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不同孕期补充叶酸的效果及其与神经管缺陷其他一级预防措施的关系。

Effects of folic acid supplementation during different pregnancy periods and relationship with the other primary prevention measures to neural tube defects.

作者信息

Gong Rui, Wang Zhi-Ping, Wang Meng, Gao Li-Jie, Zhao Zhong-Tang

机构信息

a Institute of Population Research, Peking University , Beijing , China .

b Department of Epidemiology and Health Statistics , School of Public Health, Shandong University , Jinan , China .

出版信息

J Matern Fetal Neonatal Med. 2016 Dec;29(23):3894-901. doi: 10.3109/14767058.2016.1152241. Epub 2016 Mar 29.

Abstract

OBJECTIVE

To find out the prevention effects of folic acid supplements during different pregnancy periods on neural tube defects (NTDs) and the relationship of folic acid supplements with the other NTDs' primary preventive measures.

METHODS

A 1:1 case-control study was conducted. Four hundred and fifty-nine women who delivered or gestate infants/fetuses with NTDs in the last two years were randomly selected as cases and were matched with women who delivered babies without obvious birth defects as controls.

RESULTS

For anencephaly, folic acid supplementation during the periconceptional period and preconceptional period has a 57-83% reduction in risk of NTDs(ORs ranged from 0.17 to 0.43). For spina bifida, folic acid supplementation during the periconceptional period has a 79% reduction in risk of NTDs (OR = 0.21). For encephalocele, folic acid supplementation during the periconceptional period has a 67% reduction in risk of NTDs (OR = 0.33). The prevention effects on NTDs were significant when these preventive measures combined with folic acid supplements during the periconceptional period, with OR 0.04, 0.07, 0.10 and 0.11.

CONCLUSION

The specific effects of folic acid supplementation during different periods show the reduction in the risk of NTDs, anencephaly, spina bifida, encephalocele. During periconceptional period, folic acid supplements have preventive effects on all NTDs' subtypes.

摘要

目的

探讨不同孕期补充叶酸对神经管缺陷(NTDs)的预防效果以及叶酸补充与其他NTDs一级预防措施的关系。

方法

进行1:1病例对照研究。随机选取过去两年中分娩或怀有患NTDs婴儿/胎儿的459名妇女作为病例,并与分娩无明显出生缺陷婴儿的妇女作为对照进行匹配。

结果

对于无脑儿,在围孕期和孕前补充叶酸可使NTDs风险降低57 - 83%(OR值范围为0.17至0.43)。对于脊柱裂,围孕期补充叶酸可使NTDs风险降低79%(OR = 0.21)。对于脑膨出,围孕期补充叶酸可使NTDs风险降低67%(OR = 0.33)。当这些预防措施与围孕期补充叶酸联合使用时,对NTDs的预防效果显著,OR分别为0.04、0.07、0.10和0.11。

结论

不同时期补充叶酸的具体效果显示可降低NTDs、无脑儿、脊柱裂、脑膨出的风险。在围孕期,补充叶酸对所有NTDs亚型均有预防作用。

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