Effects of intake of K-containing food among passive-smoking pregnant women on prevention of neonatal bleeding

研究目的：探讨孕期被动吸烟对脐血维生素K依赖凝血因子活性的影响，并从胎盘供应维生素K的角度探讨被动吸烟孕妇摄入含维生素K食物对预防新生儿出血的作用。研究方法：148例非吸烟产妇经胎盘分娩(被动吸烟组53例，非被动吸烟组95例)。经书面和口头解释后，获得同意。产后采脐静脉血加柠檬酸，测定凝血酶原时间、活化部分凝血活酶时间、肝活酶试验、血栓试验、维生素K依赖凝血因子活性(FII、FVII、FIX、FX)和非维生素K依赖凝血因子活性。此外，一种测定维生素K…的方法根据Wakabayashi等人(Folia Pharmacol.Jpn.116)S的高效液相色谱法，采用铂催化剂还原和电化学检测，对脐带血中更多的FVI和FIX进行了研究。结果和讨论：被动吸烟组的FVII和FIX显著低于非被动吸烟组。在两组发酵大豆摄入量的比较中，非被动吸烟组的FVII明显高于非摄入量组中的被动吸烟组，而摄入量组的组间差异不显著。两组在西兰花摄入量方面的比较显示，在非摄入量组中，非被动吸烟组的血栓测试值显著高于被动吸烟组，而摄入量组的组间差异不显著。对于可能难以避免被动吸烟的孕妇来说，定期摄入含维生素K的食物可能会提高胎儿血液中维生素K依赖的凝血因子的活性，从而提供一种预防早期新生儿出血的手段。较少

Study objective : The objectives of the present study were to elucidate the effects of passive smoking during pregnancy on changes in vitamin K-dependent clotting factor activity in cord blood, and to determine the effects of the intake of vitamin K-containing food among passive smoking pregnant women on prevention of neonatal bleeding, from the perspective of the transplacental supply of vitamin K.Study methods : Subjects were 148 non-smoking women who underwent vaginal delivery (passive smoking group, n=53; non-passive smoking group, n=95). Consent was obtained following written and oral explanations. Following delivery, citric acid-added plasma obtained from collection of umbilical venous blood was used to investigate the following : prothrombin time, activated partial thromboplastin time, hepaplastin test, thrombotest, vitamin K-dependent clotting factor activity (FII, FVII, FIX, FX) and non-vitamin K-dependent clotting factor activity. In addition, a method for measuring vitamin K … More in cord blood was investigated based on Wakabayashi et al.(Folia Pharmacol.Jpn.116)'s HPLC using platinum catalyst reduction and electrochemical detection.Results and discussion : The passive smoking group had significantly lower FVII and FIX than the non-passive smoking group. Comparison of the two groups with regard to the intake of fermented soybeans revealed a significantly higher FVII in the non-passive smoking group relative to the passive smoking group in the non-intake group, with no significant intergroup differences in the intake group. Comparison of the two groups with regard to the intake of broccoli revealed a significantly higher thrombotest value in the non-passive smoking group relative to the passive smoking group in the non-intake group, with no significant intergroup differences in the intake group. For pregnant women who may have difficulty avoiding passive smoking, regular intake of vitamin K-containing food may improve the activity of vitamin K-dependent clotting factors in fetal blood and thus provide a means of preventing early neonatal bleeding. Less