평균 혈압은 122.5 mmHg 와 75.2mmHg의 결과로 안정적인 수준이었으며 헤모글로빈 농도와 헤마토크리트치는 12.1g/dl와 36.1%로 양호하였다. 연구대상자 중 93.3%에 해당하는 임신부가 영양보충제를 복용했으며 이 중 85.7%가 엽산과 철분이 포함된 빈혈 치료제를 이용한 것으로 조사되었다. 영양보충제의 평균 복용기간은 16.3주였다. 임신부가 1일 평균 열량 섭취량은 2189.5kcal로 권장량의 93.2%였으며, 단백질은 79.3g(113.3%)으로 권장량을 상회하였다. 비타민 B$_{6}$의 평균 섭취량은 권장량은 91.4%인 1.7mg이었고, 비타민 $B_{6}$의 평균 섭취량은 권장량은 91.4%인 1.7mg이었고, 비타민 $B_{6}$ 영양밀도와 단백질 g 당 섭취량은 각각 0.8와 0.02mg으로 양호한 결과였다. 그러나, 비타민$B_{6}$의 주된 공급식품이 곡류 및 전분류 (50%)와 야채 및 과일류 (33%)로 식물성 식품이 대부분이었다. 임신 말 모체 혈장과 신생아 제대혈장의 PLP 농도는 각각 16.7$\pm$4.1 nmol/l와 61.3$\pm$19.8 nmol/l로 제대혈장의 PLP 농도가 유의적으로 높았으며, 태반조직의 PLP 농도는 898.6$\pm$159.2ng/g으로 혈장의 PLP 농도에 비해 매우 높은 값을 보였다. 모체와 태반조직 및 신생아 제대혈장간 PLP 농도의 상관성을 조사한 결과, 모체 혈장과 태반 조직간 (p<0.0001), 태반 조직과 신생아 제대혈장간 (p<0.05), 모체 혈 장과 제대혈장간(p<0.05) 유의적인 양의 상관관계가 있었다.

This study was carried out to evaluate the effect of vitamin $B_{6}$ intake by normal term delivery pregnant women on the concentration of vitamin $B_{6}$ in the material plasma, the umbilical cord plasma, and the placental tissue. Dietary intake data were obtained from a semi-quantitative frequency questionnaire. The daily mean energy and protein intakes were 2189.5 kcal (93.2% of RDA) and 79.3 g (113.3% of RDA), respectively. The average daily vitamin $B_{6}$ intake was 1.7 mg (91.4% of RDA) for the pregnant women. Their main sources of vitamin $B_{6}$ were cereal & starch (50%), and vegetables & fruits (33%). The pyridoxal phosphate (PLP) concentration of the maternal plasma, the umbilical cord plasma, and the placenta were 16.7 $\pm$ 4.1 nmol/1, 61.3 $\pm$ 19.8 nmol/l and 898.6 $\pm$ 159.2 ng/g, respectively. The PLP level was the highest in the placenta. The PLP level of the maternal plasma was significantly lower than the of the umbilical cord plasma (p < 0.001). The PLP level of maternal plasma correlated positively with that of the placenta (p < 0.0001) and the umbilical cord plasma (p < 0.05). Also the PLP level of the placenta correlated positively with that of the umbilical cord plasma (p < 0.05). These findings indicate that the vitamin $B_{6}$ nutritional status of the fetus is affected by placental vitamin $B_{6}$ levels, and that the placental vitamin B$_{6}$ levels reflect the maternal vitamin $B_{6}$ status. The umbilical cord plasma PLP level showed a positive correlation with the gestational length (p < 0.05). A negative association was observed between the PLP level showed of the umbilical cord plasma and the pregnancy weight gain (p < 0.03). The results suggest that the transfer of PLP from maternal plasma to the placental tissue could be an active transport, white the transfer of PLP from the placenta to the fetus is by means of simple diffusion. Thus, neonatal vitamin $B_{6}$ nutrition is influenced by the maternal nutritional status.

키워드

참고문헌

  1. Borschel MW. Vitamin B-6 in infancy. In: Vitamin B-6 Metabolism in Pregnancy, Lactation and Infancy. pp.109-125, CRC, 1995
  2. Ameriacn Academy of Pediatrics. Nutritional needs of low-birthweight infants. Pediatrics 60: 19-30,1977
  3. Myron B. Abnonnal trytophan metabolism in pregnancy and with the oral contracepBve pill II. Relative levels of vitamin B\{_6}-vitamers in cord and matemal blood. Am J Clin Nutr 24: 704-708,1971
  4. Hedric CB, Jan J De Kock, William JH. A new perspective in the as sessment of vitamin B6 nutritional status during pregnancy in humans. J Nutr 117: 1303-1306,1987
  5. Micharel HB, Penttiks. Pyiidoxal phosphate and hypertensive disorders of piegnancy. Am J Obstet Gynecol 15: 1075-1079,1975
  6. Jack AK, Evrard JP, Pierce R. Abnormal pyriddoxin metabolism in toxemia of pregnancy. Am J Obstet Gynecol 1: 316-321,1966
  7. Tomas RG, Herry NW. Increased concentrations vitamin $B_6$ deficient neonatal rat brain. J Neurochem 49: 1919-1926,1987
  8. Judith LB, Avanelle K. Vitamin $B_6$ nutriture during pregnancy and lactation vitamin $B_6$ intake, levds of the vitamin in tnological fluids and condition of the infant at birth. Am J Clin Nutr 32: 2249-2256,1979
  9. Karen S, Lynn BB, Charles SM. Vitamin $B_6$ status of low income adolescent and adult pregnant women and the condiHon of their infants at birth. Am J Clin Nutr 34: 1731-1735,1981
  10. Thomson AM. Diet in preganacy. Brit J Nutr 13: 509,1959 https://doi.org/10.1079/BJN19590065
  11. Smith CA. Effects of maternal undernutrition upon the newborn infant in Holland (1944 -1945). J Paediat 30: 229,1947 https://doi.org/10.1016/S0022-3476(47)80158-1
  12. Willis RS, Winn WW, Morris AT, Newsom AA, Massey WE. Clinical observation in treatment of nausea and voiniting in pregnancy with vitamin $B_1$ and $B_6$}, Am J Obstet GynecoI 44: 265,1942 https://doi.org/10.1016/S0002-9378(42)90598-2
  13. Baker H, Frank O, Deangdis B, Telingold S, Kamruetzky HA. Role of placenta in matemal-fetal vitamin transfer in humaiis. Am J Obstet Gynecol 141: 792-796,1981 https://doi.org/10.1016/0002-9378(81)90706-7
  14. Rosso P. Placental growth, devdopment, and function in relation to maternal nutrition. Fed Proc 39: 50,1980
  15. Krause MV, Mahan LK. Food, nutrition and diet therapy. In: Nutritional care. pp.200-210, Philadelpjia WB Saunders, 1984
  16. Conway SP, Rawson I, Dear PRF, Shires SE, Kelleher J. The early anaemia of the premature infant: is there a place for vitamin E supplementation? Br J Nutr 56: 105-114,1986 https://doi.org/10.1079/BJN19860090
  17. Andon M, Reynolds RD, Moser PB. Impaired ability of premature infants <29 wks gestational age to convert pyiidoxine to pyiidoxal phosphate. Fed Proc 46: A1016 (abstr), 1987
  18. Infant and Perinatal Motality Rates of Korea in 1996 and Cause of Death. Korea Institute For health and Sodal Affaiis, pp.38-50,1996
  19. Hoffman HJ, Bakketeig LS. Risk factors associated with the occurrence of preterm birth. Clin Obstet Gynecol 27: 539-552,1984 https://doi.org/10.1097/00003081-198409000-00004
  20. Greene HL, Smith R, Swift L, Poweis J, Baeckert P, Adcock E. Pyridoxine leveb in very low birth weight and adult patients receiving total paienteral nutrition (TPN). PediatrRes 25: 113A (abstr), 1989
  21. Dancis J, Lehanka J, Levitz M. Placental transport of riboflavin: Differential rates of uptake at the matemal and fetal surfaces of perfused human placenta. Am J Obstet Gynecol 158: 204-210,1988 https://doi.org/10.1016/0002-9378(88)90811-3
  22. Streeter ML, Rosso P. Transport mechanism for ascorbic add in the human placenta. Am J Clin Nutr 34: 1706-1711,1981
  23. Schenker S, Raynond FJ, Dennis M, Georage IH, Stephen PC. Human placental vitamin B (pyndoxal) transport: Normal characteiistics and effects of ethanol. Am Physi Soci R966-R974,1992
  24. Afried H, Richard MS, Wilhelm FK. Vitamin B,, status in pregnancy. Am J Clin Nutr 26: 1339-1348,1973
  25. Cleary RE, Lawrence L, Li TK. Maternal and fetal plasma leveb pyridoxial phosphate at term: Adequacy ot vitamin Bt supplementation during piegnancy. Am J Obstet Gynecol 121: 25-28,1975 https://doi.org/10.1016/0002-9378(75)90968-0
  26. Sempos CT. Some limitation of semiquantitative food frequency questionnair. Am J Epid 135: 1127-1132,1992 https://doi.org/10.1093/oxfordjournals.aje.a116212
  27. Lee HJ, Lee HS, Ha MJ, Kye SH, Kim CI, Lee CW, Yoon JS. The development and evaluation on assess the dietary of intake of adults in large cities. Korean J Commmity Nutr 2: 349-365,1997
  28. Hansen H, Sandstrom B, Jensen B. Erythrocyte levek compared with reported dietary intake of marine n-3 fatty acids in piegnant women. Br J Nutr 73: 387-395,1995 https://doi.org/10.1079/BJN19950041
  29. Kesmodel U, Olsen SF, Salvig JD. Maiine n-3 fatty add and calcium intake in relation to pregnancy induced hypertension, intrauterine growth relation and delivery. Acta Obstet Gynec Scand 76: 38-44,1996 https://doi.org/10.3109/00016349709047782
  30. Recommended dietary allowances for Koreans, 7th revision. The Korean Nutrition Society, Seoul, 2000
  31. Kang-Yoon SA, Kirksey A, Gracoia G, West K. Vitamin B-6 status of breast-fed neonates: influence of pyndoxine supplementation on mothers and neonates. Am J Clin Nutr 56: 548-558,1992
  32. Wang JW, Trumbo PR. Bioavailiability of vitamin B-6 in pregnant rats. J Nutr 122: 1892-1897,1992
  33. Bruce H, Avanelle K, Athula E, Marlene B. Analysis of B-6 vitamins in human milk by reveise-phase liquid chromatography. Am J Clin Nutr 42: 650-655, 1985
  34. Park SH, Ahn HS. Dietary Fat Intake during Pregnancy and Serum Lipid Levek in Mother and Umbilical Cord of FuB-term and Preterm Delivery. Korean J Nutrition 32(5): 577-584,1999
  35. Ahn HS, Park SH. Matemal serum zinc concentration and pregnancy outcomes. Korean J Nutrition 32(2): 182-188,1999
  36. Kim CN, Chung HK, Song ES. Maternal vitamin B-6 intake and phydoxine status of Korean newboms at partuhtion. Korean J Nutrition 27(9): 930-939,1994
  37. Ahn HS, Lee GJ, Kim YT. Relationships between Vitamin B6 Status of Matemal-Umbilical Cord Plasma and Pregnancy Outcomes. Korean J Nutrition 33(3): 263-270, 2000
  38. Cho YO, Kim YM. Dietary Intake and Major Dietary Sources of Vitamin $B_6$ in Korean Young Women. Nutrition Sciences 4(1): 20-25, 2001
  39. Leklem JE. Vitamin B-6. In: Machh LJ. Handbook of vitamins, 2nd ed., pp.341-392, New York, 1991
  40. Kabir H Leklem JE, Miller LT. RdaUonship of glycosylated vitamin B-6 content of foods of vitamin B-6 bioavailability in human. J Nutr 113: 2412-2420,1993
  41. Karen S, Lynn BB, Chailes SM. Effect of matemal pyndoxme-HCl supplementadon on the vitamin B-6 status of mother and infant and on pn-gnancy outcome. J Nufr 114: 977-988,1984
  42. Shultz TD, Leklem JE. Urinary 4-pyndoxic add, urinary vitamin B-6 and placenta pyndoxal phosphate as measures of vitamin B-6 status and dietary intake in adults. In: Method in Vitamin B-6 NutriBon. Plenum Press, New York, 1981
  43. Gerold L, Jammos Z. Intrauterine elimination of phyhdixal 5'-phosphate in full-term and preterm infant. Am J Clin Nutr 64: 184-189,1996
  44. Klieger JA, Evrad JR, Dierce R. Abnormal pyhdoxine metabolism in toxemia of pregnancy. Am J Obstet Gynecol 94(3): 316-321,1966 https://doi.org/10.1016/0002-9378(66)90651-X
  45. Klieger JA, Evrad JR, Dierce R. Abnormal pyhdoxine metabolism in toxemia of pregnancy. Am J Obstet Gynecol 94(3): 316-321,1966 https://doi.org/10.1016/0002-9378(66)90651-X
  46. Roepke JLB, Kirksey A. Vitamin B6 nutriture during pregnancy and lactation II. The effect of long-term use of oral contraceptives. Am J Clin Nutr 32: 2257-2264,1979
  47. Kang-Yoon SA, Kirksey A, Giacoia GP, West KD. Vitamin B-6 adequacy in neonatal nutrition: assodations with pieterm delivery, type of feeding, and vitamin B-6 supplementation. Am J Clin Nutr 62: 932-942,1995
  48. Moloney CJ, Dannalee AH. Convulsions in young infants as a result of pyridoxine (vitamin B-6 deficiency). J Am Med Assoc 154: 405,1954 https://doi.org/10.1001/jama.1954.02940390029008