MMWR Morb Mortal Wkly Rep. 2007 Oct 26;56(42):1106-9.
Daily intake of 400 microg of folic acid before conception can reduce by approximately 80% the risk for having an infant with a neural tube defect (NTD) such as spina bifida or anencephaly. Although other risk factors for NTDs exist, such as diabetes, obesity, and family history of NTDs, prevention measures have focused predominantly on promoting folic acid consumption. Women can ensure they are consuming the recommended amount of folic acid by eating one serving of breakfast cereal fortified with 100% of the recommended daily value of folic acid or by taking a supplement with 400 microg folic acid daily. Annual surveys conducted for the March of Dimes (MOD) Birth Defects Foundation indicate that 40% of all U.S. women of reproductive age (i.e., aged 15-45 years) took supplements containing folic acid in 2007 (MOD, unpublished data, 2007), up from 28% in 1995. To analyze trends in folic acid-containing supplement intake among California women aged 18-44 years during 2002-2006, the California Department of Public Health conducted trend analyses of data from the California Women's Health Survey (CWHS). This report summarizes the results of those analyses, which indicated that although the overall prevalence of intake of folic acid-containing supplements remained stable from 2002 (40%) to 2006 (41%) in California, use of such supplements decreased among Hispanic women and women with less education. Downward trends among Hispanic women are of particular concern because 1) Hispanic women are at increased risk for having a fetus or an infant with an NTD compared with women of other races/ethnicities, 2) the number of births to Hispanics in California increased during 1993-2003, and 3) Hispanics accounted for nearly 52% of all births in California in 2005 (California Department of Public Health, unpublished data, 2005). Development of additional targeted and evidence-based public health interventions for increasing folic acid intake among these populations is needed.
在怀孕前每天摄入400微克叶酸可使生出患有神经管缺陷（NTD）如脊柱裂或无脑儿的婴儿的风险降低约80%。尽管存在其他神经管缺陷的风险因素，如糖尿病、肥胖症以及神经管缺陷的家族史，但预防措施主要集中在促进叶酸摄入方面。女性可以通过食用一份添加了100%每日推荐量叶酸的早餐谷物食品或每天服用一片含400微克叶酸的补充剂来确保摄入推荐量的叶酸。为美国疾病控制与预防中心出生缺陷基金会开展的年度调查表明，2007年美国所有育龄妇女（即15 - 45岁）中有40%服用了含叶酸的补充剂（美国疾病控制与预防中心，未发表数据，2007年），而1995年这一比例为28%。为分析2002 - 2006年期间加利福尼亚州18 - 44岁女性中含叶酸补充剂的摄入趋势，加利福尼亚州公共卫生部对来自加利福尼亚州女性健康调查（CWHS）的数据进行了趋势分析。本报告总结了这些分析结果，结果表明，尽管加利福尼亚州含叶酸补充剂的总体摄入率在2002年（40%）至2006年（41%）期间保持稳定，但西班牙裔女性和受教育程度较低的女性服用此类补充剂的比例有所下降。西班牙裔女性的下降趋势尤其令人担忧，原因如下：1）与其他种族/族裔的女性相比，西班牙裔女性生出患有神经管缺陷胎儿或婴儿的风险更高；2）1993 - 2003年期间加利福尼亚州西班牙裔的出生人数有所增加；3）2005年西班牙裔占加利福尼亚州所有出生人数的近52%（加利福尼亚州公共卫生部，未发表数据，2005年）。需要制定更多有针对性且基于证据的公共卫生干预措施，以增加这些人群的叶酸摄入量。
