Assisted Reproduction Center, Northwest Women's and Children's Hospital of Xi'an Jiaotong University Health Science Center, No. 73 Houzaimen, Xi'an, Shaanxi, 710003, People's Republic of China.
Translational Medicine Center, Northwest Women's and Children's Hospital of Xi'an Jiaotong University Health Science Center, No.1616 Yanxiang Road, Xi'an, Shaanxi, 710061, People's Republic of China.
Sci Rep. 2019 Mar 27;9(1):5271. doi: 10.1038/s41598-019-41584-5.
The association between folic acid supplementation and birth defects other than neural tube defects remains unclear. We utilized data from a large population-based survey to examine the association between folic acid supplementation and birth defects in Northwestern China. A total of 29,204 women with infants born between 2010 and 2013 were surveyed in Shaanxi province, Northwestern China, using a stratified multistage sampling method. Propensity scores were used to match 9,293 women with optimal folic acid supplementation with 9,293 women with nonoptimal folic acid supplementation, and the effects of optimal folic acid supplementation on birth defects were assessed by a conditional logistic regression model. After propensity score matching, the overall birth defect rate, cardiovascular system defect rate and nervous system defect rate for the women with optimal folic acid supplementation were lower than those for the women with nonoptimal folic acid supplementation (overall birth defects: OR = 0.71, 95% CI = 0.57-0.89, P = 0.003; cardiovascular system defects: OR = 0.65, 95% CI = 0.44-0.96, P = 0.032; nervous system defects: OR = 0.13, 95% CI = 0.02-0.99, P = 0.049). Optimal folic acid supplementation was associated with a decreased prevalence of birth defects, especially in the cardiovascular system and nervous system. Our findings have important implications for birth defect intervention with folic acid supplementation for countries with a high prevalence of birth defects, such as China.
叶酸补充与神经管缺陷以外的出生缺陷之间的关系仍不清楚。我们利用一项基于大样本的调查数据，在中国西北地区研究叶酸补充与出生缺陷之间的关系。采用分层多阶段抽样方法，对中国西北地区陕西省 2010 年至 2013 年期间出生的 29204 名妇女进行了调查。采用倾向评分匹配法，将 9293 名叶酸补充效果最佳的妇女与 9293 名叶酸补充效果不佳的妇女进行匹配，并采用条件 logistic 回归模型评估最佳叶酸补充对出生缺陷的影响。经过倾向评分匹配后，叶酸补充效果最佳的妇女的总出生缺陷率、心血管系统缺陷率和神经系统缺陷率均低于叶酸补充效果不佳的妇女（总出生缺陷：OR=0.71，95%CI=0.57-0.89，P=0.003；心血管系统缺陷：OR=0.65，95%CI=0.44-0.96，P=0.032；神经系统缺陷：OR=0.13，95%CI=0.02-0.99，P=0.049）。最佳叶酸补充与出生缺陷发生率降低有关，尤其是心血管系统和神经系统。我们的研究结果对于中国等出生缺陷高发国家的叶酸补充出生缺陷干预具有重要意义。
