NHC Key Laboratory of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, 200237, China.
Community Health Service Center of Jing-An-Si, Jing-an District, Shanghai, 200040, China.
Reprod Health. 2023 Feb 20;20(1):34. doi: 10.1186/s12978-023-01564-5.
Maternal folate may not reach an optimal level to prevent neural tube defects if supplementation commenced post-conception or took place pre-conception only. Our study aimed to investigate the continuation of folic acid (FA) supplementation from pre-conception to post-conception during peri-conceptional period and to examine its differences in FA supplementation between the subgroups taking the initiation timing into consideration.
This study was conducted in two community health service centers in Jing-an District of Shanghai. Women accompanying their children to pediatric health clinics of the centers were recruited and asked to recall information concerning their socioeconomic and previous obstetric characteristics, utilization of healthcare and FA supplementation before and/or during pregnancy. The continuation of FA supplementation during peri-conceptional period were categorized into three subgroups: Supplementing with FA pre- and post-conception; supplementing with FA preconception only or post-conception only; no FA supplements pre-conception and post-conception. The relationship between FA continuation and couples' characteristics were examined as setting the first subgroup as the base reference.
Three hundred and ninety-six women were recruited. Over 40% of the women started FA supplementation after conception and 30.3% of them supplemented with FA from pre-conception to the first trimester of their pregnancy. Compared to this one-third of participants, women who didn't supplemented with any FA during peri-conceptional period were more likely to have no utilization of pre-conception healthcare ([Formula: see text]= 2.47, 95% [Formula: see text]: 1.33-4.61) or antenatal care ([Formula: see text]= 4.05, 95% [Formula: see text]: 1.76-9.34), or who had a lower family socioeconomic status ([Formula: see text]= 4.36, 95% [Formula: see text]: 1.79-10.64). Women who supplemented with FA pre-conception only or post-conception only were more likely to have no utilization of pre-conception healthcare ([Formula: see text]= 2.94, 95% [Formula: see text]: 1.79-4.82), or to have no previous pregnancy complication ([Formula: see text]=1.80, 95% [Formula: see text]: 0.99-3.28).
Over two-fifth of the women started FA supplementation and only one-third of them had an optimal supplementation from pre-conception to the first trimester. Maternal utilization of healthcare before or during pregnancy together with maternal and paternal socioeconomic status may play a role in the continuation to FA supplementation pre- and post-conception.
如果在受孕后开始补充叶酸或仅在受孕前补充叶酸，母体中的叶酸可能无法达到预防神经管缺陷的最佳水平。我们的研究旨在调查在围孕期内从受孕前到受孕后继续补充叶酸（FA）的情况，并研究考虑起始时间后，在不同亚组中 FA 补充的差异。
这项研究在上海静安区的两个社区卫生服务中心进行。招募了陪同孩子到中心儿科诊所就诊的妇女，并要求她们回忆有关其社会经济和以前产科特征、在妊娠前和/或妊娠期间利用医疗保健和 FA 补充剂的信息。将围孕期内 FA 补充剂的续用情况分为三个亚组：受孕前和受孕后均补充 FA；仅受孕前或仅受孕后补充 FA；受孕前和受孕后均不补充 FA。将第一个亚组设为基础参考，研究 FA 续用与夫妇特征之间的关系。
共招募了 396 名妇女。超过 40%的妇女在受孕后开始补充 FA，其中 30.3%的妇女从受孕前到孕早期都补充 FA。与这三分之一的参与者相比，在围孕期内没有补充任何 FA 的妇女更有可能没有在妊娠前接受医疗保健（[Formula: see text]=2.47，95%[Formula: see text]:1.33-4.61）或产前保健（[Formula: see text]=4.05，95%[Formula: see text]:1.76-9.34），或者社会经济地位较低（[Formula: see text]=4.36，95%[Formula: see text]:1.79-10.64）。仅在受孕前或仅在受孕后补充 FA 的妇女更有可能没有在妊娠前接受医疗保健（[Formula: see text]=2.94，95%[Formula: see text]:1.79-4.82），或者没有以前的妊娠并发症（[Formula: see text]=1.80，95%[Formula: see text]:0.99-3.28）。
超过五分之二的妇女开始补充 FA，只有三分之一的妇女从受孕前到孕早期都进行了最佳补充。妊娠前或妊娠期间孕产妇对医疗保健的利用情况以及孕产妇和父亲的社会经济地位可能会影响受孕前和受孕后的 FA 补充情况。
