不同叶酸增补剂预防出生缺陷的效果评价--一项江苏地区横断面研究  

Evaluation of effect of different folic acid supplementation preparations on preventing birth defects:A cross-sectional study in Jiangsu province

作　　者：从静 浦丹华 谭容容 葛晓云[2] 朱维培[3] 沈彩娥[4] 葛建芬[5] 骆秀翠[6] 刘娟[7] 吴洁 CONG Jing;PU Danhua;TAN Rongrong;GE Xiaoyun;ZHU Weipei;SHEN Cai'e;GE Jianfen;LUO Xiucui;LIU Juan;WU Jie(The Srate Key Laborarory of Reproductive Medicine.Deparemerr of Gynecology and Obstetrics.The First Affiliased Hospiral of Nanjing Medical University/Jiangsn Prorincial Materniry and Child Health Hospiral,Jiangsu Nanjing 210000,China;Naniong Mnnicipal Maternily and Child Healh Hospial,Jiangsu Naniong 26000,China;The See-ond Affilialed Hos pilal of Sazhou Universiy Jiangzu Suzhou 215000,China;Suthou Maternal and Child Health Med-ical Care Center.Jiangsu Suzhou 215000,China;Yancheng Municipal Maternity and Child Health Hos pital,Jiangsu Yancheng 224000,China;Lianyungang Municipal Maternity and Child Heath Hospital.Jiangsu Lianyungang 222000,China;Yangzhou Municipal Maternity and Child Health Hospiral.Jiangsu Yangchou 225000,China)

机构地区：[1]南京医科大学第一附属医院江苏省妇幼保健院妇产科,江苏南京210000 [2]南通市妇幼保健院,江苏南通226000 [3]苏州大学第二附属医院,江苏苏州215000 [4]苏州市母子医疗保健中心,江苏苏州215000 [5]盐城市妇幼保健院,江苏盐城224000 [6]连云港市妇幼保健院,江苏连云港222000 [7]扬州市妇幼保健院,江苏扬州225000

出　　处：《中国妇幼健康研究》2020年第7期916-921,共6页Chinese Journal of Woman and Child Health Research

基　　金：江苏省妇幼健康科研资助项目(F201613);江苏省妇幼保健重点学科资助项目(FXK201201)。

摘　　要：目的 比较江苏地区的不同叶酸(FA)增补剂对出生缺陷的预防效果.方法 选取2017年1月至2018年12月期间在江苏省分娩的胎龄≥28周的孕妇资料10662例.将服用FA增补剂者分为FA组,未增补FA者分为无FA组;根据孕期FA补充的剂量与成份分为三组:单纯0.4mg FA(0.4FA)组、含0.4mg FA的复合维生素(MV+0.4FA)组及含0.8mg FA的复合维生素(MV+0.8FA)组;同时根据补充FA增补剂的时间分为早孕期(妊娠3个月内)补充组和全孕期补充组.根据问卷调查表,由培训专员收集孕妇的一般情况、FA增补情况、生育史、职业和环境因素、新生儿出生缺陷情况等信息,并进行详细记录.用Logistic回归及卡方检验等方法对FA增补剂量、成份及时间与出生缺陷发生的关系进行统计分析.结果 在10662例江苏省女性分娩的新生儿中,总出生缺陷发生率为1.37%(146/10662).与FA组比较,无FA组中总出生缺陷发生率显著增加(OR=2.23,95%C I:1.05~4.73,P=0.03);进一步分析排名前八的具体出生缺陷类型为多指畸形、先天性心脏病、耳畸形、尿道下裂、脑积水、唇裂、腭裂及马蹄内翻,组间差异均无统计学意义(均P>0.05).不同FA增补剂量的三组总出生缺陷发生率比较差异无统计学意义(P>0.05);不同FA增补时间的两组总出生缺陷发生率比较差异无统计学意义(P>0.05).结论 孕期FA增补剂可显著降低总出生缺陷发生率,不同增补剂量及剂型的效果类似,且孕妇仅在早孕期补充FA可预防出生缺陷.Objective To compare preventive effect of different preparations of folic acid(FA)supplementation on birth defects in Jiangsu province.Methods A institution-based cross-sectional study was conducted.The clinical data of 10662 pregnant women with gestational age≥28 weeks who delivered in Jiangsu province from January 2017 to December 2018 were collected.According to whether the pregnant women having had taken FA supplementation,the pregnant women were divided into FA group and Non-FA group.And according to the FA content in the preparation,the pregnant women again divided into three subgroups:FA0.4 group(pure 0.4 mg of FA),MV+FA0.4 group(multivitamins with 0.4 mg of FA)and MV+FA0.8 group(multivitamins with 0.8 mg of FA).According to the duration of FA supplementation,the pregnant women were divided into two groups:FA supplementation in the first trimester group and FA supplementation in the whole pregnancy group.General information of the pregnant women,FA intake during the gestational period,childbearing history,occupation and environmental factors and birth defects were collected and recorded in detail through face-to-face interview and chart-review by the trained doctors or midwives.Logistic regression and chi-square test were conducted and relationships of dose,content and duration of FA supplementation with occurrence of birth defect was statistically analyzed.Variables with P value<0.05 were considered statistically significant at 95%confidence interval(CI).Results The incidence of total birth defects in Jiangsu province was 1.37%(146/10662)and that in the non-FA group was significantly higher than that in the FA supplementation group(OR=2.23,95%CI:1.05~4.73,P=0.03).And no significant difference was found in the incidence among the top eight specific birth defects subgroups,including polydactyly,congenital heart disease,ear malformation,hypospadia,hydrocephalus,cleft lip,cleft palate and equinovarus(all P>0.05).However,no significant difference in total birth defects or specific birth defects among three F

关 键 词：叶酸 叶酸剂量 复合维生素 出生缺陷 江苏省 

分 类 号：R714.7[医药卫生—妇产科学]