Christian Parul, Khatry Subarna K, LeClerq Steven C, Dali Sanu Maiya
Department of International Health, Center for Human Nutrition, Bloomberg School of Public Health, Baltimore, MD 21205, USA.
Int J Gynaecol Obstet. 2009 Jul;106(1):3-7. doi: 10.1016/j.ijgo.2009.03.040. Epub 2009 Apr 15.
To examine the effect of supplemental prenatal folic acid, folic acid-iron, folic acid-iron-zinc, and multiple micronutrients on maternal morbidity in rural Nepal.
A cluster-randomized double-masked controlled trial of pregnant women who received daily supplements from early pregnancy through 3 months post partum as per the treatment allocation. Women were interviewed at birth about labor and delivery complications and for 9 days post partum to obtain 24-hour histories of morbidity.
A total of 3986 (97.3%) women completed an interview regarding labor and delivery; morbidity history was available for 3564 (87.0%) women. Folic acid-iron reduced the risk of postpartum hemorrhage (relative risk [RR] 0.59; 95% confidence interval [CI] 0.35-0.98). Risk of dysfunctional labor increased with multiple micronutrient supplementation (RR 1.28; 95% CI, 1.01-1.60), although preterm premature rupture of membrane decreased (RR 0.40; 95% CI, 0.21-0.79). Puerperal sepsis was lower in those receiving folic acid-iron, folic acid-iron-zinc, and multiple micronutrients compared with controls (P<0.05).
Prenatal folic acid-iron supplementation reduced the risk of obstetric complications in this South Asian setting.
研究孕期补充叶酸、叶酸铁、叶酸铁锌及多种微量营养素对尼泊尔农村地区孕产妇发病情况的影响。
一项整群随机双盲对照试验，研究对象为怀孕女性，根据治疗分配方案，从妊娠早期至产后3个月每日接受补充剂。在分娩时对女性进行访谈，了解分娩并发症情况，并在产后9天获取其24小时发病史。
共有3986名（97.3%）女性完成了关于分娩的访谈；3564名（87.0%）女性有发病史。叶酸铁降低了产后出血风险（相对危险度[RR]0.59；95%置信区间[CI]0.35 - 0.98）。补充多种微量营养素会增加产程异常风险（RR 1.28；95% CI 1.01 - 1.60），不过胎膜早破风险降低（RR 0.40；95% CI 0.21 - 0.79）。与对照组相比，接受叶酸铁、叶酸铁锌及多种微量营养素的产妇产褥期败血症发生率较低（P<0.05）。
在这一南亚地区，孕期补充叶酸铁可降低产科并发症风险。
