孕期个性化补充叶酸对新疆地区新生儿出生缺陷的影响  

Effect of personalized folic acid supplementation during pregnancy on birth defects in Xinjiang

作　　者：钱芳 纵瑞奇 王军 王志勇 QIAN Fang;ZONG Ruiqi;WANG Jun;WANG Zhiyong(Department of Genetics,the Eighth People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi,Xinjiang 8300o0,China;Xinjiang Uygur Autonomous Region Science and Technology Project Service Center,Urumqi,Xinjiang 830000,China;Laboratory Department of the Eighth People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi,Xinjiang,830000,China;Department of Andrology,the Eighth People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi,Xinjiang 830000,China)

机构地区：[1]新疆维吾尔自治区第八人民医院遗传科,新疆乌鲁木齐830000 [2]新疆维吾尔自治区科技项目服务中心项目中心,新疆乌鲁木齐830000 [3]新疆维吾尔自治区第八人民医院检验科,新疆乌鲁木齐830000 [4]新疆维吾尔自治区第八人民医院男科,新疆乌鲁木齐830000

出　　处：《中国优生与遗传杂志》2022年第9期1531-1535,共5页Chinese Journal of Birth Health & Heredity

基　　金：新疆维吾尔自治区自然科学基金资助项目(2018D01A59)。

摘　　要：目的 探讨孕期个性化补充叶酸对新疆地区新生儿出生缺陷的影响。方法 选择新疆14个县市4200名汉族、维吾尔族、哈萨克族妇女作为研究组,对照组4200名妇女按照年龄±1、地区相同、民族相同、产次相同的方案1∶1匹配。对照组根据WHO建议,从入组日起每日额外补充叶酸400μg,维持至妊娠12周。观察组给予MTHFR C677T、MTHFR A1298C和MTRR A66G基因检测,评估受试者叶酸利用能力障碍情况,给予个体化叶酸干预。观察指标2组新生儿出生缺陷的发生率、小于胎龄儿(SGA)、早产及出生体质量、身长、头围、孕期贫血发生率和服用叶酸依从率。结果 观察组新生儿出生缺陷率低于对照组,差异有统计学意义(P<0.05)。观察组SGA、早产率低于对照组,差异有统计学意义(P<0.05);观察组出生体、身长均高于对照组,差异均有统计学意义(P<0.05);2组头围相比较差异均无统计学意义(P>0.05)。观察组孕早期、中期和晚期时贫血发生率均低于对照组,差异均有统计学意义(P<0.05)。观察组服用叶酸依从率高于对照组,但差异无统计学意义(P>0.05)。结论 针对新疆地区育龄期妇女的特点进行个化、针对性叶酸补充,有利于减少新生儿出生缺陷发生率。Objective To explore the effect of personalized folic acid supplementation during pregnancy on birth defects in Xinjiang. Methods 4200 Han, Uygur and Kazak women from 14 counties and cities in Xinjiang were selected as the study group. 4200 women in the control group were matched according to the scheme of age±1, the same region, the same nationality and the same birth time. The control group was additionally supplemented with folic acid 400 per day from the date of enrollment according to the recommendations of who μg. Maintained until 12 weeks of gestation. The observation group was given MTHFR C677T, MTHFR A1298C and MTRR A66G gene detection to evaluate the disorder of folate utilization ability, and individualized folate intervention was given. Outcome measures the incidence of neonatal birth defects, small for gestational age(SGA), preterm birth, birth weight, body length, head circumference, incidence of anemia during pregnancy and compliance with folic acid in the two groups. Results The rate of birth defects in the observation group was lower than that in the control group(P<0.05). The SGA and preterm birth rates in the observation group were lower than those in the control group(P<0.05). The birth body and body length in the observation group were higher than those in the control group(P<0.05),and there was no significant difference in head circumference between the two groups(P>0.05). The incidence of anemia in the early, middle and late pregnancy of the observation group was lower than that of the control group, and the difference was statistically significant(P<0.05). Conclusion Individualized and targeted folic acid supplementation according to the characteristics of women of childbearing age in Xinjiang is helpful to reduce the incidence of neonatal birth defects.

关 键 词：新生儿出生缺陷 叶酸 叶酸代谢关键酶 孕妇 

分 类 号：R174[医药卫生—妇幼卫生保健]