| 严双琴,徐叶清,苏普玉,曹慧,潘维君,陶芳标.沿着苏德隆教授开辟的学术道路深入开展现场流行病学调查[J].Chinese journal of Epidemiology,2013,34(1):1-4 |
| 沿着苏德隆教授开辟的学术道路深入开展现场流行病学调查 |
| Relationship between folic acid supplements during peri-conceptional period and the adverse pregnancy outcomes a cohort study |
| Received:July 29, 2012 |
| DOI：10.3760/cma.j.issn.0254-6450.2013.01.001 |
| KeyWord: 叶酸 出生结局 队列 |
| English Key Word: Folic acid Birth outcomes Cohort |
| FundProject:国家科技支撑计划(2006BAIOSA03 ) |
| Author Name | Affiliation | E-mail | | Yan Shuang-qin | Department of Health Care, Maternal and Child Health Care Centers of Maanshan, Anhui 243000, China | | | Xu Ye-qing | Department of Health Care, Maternal and Child Health Care Centers of Maanshan, Anhui 243000, China | | | Su Pu-yu | Departmeru of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University | | | Cao Hui | Department of Health Care, Maternal and Child Health Care Centers of Maanshan, Anhui 243000, China | | | Pan Wei-jun | Department of Health Care, Maternal and Child Health Care Centers of Maanshan, Anhui 243000, China | | | Tao Fang-biao | Departmeru of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University | fbtao@126.com |
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| Abstract: |
| 目的探讨围孕期增补叶酸与子代不良出生结局的关联。方法选取马鞍山市4家市级医疗卫生机构2008年10月至2010年10月孕期保健的孕妇建立孕妇队列。随访期间收集孕妇社会人口统计学资料、妊娠间隔、妊娠并发症、围孕期服用叶酸等情况。追踪随访分娩情况，包括新生儿体重、身长、出生头围、胸围等。共获得有效问卷和出生详细信息的活产单胎儿4448人，其中早90人，小于胎龄儿147人，低出生体重104人。数据使用Dunnett-t检验、x2检验和多因素logistic回归模型进行分析结果围孕期规范增补叶酸，或单纯孕早期增补叶酸其子代出生体重、身长、头围等体格指标明显好于未增补者;控制初次建卡孕龄、孕妇年龄、文化程度、户籍、家庭人均月收人、孕前BMI、孕周、孕次、产次、妊娠间隔、既往不良孕育史、妊娠合并症后，多因素logistic回归模型分析结果显示:规范增补叶酸是不良出生结局的保护因素，可降低小于胎龄儿、早产、低出生体重发生的风险，其RR值(95%CI)分别为0.45 ( 0.24~0.86),0.52(0.32~0.87),0.39(0.19~0.80 )。而单纯孕前增补、单纯孕早期增补和其他增补叶酸情况对早产、小于胎龄儿和低出生体重的发生率并无明显影响。结论围孕期增补叶酸是否规范，直接影响子代不良出生结局的发生。 |
| English Abstract: |
| Objective To examine the association between folic acid supplements during peri-conception and the related adverse birth outcome. Methods Pregnant women who received first prenatal care at 4 municipal-level medical institutions in Maanshan, from Oct. 2008 to Oct. 2010 were selected as the target population. All participants were asked to complete a self-administered questionnaire which including data on demographic characteristics, interval, complications and frequency of taking folic acid etc.，during pregnancy. The follow-up-records after delivery would include factors as: fetal weight, height, circumference of head, chest circumference of the neonates. Finally, 4448 valid questionnaires were gathered, including 190 premature, 147 small for gestational age and 104 low birth weight babies. Descriptive statistics and logistic regression models were used for data analysis. Results Data showed that the weight, height and head circumference of the fetels at birth among pregnant women who had taken supplementary standard folic acid during peri-conception period or only during the first trimester, were all better than those pregnant women who had not taken the standard folic acid supplements. After adjustment for potential confounders as gestational weeks, maternal age, mather' s education level, results from the logistic regression showed that intake of standard folic acid supplements appeared a protective factor for those babies who were smaller than the gestational age (RR=0.45, 95% CI: 0.24-0.86)，at premature delivery (RR=0.52, 95% CI:0.32-0.87) or with low birth weight(RR=0.39, 95%CI: 0.19-0.80). However, data from this study showed that provision of folic acid supplements to the pre-pregnant or at first trimester alone did not make obvious impact on those babies as prematured,small for gestational age and at low birth weight.Conclusion Standardized provision of folicatured, small for gestational age and at low birth weight.acid supplements during peri-conceptional period couldimprove the outcomes of birth. |
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