围孕期补充叶酸与不良妊娠结局的关系：一项队列研究

[Relationship between folic acid supplements during peri-conceptional period and the adverse pregnancy outcomes: a cohort study].

作者信息

Yan Shuang-qin, Xu Ye-qing, Su Pu-yu, Cao Hui, Pan Wei-jun, Tao Fang-biao

机构信息

Department of Health Care, Maternal and Child Health Care Centers of Maanshan, Anhui, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2013 Jan;34(1):1-4.

PMID:23648239

Abstract

OBJECTIVE

To examine the association between folic acid supplements during peri-conception and the related adverse birth outcome.

METHODS

Pregnant women who received first prenatal care at 4 municipal-level medical institutions in Maanshan, from Oct. 2008 to Oct. 2010 were selected as the target population. All participants were asked to complete a self-administered questionnaire which including data on demographic characteristics, interval, complications and frequency of taking folic acid etc., during pregnancy. The follow-up-records after delivery would include factors as: fetal weight, height, circumference of head, chest circumference of the neonates. Finally, 4448 valid questionnaires were gathered, including 190 premature, 147 small for gestational age and 104 low birth weight babies. Descriptive statistics and logistic regression models were used for data analysis.

RESULTS

Data showed that the weight, height and head circumference of the fetal at birth among pregnant women who had taken supplementary standard folic acid during peri-conception period or only during the first trimester, were all better than those pregnant women who had not taken the standard folic acid supplements. After adjustment for potential confounders as gestational weeks, maternal age, mather's education level, results from the logistic regression showed that intake of standard folic acid supplements appeared a protective factor for those babies who were smaller than the gestational age (RR = 0.45, 95%CI: 0.24 - 0.86), at premature delivery (RR = 0.52, 95%CI: 0.32 - 0.87) or with low birth weight (RR = 0.39, 95%CI: 0.19 - 0.80). However, data from this study showed that provision of folic acid supplements to the pre-pregnant or at first trimester alone did not make obvious impact on those babies as prematured, small for gestational age and at low birth weight.

CONCLUSION

Standardized provision of folic acid supplements during peri-conceptional period could improve the outcomes of birth.

摘要

目的

探讨孕期补充叶酸与相关不良出生结局之间的关联。

方法

选取2008年10月至2010年10月在马鞍山市4家市级医疗机构接受首次产前检查的孕妇作为研究对象。所有参与者均需填写一份自填式问卷，内容包括人口统计学特征、孕周、并发症以及孕期服用叶酸的频率等。产后随访记录包括胎儿体重、身高、头围、新生儿胸围等因素。最终收集到4448份有效问卷，其中包括190例早产、147例小于胎龄儿和104例低体重儿。采用描述性统计和逻辑回归模型进行数据分析。

结果

数据显示，在围孕期或仅在孕早期服用标准叶酸补充剂的孕妇，其出生胎儿的体重、身高和头围均优于未服用标准叶酸补充剂的孕妇。在对孕周、产妇年龄、产妇教育水平等潜在混杂因素进行调整后，逻辑回归结果显示，服用标准叶酸补充剂对小于胎龄儿（RR = 0.45，95%CI：0.24 - 0.86）、早产（RR = 0.52，95%CI：0.32 - 0.87）或低体重儿（RR = 0.39，95%CI：0.19 - 0.80）具有保护作用。然而，本研究数据表明，仅在孕前或孕早期提供叶酸补充剂对早产、小于胎龄儿和低体重儿并无明显影响。