Liu Jufen, Li Zhiwen, Ye Rongwei, Ren Aiguo, Liu Jianmeng
Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing, People's Republic of China.
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing100191, People's Republic of China.
Br J Nutr. 2021 Nov 28;126(10):1558-1563. doi: 10.1017/S0007114521000337. Epub 2021 Jan 26.
Folic acid (FA) can reduce the risk for selected birth defects other than neural tube defects. We examined whether FA has preventive effects against fetal abdominal wall defects (AWD) in a unique intervention cohort in China. Birth outcomes of 247 831 singleton births from a population-based cohort study with detailed pre-conceptional FA intake information were collected in China in 1993-1996. Information on births at 20 complete gestational weeks, including live births, stillbirths and pregnancy terminations, and all structural birth defects regardless of gestational week were recorded. The birth prevalence of omphalocele, gastroschisis and total fetal AWD was classified by maternal FA supplementation. The prevalence of total AWD was 4·30 per 10 000 births among women who took FA compared with 13·46 per 10 000 births among those who did not take FA in northern China and 6·28 and 5·18 per 10 000 births, respectively, in southern China. The prevalence of omphalocele was 0·54 per 10 000 births among women who took FA compared with 3·74 per 10 000 births among those who did not take FA in northern China and 1·79 and 1·44 per 10 000 births, respectively, in southern China. FA supplementation significantly prevented total AWD in multivariate analysis (relative risk 0·26, 95 % CI 0·11, 0·61) in northern China, although no preventive effect of FA on AWD was observed in southern China. FA supplementation successfully reduced the prevalence of AWD in northern China.
叶酸（FA）可降低除神经管缺陷以外的某些特定出生缺陷的风险。我们在中国一个独特的干预队列中研究了FA对胎儿腹壁缺陷（AWD）是否具有预防作用。1993年至1996年在中国收集了一项基于人群的队列研究中247831例单胎出生的出生结局，该研究有详细的孕前FA摄入信息。记录了妊娠20周时的出生信息，包括活产、死产和终止妊娠情况，以及所有孕周的所有结构性出生缺陷。根据母亲补充FA的情况对脐膨出、腹裂和胎儿总AWD的出生患病率进行分类。在中国北方，服用FA的女性中AWD的总患病率为每10000例出生中有4.30例，而未服用FA的女性中为每10000例出生中有13.46例；在中国南方，相应的患病率分别为每10000例出生中有6.28例和5.18例。服用FA的女性中脐膨出的患病率为每10000例出生中有0.54例，而在中国北方未服用FA的女性中为每10000例出生中有3.74例；在中国南方，相应的患病率分别为每10000例出生中有1.79例和1.44例。多因素分析显示，在中国北方，补充FA可显著预防总AWD（相对风险0.26，95%CI 0.11，0.61），尽管在中国南方未观察到FA对AWD的预防作用。在中国北方，补充FA成功降低了AWD的患病率。
