Nelson Anita L
Womens Health (Lond). 2012 Nov;8(6):619-33. doi: 10.2217/whe.12.50.
The incidence of pregnancies affected with neural tube defects (NTDs) has been reduced by food fortification programs and public health campaigns promoting folic acid supplementation, but the incidence of NTDs in the USA has not achieved the full potential reduction expected with adequate periconceptional folate utilization. In seeking new ways to access sexually active women at risk for pregnancy, one option would be to link folic acid supplementation to contraceptive use. Since birth control pills are the most popular method of reversible contraception in the USA, it would seem quite logical to find a way to supplement them. To this end, a very efficient folate, levomefolate calcium salt (metafolin), has been added to drospirenone-containing oral contraceptives in equimolar concentrations to the recommended supplements of folic acid to reduce the risk for pregnancy and to reduce the risk of NTDs in pregnancies that occur while women are taking the pill or shortly after they discontinue its use. This article will focus on the need for such folate supplementation and will summarize the contraceptive and noncontraceptive benefits of the 30 µg EE/3 mg drospirenone pill (Yasmin(®), Bayer Healthcare, NJ, USA) to which has been added 451 metafolin (Safyral(®), Bayer Healthcare). The new information about thromboembolism risks associated with use of drospirenone-containing pills is also discussed.
通过食品强化计划和推广补充叶酸的公共卫生运动，神经管缺陷（NTDs）相关妊娠的发生率有所降低，但美国NTDs的发生率尚未达到预期的充分降低水平，即未能通过孕期充分利用叶酸实现这一目标。在寻找接触有妊娠风险的性活跃女性的新方法时，一种选择是将补充叶酸与使用避孕药联系起来。由于避孕药丸是美国最常用的可逆避孕方法，因此找到一种将叶酸添加到避孕药丸中的方法似乎很合理。为此，一种非常有效的叶酸——左亚叶酸钙盐（活性叶酸），已以与叶酸推荐补充剂等摩尔浓度添加到含屈螺酮的口服避孕药中，以降低妊娠风险，并降低女性服用避孕药期间或停药后不久怀孕时发生NTDs的风险。本文将重点讨论这种叶酸补充的必要性，并总结添加了451活性叶酸（Safyral®，拜耳医疗保健公司）的30µg炔雌醇/3mg屈螺酮避孕药丸（优思明®，拜耳医疗保健公司，美国新泽西州）的避孕和非避孕益处。还将讨论与使用含屈螺酮避孕药丸相关的血栓栓塞风险的新信息。
