Liu C, Li Z, Jin L, Liu C, Wang C, Zhang J, Jin L
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.
Beijing Da Xue Xue Bao Yi Xue Ban. 2025 Jun 18;57(3):473-480. doi: 10.19723/j.issn.1671-167X.2025.03.010.
To describe the prevalence of perinatal death in Tongzhou District of Beijing, and to estimate the association between maternal periconceptional supplementation of folic acid or multiple micronutrients containing folic acid and perinatal mortality rate.
A retrospective cohort study was conducted based on the maternal and child care system in Tongzhou District of Beijing. The subjects were 94 490 perinatal who were born during January 2013 to December 2018. The information on perinatal outcomes and maternal periconceptional supplementation of folic acid or multiple micronutrients containing folic acid were collected. The Poisson log-linear model was used to estimate the association between maternal periconceptional folic acid or multiple micronutrients supplementation and perinatal mortality rate.
The overall perinatal mortality rate was 2.71‰. The perinatal mortality rates for maternal nutrients supplementation containing folic acid and no supplementation during periconceptional period were 2.63‰ and 3.43‰, respectively, and the difference in rates was not statistically significant [crude risk ratio () = 0.77, 95%: 0.54-1.14]. After adjusting for potential confounding factors including ethnicity, age, education level, occupation, household registration, parity, numbers of fetuses, gestational age, pregnant with assisted reproductive technology, delivery year and pre-pregnancy body mass index, the rates remained not statistically significant [adjusted risk ratio () = 0.93, 95% 0.77-1.13]. The perinatal mortality rates were 2.23‰ and 2.99‰ for pure folic acid and multi-nutrients supplements containing folic acid, respectively, and the difference in rates was statistically significant ( = 1.34, 95% : 1.02-1.76). The rates difference remained statistically significant after adjusting for potential confounders ( = 1.31, 95% : 1.06-1.62). Additionally, the perinatal mortality rates differences among the non-supplementation group and the supplementation group with variate timing of initiation (pre-conception or post-conception) or frequency of supplementation (low-frequency or high-frequency) were not statistically significant, regardless of adjusting for confounders.
The overall perinatal mortality rate was lower than the national average level in Tongzhou District of Beijing. Maternal periconceptional supplementation of pure folic acid or micronutrients containing folic acid had no impact on perinatal mortality. The association between maternal periconceptional supplementation of multiple micronutrients containing folic acid and perinatal mortality rate need further research.
描述北京市通州区围产儿死亡的发生率，并评估孕期补充叶酸或含叶酸多种微量营养素与围产儿死亡率之间的关联。
基于北京市通州区妇幼保健系统开展一项回顾性队列研究。研究对象为2013年1月至2018年12月期间出生的94490例围产儿。收集围产儿结局及孕期补充叶酸或含叶酸多种微量营养素的信息。采用泊松对数线性模型评估孕期补充叶酸或含叶酸多种微量营养素与围产儿死亡率之间的关联。
总体围产儿死亡率为2.71‰。孕期补充含叶酸的母体营养素组和未补充组的围产儿死亡率分别为2.63‰和3.43‰，差异无统计学意义[粗风险比（RR）=0.77，95%可信区间（CI）：0.54 - 1.14]。在调整了包括种族、年龄、教育程度、职业、户籍、产次、胎儿数、孕周、辅助生殖技术受孕、分娩年份和孕前体重指数等潜在混杂因素后，差异仍无统计学意义[调整后风险比（aRR）=0.93，95%CI：0.77 - 1.13]。单纯叶酸补充组和含叶酸多种营养素补充组的围产儿死亡率分别为2.23‰和2.99‰，差异有统计学意义（RR = 1.34，95%CI：1.02 - 1.76）。调整潜在混杂因素后，差异仍有统计学意义（aRR = 1.31，95%CI：1.06 - 1.62）。此外，无论是否调整混杂因素，非补充组与不同起始时间（孕前或孕后）或补充频率（低频或高频）的补充组之间的围产儿死亡率差异均无统计学意义。
北京市通州区总体围产儿死亡率低于全国平均水平。孕期补充单纯叶酸或含叶酸的微量营养素对围产儿死亡率无影响。孕期补充含叶酸多种微量营养素与围产儿死亡率之间的关联有待进一步研究。
