孕妇红细胞叶酸水平与胎儿出生缺陷发病关系的研究  

Red cell folate concentration in relation to birth defects

作　　者：谭春英[1] 王燕[1] 楚严[1] 毛学群[1] 张邵勤[1] 

机构地区：[1]北京市海淀区妇幼保健院,北京100080

出　　处：《中国优生与遗传杂志》2011年第8期81-83,共3页Chinese Journal of Birth Health & Heredity

摘　　要：目的探讨孕妇红细胞叶酸水平与胎儿出生缺陷的发病关系。方法选择2007年9月至2008年12月在北京市海淀区妇幼保健院行常规产检的孕妇1504例作为研究对象,初检孕周12-15周,根据口服叶酸的时间不同分为三组：A组：孕前、孕期从未口服叶酸者210例;B组：孕后口服叶酸组者480例;C组：孕前口服叶酸者801例。在孕妇初诊时抽取外周血检测红细胞叶酸水平,比较三组间的叶酸水平有无差异;同时跟踪随访上述1504例孕妇至分娩,调查新生儿出生情况,对出生缺陷进行分类,比较三组间的差异。结果①A组平均红细胞叶酸水平348.88±93.34nmol/L,B组平均红细胞叶酸水平577.64±216.14 nmol/L,C组平均红细胞叶酸水平932.09±200.25 nmol/L。A组与B组比较差异有统计学意义（P〈0.01）,A组与C组比较差异有统计学意义（P〈0.01）。②A组孕妇胎儿发生出生缺陷35例（其中心脏系统畸形9例,包括先天性室间隔缺损6例,左心发育不全1例,法洛氏四联征1例,右室双出口、永存动脉干1例。染色体异常3例,包括2例经典型和1例易位型21-三体综合征。面部畸形5例,为先天性唇腭裂。泌尿生殖系统畸形10例,包括尿道下裂4例,肾缺如2例,多囊肾2例,肾积水（肾盂输尿管狭窄）1例,马蹄肾1例。神经管畸形3例,包括脊柱裂2例,脑积水1例。四肢发育异常2例,包括1例上肢缺如,1例多趾畸形。消化道畸形1例为先天性肛门闭锁。其他异常3例,为多系统发育畸形）。B组胎儿出生缺陷8例,包括染色体异常2例,1例为47,XXY,另1例为21-三体综合征。先天性多囊肾1例,尿道下裂1例,多趾畸形2例,唇腭裂1例,先心病（室缺）1例。C组胎儿出生缺陷7例,其中21-三体综合征1例,多趾畸形2例,尿道下裂2例,唇裂1例,肺囊腺瘤1例。结论孕前进行叶酸制剂的补充可以有效的提高孕妇红细胞叶酸水平,对于胎儿出生缺陷的预防有一定作用,尤其对先天性Objective：Make know the relationship between the red cell folate concentration and the birth defeces.Methods：Subjects were women in their first trimester of pregnancy.The 1504 gravidas were invided into three groups：A group：have no folate supplement;B group：have folate supplement after pregnant;C group：have folate supplement before pregnant.A face-to-face questionnaire was administrated to each woman.2 ml venous blood was drawn and red cell folat concentrations were determined and follow-up the fetus.Then analysis contrast amongst three groups.Results：① In A group the mean red cell folate concentration was 348.88±93.34nmol/L,B was 577.64±216.14 nmol/L,C was 932.09±200.25 nmol/L.There was significant difference among the three groups（P0.01）.② In A group there were 35 fetus who were congenital defects（including congenital heart defects 9,chromosome disorder 3,orofacial clefts 5,urogenital system anomalies 10,NTDs 3,limb anomalies 2,alimentary system 1 and others were 3.In B group there were 8,including chromosome disorder 2,urogenital system anomalies 2,limb anomalies 2,orofacial clefts 1,congenital heart defects 1.In C group there were 7,including Down′s syndrome 1,limb anomalies 2,urogenital system anomalies 2,orofacial clefts 1,pulmocystodeoma 1.Conclusion Periconceptional intake of folic acid can increase the red cell folate concentration and can low the morbility of congenital defects,especially in chromosome disorder and congenital heart defects.

关 键 词：妊娠 红细胞叶酸 出生缺陷 先天性心脏病 唐氏综合征 

分 类 号：R714.5[医药卫生—妇产科学]