围孕期叶酸补充情况及其对妊娠结局影响  

The study of periconception folic acid supplementation and its relationship with pregnancy outcome

作　　者：陈甘讷[1] 蒋敏[2] 黄伟雯 赵欣洁[1] 刘云辉[1] 黄婉平[1] CHEN Gan-ne;JIANG Min;HUANG Wei-wen;ZHAO Xin-jie;LIU Yun-hui;HUANG Wan-ping(Department of Health,Guangzhou Huadu District Maternal and Child Health Hospital,Guangzhou Huadu District,Guangzhou 510800,China;Department of Epidemiology and Health Statistics,West China School of Public Health,Sichuan University,Chengdu 610041,China)

机构地区：[1]广州市花都区妇幼保健院保健部,广东510800 [2]四川大学华西公共卫生学院流行病与卫生统计学系,四川610041

出　　处：《中华疾病控制杂志》2021年第2期160-164,共5页Chinese Journal of Disease Control & Prevention

基　　金：四川省科技厅重点研发项目(2019YFS0409);广州市科学研究专项(201707010239);花都区医疗卫生一般科研专项(19-HDWS-082)。

摘　　要：目的了解单胎妊娠围孕期叶酸补充情况和补充剂量,探讨围孕期叶酸补充与妊娠结局的关系。方法以2017年10月―2019年6月期间在广州市花都区妇幼保健院分娩的6 536例单胎活产的孕妇作为研究对象。在分娩前或分娩后回顾性的调查孕妇一般人口学特征、围孕期增补叶酸情况及妊娠结局等信息。结果孕前半年服用叶酸坚持1个月以上的孕妇1 345人(20.18%);围孕期每日叶酸服用剂量正常的孕妇764人(11.69%)。与未补充叶酸相比,孕前补充叶酸可使新生儿增加74.68 g出生体重,孕后补充增加55.05 g(P<0.05)。在控制孕妇年龄、文化水平、孕前BMI、被动吸烟时间等相关因素后,孕前补充叶酸可以使小于胎龄儿(small for gestational age, SGA)的发生风险降低(aOR=0.66, 95%CI:0.46~0.95)。低出生体重(low birth weight, LBW)和自发早产与叶酸补充类型无关。围孕期高剂量补充叶酸可能增加自发早产的发生风险(aOR=1.75, 95%CI:1.02~3.01)。SGA和LBW与叶酸补充剂量无关。结论围孕期补充叶酸可以促进胎儿生长,降低SGA的发生风险。Objective This study aimed to investigate the situation and dosage of penconception folic acid supplementation and to explore the association between periconception folic acid supplementation and pregnancy outcome. Methods A total of 6 526 pregnant women were recruited from October 2017 to June 2019 in Huadu District of Guangzhou. R retrospective surveys before or after delivery were conducted to collect information about general demographic characteristics, periconception folic acid supplementationand pregnancy outcomes. Results There were 1 345 pregnant women(20.18%) taken folic acid for more than one month at half a year before pregnancy. 764(11.69%) pregnant women took normal daily dosage of folic acid during periconception. Preconception folic acid supplementation was associated with 74.68 g higher birth weight and the first-trimester supplementation increased 55.05 g(P<0.05), compared to no folic acid supplementation. After adjusted maternal age, educational level, pre-gestational body mass index(BMI), passive smoking time, periconception folic acid supplementation could reduced the risk of small for gestational age( SGA) infants(aOR=0.66;95% CI:0.46-0.95). Low birth weight(LBW) and spontaneous preterm delivery were not related to the type of folic acid supplementation. High-dose folic acid during periconception may increased the risk of spontaneous preterm(aOR=1.75;95% CI: 1.02-3.01). SGA and LBW were not related to folic acid dose. Conclusions Periconception folic acid supplementation was positively associated with fetal growth resulting in birth weight, and decreased risks of SGA.

关 键 词：叶酸 出生体重 妊娠结局 

分 类 号：R715.3[医药卫生—妇产科学]