叶酸预防神经管畸形经济学效果的系统评价  

Systematic evaluation of economic effect of folic acid in prevention of neural tube defect

作　　者：吴博生 耿劲松[2] 黄媛[1] 陈英耀[1] 

机构地区：[1]复旦大学公共卫生学院卫生计生委卫生技术评估重点实验室,上海200032 [2]南通大学医学院

出　　处：《中国妇幼保健》2014年第16期2644-2647,共4页Maternal and Child Health Care of China

基　　金：上海市公共卫生高端人才海外研修项目〔GWHW2012S10〕;上海市公共卫生优秀学科带头人培养计划〔GWDTR201205〕;上海市公共卫生重点学科建设项目-卫生经济〔12GWZX0601〕

摘　　要：目的:系统评价叶酸预防神经管畸形的经济学效果。方法:在PubMed、Web of knowledge、Embase、NH SEED、CNKI、万方数据库对孕妇叶酸干预的文献进行检索。结果:共检索到6个国家11项研究,9篇是评价叶酸食品强化的成本效果〔3,4-6,8-9,11-13〕,另外2篇分析的是围孕期补充叶酸的成本效果〔7,10〕,其中只有1项研究〔11〕计算了间接成本,其他10项研究都只计算了花费的直接医疗成本。叶酸食品强化预防NTD的成本效益比,美国为4.3∶1,智利为11.8∶1,南非为30∶1,这些研究都显示通过围孕期补充叶酸预防神经管畸形是一种具有成本效果干预手段(除了新西兰叶酸食品强化项目之外)。结论:叶酸食品强化和围孕期直接补充叶酸,都是有效且具有成本效果的预防神经管畸形的干预措施。Objective： To systematically evaluate the economic effect of folic acid in prevention of neural tube defect. Methods：The literatures about intervention of pregnant women with folic acid were retrieved in PubMed,Web of Knowledge,Embase,NH SEED,CNKI and Wanfang Database. Results： A total of 11 studies in 6 countries were retrieved,including 9 studies evaluating the cost effectiveness of folic acid food fortification〔3,4-6,8-9,11-13〕and 2 studies analyzing the cost effectiveness of folic acid food supplement during periconceptional period〔7,10〕; among11 studies,only one study〔11〕calculated the indirect cost,the other ten studies only calculated the direct cost;the cost performance ratios of folic acid food fortification in prevention of neural tube defect in American,Chile and South Africa were 4. 3∶1,11. 8∶ 1 and 30∶ 1,respectively; all the studies showed that folic acid supplement during periconceptional period was an intervention method with cost effectiveness in prevention of neural tube defect（ except for the folic acid food fortification projects in New Zealand）. Conclusion： Both folic acid food fortification and direct supplement of folic acid are intervention measures with effectiveness and cose- effectiveness in prevention of neural tube defect.

关 键 词：叶酸 神经管畸形 经济学评价 

分 类 号：R715[医药卫生—妇产科学]