[围孕期补充叶酸或含叶酸的多种微量营养素与女性早产之间的关联]
[Association between periconceptional supplementation of folic acid or multiple-micronutrients containing folic acid and preterm delivery in women].
作者信息
Bai Y X, Liu C Y, Zhang J, Meng W Y, Jin L, Jin L
机构信息
Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China.
Institute of Reproductive and Child Health, Peking University, Beijing 100191, China.
出版信息
Beijing Da Xue Xue Bao Yi Xue Ban. 2023 Jun 18;55(3):495-501. doi: 10.19723/j.issn.1671-167X.2023.03.016.
OBJECTIVE
To explore the association between periconceptional supplementation of folic acid or multiple-micronutrients containing folic acid(MMFA) and risk of preterm delivery in women with natural conception, singleton pregnancy and vaginal delivery.
METHODS
A retrospective cohort study was performed based on the prenatal health care system and hospital information system of Tongzhou Maternal and Child Health Hospital of Beijing and the women who had their prenatal care in the hospital from January 2015 to December 2018 were included. The information of 16 332 women who conceived naturally, had a singleton pregnancy, and delivered vaginally was collected. Compliance scores were constructed based on the time of initiation and the frequency of taking nutritional supplements. The association between maternal periconceptional micronutrient supplementation, including pure folic acid (FA) pills or MMFA and the rate of preterm delivery was evaluated using Logistic regression models.
RESULTS
The preterm delivery rate (gestational week < 37 weeks) of the study population was 3.8%, and the mean (standard deviation) of gestational age was (38.98±1.37) weeks. A total of 6 174 (37.8%) women took FA during the periconceptional period, 8 646 (52.9%) women took MMFA, and 1 512 (9.3%) women did not take any nutritional supplements. The association between periconceptional supplementation of FA or MMFA and risk of preterm delivery in women was not statistically significant [adjusted odds ratio (a)=1.01, 95%: 0.74-1.37]. The associations with preterm birth were not statistically significant in further analysis by the type of nutritional supplements, time of initiation, and the frequency of supplementation. In addition, the association between the compliance score of taking supplements and the rate of preterm delivery was not statistically significant, either.
CONCLUSION
This study did not find an association between the risk of preterm delivery and the use of FA or MMFA during the periconcep-tional period in women with natural conception, singleton pregnancy, and vaginal delivery. In the future, multicenter studies with large-scale prospective cohort or population-based randomized controlled trials are warranted to confirm the association between taking FA or MMFA during the periconceptional period and preterm delivery among women.
目的
探讨孕前补充叶酸或含叶酸的多种微量营养素（MMFA）与自然受孕、单胎妊娠及阴道分娩女性早产风险之间的关联。
方法
基于北京市通州区妇幼保健院的产前保健系统和医院信息系统进行一项回顾性队列研究，纳入2015年1月至2018年12月在该院进行产前检查的女性。收集16332名自然受孕、单胎妊娠并阴道分娩的女性的信息。根据开始服用时间和服用营养补充剂的频率构建依从性评分。使用逻辑回归模型评估孕早期母体微量营养素补充，包括单纯叶酸（FA）片或MMFA与早产率之间的关联。
结果
研究人群的早产率（孕周<37周）为3.8%，平均（标准差）孕周为（38.98±1.37）周。共有6174名（37.8%）女性在孕早期服用了FA，8646名（52.9%）女性服用了MMFA，1512名（9.3%）女性未服用任何营养补充剂。孕早期补充FA或MMFA与女性早产风险之间的关联无统计学意义[调整优势比（a）=1.01，95%：0.74 - 1.37]。按营养补充剂类型、开始时间和补充频率进行的进一步分析中，与早产的关联也无统计学意义。此外，服用补充剂的依从性评分与早产率之间的关联也无统计学意义。
结论
本研究未发现自然受孕、单胎妊娠及阴道分娩女性在孕早期使用FA或MMFA与早产风险之间存在关联。未来，有必要进行多中心大规模前瞻性队列研究或基于人群的随机对照试验，以证实孕早期服用FA或MMFA与女性早产之间的关联。
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