Adhikari K M, Singh Sanjay, Kannan Venkatnarayan, Mathai Sheila
Professor & Head, Department of Pediatrics, Armed Forces Medcal College, Pune, India.
Senior Advisor (Obstetrics & Gynaecology), Base Hospital, Delhi Cantt, India.
Med J Armed Forces India. 2022 Sep;78(Suppl 1):S246-S250. doi: 10.1016/j.mjafi.2021.05.013. Epub 2021 Aug 13.
Survey-based studies have examined the timing of receiving periconceptional folic acid supplementation. To assess the impact of the periconceptional folic acid supplementation, a postulate that multigravida mothers are more likely to have received the supplementation and the level of serum folic acid in them assayed during the first trimester is likely to be higher than primigravida mothers was put forth. Serum folic acid levels were measured in primigravida and multigravida mothers during the first trimester.
One hundred twenty primigravida and multigravida mothers registered at antenatal clinic of a tertiary care referral centre were included. Serum folic acid assay from samples collected during the first trimester was carried out by chemiluminescence immuneassay. The mothers were followed up during subsequent OPD visits, during admission for delivery and through mobile phones for assessing the delivery outcomes. World Health Organization cutoff values for serum folic acid were used to analyse the results.
None of the mothers received folic acid supplement before conception. Mean interval from last menstrual period to receiving the first dose of folic acid supplementation was 71.2 days in primigravida and 67.6 days in multigravida mothers. Overall, 21/120 (17.5%) of primigravida mothers and 34/120 (28.3%) of multigravida mothers had serum folic acid values less than 6 ng/ml (deficiency and possible deficiency).
None of the mothers received folic acid supplements before conception. Significant proportion of mothers, particularly the multigravida having less than normal levels serum folic acid indicates correctable lacunae amenable for preventive intervention.
基于调查的研究已经探讨了孕前补充叶酸的时间。为了评估孕前补充叶酸的影响,提出了一个假设,即经产妇母亲更有可能接受了补充,并且她们在孕早期检测的血清叶酸水平可能高于初产妇母亲。在初产妇和经产妇母亲的孕早期测量血清叶酸水平。
纳入了在一家三级医疗转诊中心产前诊所登记的120名初产妇和经产妇母亲。通过化学发光免疫分析法对孕早期采集的样本进行血清叶酸检测。在随后的门诊就诊、分娩住院期间以及通过手机对母亲进行随访,以评估分娩结局。使用世界卫生组织血清叶酸临界值来分析结果。
没有一位母亲在受孕前接受叶酸补充。初产妇从末次月经到接受第一剂叶酸补充的平均间隔时间为71.2天,经产妇母亲为67.6天。总体而言,21/120(17.5%)的初产妇母亲和34/120(28.3%)的经产妇母亲血清叶酸值低于6 ng/ml(缺乏和可能缺乏)。
没有一位母亲在受孕前接受叶酸补充。相当比例的母亲,特别是血清叶酸水平低于正常的经产妇,表明存在可纠正的缺陷,适合进行预防性干预。