待产女性血清维生素B12和叶酸水平的流行病学特征  

Epidemiological characteristics of serum vitamin B12 and folate levels in women awaiting delivery

作　　者：杜玉娇 李晶 王红丽 杜姣洋 屈鹏飞 张若 郭乐倩 颜虹 党少农 Du Yujiao;Li Jing;Wang Hongli;Du Jiaoyang;Qu Pengfei;Zhang Ruo;Guo Leqian;Yan Hong;Dang Shaonong(Department of Epidemiology and Biostatistics,School of Public Health,Xi’an Jiaotong University Health Science Center,Xi’an 710061,China;Assisted Reproduction Center,Northwest Women’s and Children’s Hospital,Xi’an 710003,China)

机构地区：[1]西安交通大学医学部公共卫生学院流行病与卫生统计系,710061 [2]西北女性儿童医院辅助生殖中心,西安710003

出　　处：《中华流行病学杂志》2020年第8期1359-1364,共6页Chinese Journal of Epidemiology

基　　金：陕西省卫生和计划生育委员会出生缺陷防治课题研究(Sxwsjswzfcght2016-013);国家自然科学基金重点项目(81230016);国家重点研发计划(2017YFC0907200,2017YFC0907201)。

摘　　要：目的分析陕西省待产女性维生素B12和叶酸水平及两者间关系的流行病学特征。方法资料来源于2014年1月至2016年12月在6所三甲医院待产的健康孕妇,产前采集血样以测定维生素B12和叶酸水平。采用分位数回归模型分析待产女性维生素B12和叶酸水平间的关系。结果共纳入1277名待产女性,其血清维生素B12的中位数为164.7 pg/ml,缺乏率为69.6%,血清叶酸的中位数为7.6 ng/ml,缺乏率为12.1%,单纯缺乏维生素B12者占58.4%,单纯缺乏叶酸者占0.9%。农村待产女性维生素B12和叶酸水平低于城市女性,维生素B12和叶酸水平随年龄的增长而呈不同幅度增加,<25岁者维生素B12和叶酸水平明显较低。叶酸缺乏者的维生素B12水平比非缺乏者平均低37.62 pg/ml,分位数回归模型显示,在不同的维生素B12分位点上,叶酸缺乏者的维生素B12水平明显低于不缺乏者,且这种差异随着维生素B12水平的升高而增大。结论陕西省待产女性维生素B12和叶酸缺乏症仍普遍存在,在妇幼保健实践中,叶酸增补的同时可能需重视维生素B12补充。加大健康教育力度,重点提高农村和年轻女性对营养素补充重要性的认识,从而改善其维生素B12和叶酸水平。Objectives To analyze the epidemiological characteristics and levels of vitamin B12 and folate as well as their relationship in women awaiting delivery,in Shaanxi province.Methods Data were collected from healthy pregnant women who gave birth at six top hospitals in Shaanxi,from January 2014 to December 2016.Blood samples were taken prenatally to determine the levels of vitamin B12 and folate.Quantile regression model was used to analyze the relationship between the levels of vitamin B12 and folates in women awaiting delivery.Results A total of 1277 women awaiting delivery were included in this study.Among them,the median level of serum vitamin B12 was 164.7 pg/ml,in women at late pregnancy,with the deficiency rate as 69.6%,while the median level of serum folate was 7.6 ng/ml,with the deficiency rate as 12.1%.58.4%of these women presented simple vitamin B12 deficiency and 0.9%with simple folate deficiency.Women living in rural areas showed lower levels of both vitamin B12 and folate than the women from the urban areas.Both the levels of vitamin B12 and folate increased with age but were significantly lower in women under the age of 25.Among those with or without folate deficiency,the average difference in the levels of vitamin B12 was 37.62 pg/ml.Quantile regression models showed that the vitamin B12 levels in women with folate deficiency were significantly lower than those without,despite the different levels of vitamin B12.This difference appeared increasing along with the increase of the vitamin B12 levels.Conclusions Our data showed that both vitamin B12 and folate were deficient in women awaiting delivery,in Shaanxi.We suggest that vitamin B12 should also be added into the folic acid supplementation program,together with the reinforcement on health education program to improve the awareness of nutrient supplementation in rural and young women.Hopefully,these strategies could increase the levels of both vitamin B12 and folate,in the province.

关 键 词：维生素B12 叶酸 待产 缺乏率 

分 类 号：R715.3[医药卫生—妇产科学]