Navarrete-Muñoz Eva María, Giménez Monzó Daniel, García de La Hera Manuela, Climent Maria Dolores, Rebagliato Marisa, Murcia Mario, Iñiguez Carmen, Ballester Ferrán, Ramón Rosa, Vioque Jesús
Departamento de Salud Pública, Universidad Miguel Hernández, Elche, Alicante, España.
Med Clin (Barc). 2010 Nov 13;135(14):637-43. doi: 10.1016/j.medcli.2010.03.033. Epub 2010 Jun 17.
We examined the dietary intake and the use of supplements of folic acid (FA) in a cohort of pregnant women. We also explored the factors associated with non-compliance of both the recommended intake (RI) of 600 μg/day and the supplement use of 400 μg/day provided to prevent neural tube defects (NTD).
We studied 782 pregnant women from the INMA-Valencia cohort. The dietary intake was estimated using a food frequency questionnaire in two periods of pregnancy; from preconception to the second month and from the 3rd to the 7th month. Information on supplement use was also collected which allowed us to estimate the total FA intake (diet+supplements). We explored factors associated with non-compliance of the recommendations by logistic regression.
The periconceptional mean daily FA intake was 304 μg/day. FA supplements were taken by 19.2, 30.2 and 66.2% of women in preconception, first and second month of pregnancy, respectively. Among women using supplements in periconception, 30% exceeded the tolerable upper intake level (UL) of 1.000 μg/day. Non-compliance with RI was more common among women of foreign origin, of low educational level, who smoked, with unplanned pregnancy, who did not visit a private gynaecologist, who had had children or without previous medical illness.
Diet by itself is not sufficient to reach RI for FA during pregnancy and many women initiate supplement use after the recommended period and inadequately. The youngest women, with lowest educational attainment and unplanned pregnancies are more likely not to comply.
我们对一组孕妇的叶酸（FA）膳食摄入量及补充剂使用情况进行了研究。我们还探究了与未达到每日600μg推荐摄入量（RI）以及未使用每日400μg补充剂以预防神经管缺陷（NTD）相关的因素。
我们研究了来自INMA - 瓦伦西亚队列的782名孕妇。通过食物频率问卷在孕期的两个阶段估算膳食摄入量，即从孕前到孕第二个月以及从孕第三个月到第七个月。还收集了补充剂使用信息，据此估算总叶酸摄入量（膳食 + 补充剂）。我们通过逻辑回归探究与未遵循推荐相关的因素。
受孕前平均每日叶酸摄入量为304μg/天。在孕前、孕第一个月和孕第二个月，分别有19.2%（孕前）、30.2%（孕第一个月）和66.2%（孕第二个月）的女性服用叶酸补充剂。在受孕前使用补充剂的女性中，30%超过了每日1000μg的可耐受最高摄入量（UL）。未达到RI在外国裔、低教育水平、吸烟、意外怀孕、未就诊于私立妇科医生、已育或无既往病史的女性中更为常见。
孕期仅靠饮食不足以达到叶酸的RI，许多女性在推荐时间之后才开始使用补充剂且用量不足。最年轻、教育程度最低以及意外怀孕的女性更有可能不遵循推荐。
