Lu Qing-Bin, Wang Zhi-Ping, Gao Li-Jie, Gong Rui, Sun Xi-Hong, Wang Meng, Zhao Zhong-Tang
School of Public Health, Peking University, Beijing, 100191, P. R. China.
Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan, 250012, P. R. China.
Sci Rep. 2015 Jan 8;5:7674. doi: 10.1038/srep07674.
There has been considerable professional debate on the association between nausea and vomiting in early pregnancy (NVP) and neural tube defects (NTDs) risk. This study explored the association between NVP and NTDs risk, and the effect of folic acid supplements on the association. A 1:1 matched case-control study was conducted and conditional logistic regression model was used to analyze the associations. The result showed the odds ratio (OR) of severe NVP for NTDs was 2.403 (95%CI 1.437,4.017; P<0.001) and that of moderate NVP was 1.469 (95%CI 1.063,2.031; P = 0.020) compared with light NVP when adjusted by the potential confounders. Stratified by intake of folic acid supplements, the ORs for severe and moderate NVP turned to 2.147 (95%CI 1.140, 4.043; P = 0.018) and 2.055 (95%CI 1.320, 3.199; P = 0.001) in the stratum of non-intake of folic acid supplements while ORs reduced to 1.851 (95%CI 0.729, 4.699; P = 0.195) and 1.003 (95%CI 0.594, 1.694; P = 0.992) in the stratum of intake of folic acid supplements, respectively. We conclude that severe/moderate NVP has an association with the risk of NTDs, which was not found in the group with intake of folic acid supplements. Folic acid supplements should be recommended to use for the prevention of NTDs.
关于妊娠早期恶心和呕吐（NVP）与神经管缺陷（NTDs）风险之间的关联，一直存在大量专业争论。本研究探讨了NVP与NTDs风险之间的关联，以及叶酸补充剂对该关联的影响。进行了一项1:1匹配病例对照研究，并使用条件逻辑回归模型分析这些关联。结果显示，在调整潜在混杂因素后，与轻度NVP相比，重度NVP患NTDs的比值比（OR）为2.403（95%CI 1.437,4.017；P<0.001），中度NVP的比值比为1.469（95%CI 1.063,2.031；P = 0.020）。按叶酸补充剂摄入量分层，在未摄入叶酸补充剂组中，重度和中度NVP的OR分别变为2.147（95%CI 1.140, 4.043；P = 0.018）和2.055（95%CI 1.320, 3.199；P = 0.001），而在摄入叶酸补充剂组中，OR分别降至1.851（95%CI 0.729, 4.699；P = 0.195）和1.003（95%CI 0.594, 1.694；P = 0.992）。我们得出结论，重度/中度NVP与NTDs风险相关，而在摄入叶酸补充剂的人群中未发现这种关联。应推荐使用叶酸补充剂来预防NTDs。
