Department of Global Public Health and Primary Care, University of Bergen, Kalfarveien 31, N-5018, Bergen, Norway.
Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway.
BMC Pregnancy Childbirth. 2018 May 30;18(1):188. doi: 10.1186/s12884-018-1830-1.
Maternal predictors of folic acid (FA) supplementation use to reduce offspring risk of neural tube defects are well known, while paternal determinants for maternal FA use are less known. Such knowledge is important to increase women's compliance to recommended periconceptional FA use.
In a nation-wide study of 683,785 births registered in the Medical Birth Registry of Norway during 1999-2010, the associations between paternal characteristics (age, education, occupation, country of origin) and maternal FA use were estimated by relative risks (RR) with 95% confidence intervals (CI), using log-binomial regression.
Maternal FA use before and during pregnancy (adequate FA use) was found in 16% of the births. The association between paternal age and adequate FA use was inversely U-shaped; adjusted RRs for adequate FA use were 0.35 (95% CI 0.28-0.43) and 0.72 (95% CI 0.71-0.74) for paternal age < 20 and ≥ 40 years, respectively, comparing age 30-34 years. Compulsory education (1-9 years) among fathers was compared to tertiary education; the RR was 0.69 (95% CI 0.68-0.71) for adequate FA use. The lower risk of adequate FA use for paternal compulsory education was present in all categories of maternal education. Occupation classes other than "Higher professionals" were associated with decreased risk of adequate FA use, compared with the reference "Lower professionals". RR for adequate FA use was 0.58 (95% CI 0.56-0.60) comparing fathers from "Low/middle-income countries" with fathers born in Norway.
Adequate FA use in the periconceptional period was lower when fathers were younger or older than 30-34 years, had shorter education, had manual or self-employed occupations, or originated from low/middle-income countries. Partners may contribute to increase women's use of periconceptional FA supplementation.
众所周知，母体因素可预测叶酸（FA）补充剂的使用，以降低后代神经管缺陷的风险，而父亲因素对母亲 FA 使用的影响则知之甚少。这种知识对于提高女性对推荐的围孕期 FA 使用的依从性很重要。
在挪威医学出生登记处（1999-2010 年）登记的 683785 例出生的全国性研究中，使用对数二项式回归估计了父亲特征（年龄、教育程度、职业、原籍国）与母亲 FA 使用之间的关联，并采用相对风险（RR）和 95%置信区间（CI）进行表示。
在研究期间，16%的婴儿母亲进行了孕期前后的 FA 补充（适当 FA 使用）。父亲年龄与适当 FA 使用之间的关系呈倒 U 型；与 30-34 岁年龄组相比，父亲年龄<20 岁和≥40 岁时，适当 FA 使用的调整 RR 分别为 0.35（95%CI 0.28-0.43）和 0.72（95%CI 0.71-0.74）。与接受高等教育的父亲相比，父亲接受的义务教育（1-9 年）的 RR 为 0.69（95%CI 0.68-0.71）。所有类别的母亲教育中，父亲接受义务教育时适当 FA 使用的风险较低。与参考“低等专业人员”相比，“高等专业人员”以外的职业类别与适当 FA 使用的风险降低相关。与挪威出生的父亲相比，来自“低/中等收入国家”的父亲的适当 FA 使用 RR 为 0.58（95%CI 0.56-0.60）。
当父亲年龄小于 30-34 岁或大于 30-34 岁、教育程度较低、从事体力劳动或自营职业、或来自低/中等收入国家时，围孕期 FA 补充的适当使用水平较低。伴侣可能有助于提高女性围孕期 FA 补充的使用。
