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1.
王民 《河北医学》2016,(3):450-453
目的:探讨育龄妇女围孕期服用叶酸营养素软胶囊(小剂量叶酸增补剂+B族维生素+微量元素)预防神经管畸形(NTDS)的临床疗效.方法:对1600名自愿参加实验的计划怀孕的育龄妇女,随机抽取并分为两组:实验组(A组)800例,从计划怀孕开始,服用叶酸营养素软胶囊3~6个月;对照组(B组)800例,除进行必要的优生优育知识教育外,不服用任何叶酸类药物,从孕16周至结束分娩,对出现的神经管畸形(NTDS)率进行统计分析,对比观察服用叶酸营养素软胶囊后预防神经管畸形的临床疗效.结果:A组800名妇女出现神经管畸形2例;而B组800名妇女出现神经管畸形10例,A组发生率为2.50‰ (2/800),B组发生率为12.5‰(10/800),两组神经管畸形发生率有显著性差异(P<0.05);同时也发现孕前3个月开始服用叶酸营养素软胶囊者占70%(560/800),孕前2个月开始服用者占26.75% (214/800),孕前1个月开始服用者占3.33% (26/800).连续服用3个月者占20.75%(166/800),连续服用4~6个月者占79.25% (634/800),无论是在服药时长,还是孕前服药开始时间上,生育一胎的妇女人数都明显高于生育第二胎的育龄妇女人数.结论:叶酸营养素软胶囊既是小剂量叶酸增补剂,又含有孕期妇女所需要的水溶性维生素、铁、锌、硒等多种微量元素,围孕期服用可以更好地预防和减少NTDS的发生,能有效降低神经管畸形的发生率,因此推广育龄妇女围孕期服用叶酸营养素软胶囊很有必要,值得大力提倡.  相似文献   

2.
目的: 了解北京市妇女围受孕期服用叶酸的依从性,探索服用叶酸对胎儿神经管缺陷(neural tube defects,NTDs)的预防效果,分析影响叶酸服用依从性的因素,并提出改善叶酸服用依从性的对策和建议。方法: 以通州区2013—2018年92 121例分娩妇女的常规孕期保健数据和人群出生缺陷监测数据为基础,计算妇女的叶酸服用率和依从服用率(即孕前开始且规律服用率), 并分析服用叶酸与NTDs发生率的关系,同时采用单因素及多因素Logistic回归模型分析叶酸依从服用率的影响因素,并提出改善妇女围受孕期叶酸服用依从性的对策。结果: 6年间,妇女围受孕期叶酸总服用率为90.08%,有微弱上升趋势,而叶酸依从服用率仅为41.5%,且呈明显下降趋势。服用叶酸的妇女其胎儿NTDs的发生率是(5.5/万)未服用叶酸者(19.7/万)的27.9% (χ2=23.74,P<0.001),而服用单纯叶酸片和服用含叶酸的多种微量营养素的NTDs发病率未见统计学差异。母亲围受孕期补充叶酸可以减少70%的NTDs发病风险(RR=0.28,95%CI:0.16~0.49),且对无脑畸形和脊柱裂亚型均有预防效果。控制混杂因素后,本地户籍、文化程度为高中及以上的妇女叶酸依从服用率高于外地户籍、文化程度为初中及以下的妇女(P<0.05),年龄小于25岁、孕前偏瘦或肥胖的妇女、经产妇的叶酸依从服用率低于相应对比组(P<0.05)。结论: 北京市通州区妇女围受孕期叶酸服用率较高,但服用依从性较低,妇女围受孕期未服用叶酸严重影响NTDs的预防效果。叶酸依从服用率受妇女的年龄、文化程度、职业、户籍地、产次等多种因素影响,应重点关注年龄小于25岁、体型消瘦或肥胖、文化程度较低、经产及夫妻均为外地户籍的妇女,以提高围受孕期叶酸服用的依从性,更好地发挥叶酸预防NTDs的效果。  相似文献   

3.
3000例妇女孕前增补叶酸预防神经管畸形效果分析   总被引:1,自引:0,他引:1  
目的 为了降低神经管畸形的发病率,降低出生缺陷的发生。方法 此项目2000年-2001年在精河县开始推广,县妇幼保健站对全县3000名妇女正确服用叶酸增补剂预防神经管畸形的妇女进行调查。结果 3000名妇女正确服药人群中出生缺陷儿下降了15%-28%。结论 妇女正确服用叶酸可以降低出生缺陷的发生。  相似文献   

4.
目的: 了解北京市妇女围受孕期服用叶酸的依从性,探索服用叶酸对胎儿神经管缺陷(neural tube defects,NTDs)的预防效果,分析影响叶酸服用依从性的因素,并提出改善叶酸服用依从性的对策和建议。方法: 以通州区2013—2018年92 121例分娩妇女的常规孕期保健数据和人群出生缺陷监测数据为基础,计算妇女的叶酸服用率和依从服用率(即孕前开始且规律服用率), 并分析服用叶酸与NTDs发生率的关系,同时采用单因素及多因素Logistic回归模型分析叶酸依从服用率的影响因素,并提出改善妇女围受孕期叶酸服用依从性的对策。结果: 6年间,妇女围受孕期叶酸总服用率为90.08%,有微弱上升趋势,而叶酸依从服用率仅为41.5%,且呈明显下降趋势。服用叶酸的妇女其胎儿NTDs的发生率是(5.5/万)未服用叶酸者(19.7/万)的27.9% (χ2=23.74,P<0.001),而服用单纯叶酸片和服用含叶酸的多种微量营养素的NTDs发病率未见统计学差异。母亲围受孕期补充叶酸可以减少70%的NTDs发病风险(RR=0.28,95%CI:0.16~0.49),且对无脑畸形和脊柱裂亚型均有预防效果。控制混杂因素后,本地户籍、文化程度为高中及以上的妇女叶酸依从服用率高于外地户籍、文化程度为初中及以下的妇女(P<0.05),年龄小于25岁、孕前偏瘦或肥胖的妇女、经产妇的叶酸依从服用率低于相应对比组(P<0.05)。结论: 北京市通州区妇女围受孕期叶酸服用率较高,但服用依从性较低,妇女围受孕期未服用叶酸严重影响NTDs的预防效果。叶酸依从服用率受妇女的年龄、文化程度、职业、户籍地、产次等多种因素影响,应重点关注年龄小于25岁、体型消瘦或肥胖、文化程度较低、经产及夫妻均为外地户籍的妇女,以提高围受孕期叶酸服用的依从性,更好地发挥叶酸预防NTDs的效果。  相似文献   

5.
目的探讨优化随访方式对增补叶酸预防神经管缺陷服用依从率的影响。方法对来广益中心普通增补叶酸预防神经管缺陷的妇女111例进行宣传指导后分为观察组和对照组,观察组采用短信与电话随访方式以及闹钟提醒服药,对照组采用常规的电话随访方式.结果〗观察组42例,服用依从42例,服用依从率100%;对照组69例,服用依从60例,服用依从率86.96%,观察组明显高于对照组结论优化随访方式和闹钟提醒服药可以提高增补叶酸预防神经管缺陷服药依从率。  相似文献   

6.
背景 妇女围孕期增补叶酸是预防神经管缺陷的有效干预措施之一,并且预防效果受到叶酸服用量和服用时间的影响。2019年我国将“增补叶酸预防神经管缺陷项目”纳入基本公共卫生服务内容。目的 了解我国云南省育龄妇女围孕期叶酸增补情况及其影响因素,为提高叶酸干预效果提供依据。方法 利用云南省16个市(自治州)2018年参加“国家免费孕前优生项目”妇女数据,对完成了孕早期随访且叶酸服用状况完整的33 173例育龄妇女的叶酸服用状况及其影响因素进行分析。结果 2018年云南省育龄妇女围孕期叶酸服用率为93.81%〔95%CI(93.55%,94.07%)〕,叶酸规范服用率为47.16%〔95%CI(46.62%,47.70%)〕。不同市(自治州)妇女围孕期叶酸服用率和叶酸规范服用率差异较大,多数市(自治州)的叶酸服用率在85%以上,但叶酸规范服用率相对较低,文山壮族苗族自治州的育龄妇女围孕期叶酸规范服用率最低,仅为27.47%。多因素Logistic回归分析结果显示,年龄、受教育程度、职业、居住地区是育龄妇女叶酸服用率的影响因素(P<0.05);年龄、受教育程度、分娩史、流产史、居住地区是育龄妇女叶酸规范服用率的影响因素(P<0.05)。结论 云南省育龄妇女围孕期叶酸服用状况良好,但叶酸规范服用率相对较低,各市(自治州)差异较大。因此,要关注年龄较小、受教育程度较低、职业为农民、有分娩史及流产史的妇女围孕期叶酸服用状况,加强健康教育,进一步提高妇女围孕期叶酸服用率和规范服用率。  相似文献   

7.
周彦珩  杨淑荣 《当代医学》2014,(23):152-153
目的:通过分析育龄妇女增补叶酸对神经管缺陷(neural tuber defects,NTDs)的预防作用和影响增补叶酸相关因素,探讨提高叶酸服用率和叶酸知晓水平的有效途径,为进一步探索提高妇女叶酸增补率以提高增补叶酸预防NTDs效果。方法对计划怀孕与非计划怀孕的育龄妇女孕前-围孕期增补叶酸。结果育龄妇女围孕期增补叶酸可有效预防NTDs,但由于多种因素影响,育龄妇女叶酸增补剂服用依从率较低。结论育龄妇女孕前-围孕期增补小剂量叶酸可有效预防NTDs。  相似文献   

8.
贾新朝  王晓军  罗毅 《当代医学》2008,(10):109-110
本研究通过2000年至2002年,在乌鲁木齐七区一县15223名新婚妇女中从怀孕开始到孕后3个月末每日口服"斯利安片"(含0.4mg叶酸)的人群干预研究,评价小剂量叶酸增补剂对神经管畸形初发的预防作用,干预结果表明乌鲁木齐市的神经管畸形的发病率从服药前的32.52/10万下降至服药后的14.55/10万,这种经济简单、有效可行的增补叶酸预防神经管畸形的推广研究工作,可进一步在全疆范围内推广应用,为实现妇女儿童发展纲要、预防出生缺陷发生作出应有的贡献.  相似文献   

9.
目的:了解玉林市农村适龄妇女孕前和孕早期叶酸服用情况,围产儿神经管缺陷出生缺陷状况以及育龄妇女对服用叶酸预防神经管缺陷知识知晓状况,为改进预防神经管缺陷工作提供资料。方法:对2012年增补叶酸预防神经管缺陷项目月报表资料进行统计分析。结果:2012年玉林市农村适龄妇女孕前和孕早期叶酸服用调查,新增应服用人数130094例,新增服用人数119168例,新增服用率为91.60%,其中,新增服用率北流市为86.34%,容县为93.31%,博白县为85.74%,兴业县为98.83%,陆川县为99.54%,玉州区为92.93%,福绵区为99.08%;育龄妇女对服用叶酸预防神经管缺陷知识知晓状况问卷调查,全市共发放并收回有效问卷31711份,知晓人数30223人,知晓率为95.31%,其中,北流市为94.85%,容县为96.70%,博白县为94.54%,兴业县为95.68%,陆川县为94.27%,玉州区为95.29%,福绵区为98.50%;2012年玉林市出生缺陷数总数790例,其中,神经管缺陷22例,占出生缺陷数总数的2.78%。结论:2012年玉林市农村适龄妇女孕前和孕早期叶酸服用率高,育龄期妇女的叶酸知识知晓率较高。  相似文献   

10.
于琦 《黑龙江医学》2014,(3):357-358
目的 探寻一种预防胎儿早产的新方法,预防胎儿早产.方法 对准备生育的育龄妇女,进行“在孕前、孕期补充叶酸可以预防胎儿早产”的宣教及叶酸发放工作,在孕前3个月、整个孕期每天服用小剂量叶酸,即服用叶酸0.4 mg/d,预防胎儿早产;对完全依从本要求条件的孕妇进行疗效观察,观察其早产发生率;并与往年孕妇未补充叶酸的胎儿早产发生率对比,从而得出结论.结果 本次有2080例完全依从本要求条件,在孕前3个月、整个孕期每天服用叶酸,并实际分娩;其中早产分娩为18例,早产发生率为0.87%.对比先前已经调查统计记录:2008 ~2009年,本镇区2100例分娩孕妇均未服用叶酸,其早产发生率为2.24%.经比对发现,服用叶酸孕妇早产发生率较未服用叶酸孕妇的早产发生率减少1.37%,降幅为61.16%.结论 孕妇在孕前、孕期补充叶酸可以有效预防胎儿早产;这为预防胎儿早产提供了一个新的方法,是行之有效的预防措施;对今后在妇幼保健工作中,预防胎儿早产、保障生育健康胎儿,有着巨大的实际应用和推广价值.  相似文献   

11.
OBJECTIVE: To prevent the recurrence of neural tube defects (NTDs) in families at increased risk of having offspring with NTDs with the use of periconceptional folic acid supplementation. OPTIONS: Genetic counselling and prenatal diagnosis of NTDs. OUTCOMES: NTDs cause stillbirth, neonatal death and severe disabilities. The cost for medical care and rehabilitation in the first 10 years of life of a child with spina bifida cystica was estimated to be $42,507 in 1987. EVIDENCE: The authors reviewed the medical literature, communicated with investigators from key studies, reviewed policy recommendations from other organizations and drew on their own expertise. A recent multicentre randomized controlled trial showed that among women at high risk of having a child with an NTD those who received 4 mg/d of folic acid had 72% fewer cases of NTD-affected offspring than nonsupplemented women. Two previous intervention studies also demonstrated that folic acid supplementation was effective in reducing the rate of NTD recurrence. Several retrospective studies support this conclusion. VALUES: Recommendations are the consensus of the Clinical Teratology Committee of the Canadian College of Medical Geneticists (CCMG) and have been approved by the CCMG Board. The committee believes that primary prevention of NTDs is preferable to treatment or to prenatal detection and abortion. BENEFITS, HARMS AND COSTS: Folic acid supplementation should result in fewer NTDs among infants in Canada and ancillary savings in medical costs. The recommended dosage of folic acid is not known to be associated with adverse effects. Higher dosages of folic acid may make vitamin B12 deficiency difficult to diagnose and may alter seizure frequency in patients with epilepsy due to drug interactions with anticonvulsants. RECOMMENDATIONS: A minimum dosage of folic acid of 0.8 mg/d, not to exceed 5.0 mg/d, is recommended along with a well-balanced, nutritious diet for all women who are at increased risk of having offspring with NTDs and who are planning a pregnancy or may become pregnant. Supplementation should begin before conception and continue for at least 10 to 12 weeks of pregnancy. VALIDATION: These guidelines are similar to those of the Society of Obstetricians and Gynaecologists of Canada, the US Centers for Disease Control and Prevention and the Department of Health in Britain. SPONSORS: These guidelines were developed by the CCMG Clinical Teratology Committee and endorsed by the Board of the CCMG. No funding for the development of these guidelines was obtained from any other sources.  相似文献   

12.
目的:探讨还原叶酸载体基因(Reduced folate carrier gene,RFC1)A80G多态性及可疑危险因素对神经管畸形(neural tube defects,NTDs)的影响,为寻找NTDs的遗传易感标志物提供流行病学依据.方法:采用限制性片段长度多态性-聚合酶链式反应(polymerase chain reaction-restriction fragment length polymorphism,RFLP-PCR)方法,对104个NTDs儿核心家庭和100个健康对照儿核心家庭RFC1 A80G多态性进行检测,并且对家系成员RFC1基因型及其他因素进行单因素和多因素分析,在控制其他因素后观察RFC1基因型、母亲孕早期未增补叶酸对NTDs的独立影响,对NTDs杂合子父母G等位基因进行传递不平衡检验(transmission/disequilibrium test,TDT).结果:NTDs患儿G等位基因频率(64.42%)高于对照儿(52.53%),并且差异有统计学意义(χ2=5.9198,P<0.05);在单因素分析中,携带RFC1 GG基因型的子代发生NTDs危险高于AA基因型子代(OR=2.56,95% CI=1.04~6.36),母亲孕早期未增补叶酸,生育NTDs的危险高于增补叶酸的母亲(OR=7.69,95% CI=2.86~21.75),其他危险因素(如父亲年龄、母亲孕早期发热、母亲自然流产史)在病例对照之间差异有统计学意义;在多因素Logistic回归分析中,子代RFC1 GG基因型(OR=2.91,95% CI=1.35~6.30)、母亲孕早期未增补叶酸(OR=4.32,95%CI=1.62~11.55)、母亲孕早期发热(OR=3.22,95%CI=1.26~8.26)对NTDs的发病危险具有统计学意义.TDT结果显示,RFC1基因G等位基因与NTDs之间存在关联(χ2=5.236,P<0.05).结论:在该研究人群中,RFC1 GG基因型可能是NTDs发生的遗传易感基因之一,母亲孕早期未增补叶酸、发热对NTDs的发病也具有重要影响.  相似文献   

13.
Folic acid has been shown to reduce the risk of pregnancies affected by neural tube defects (NTDs) by as much as 70%. Cereal grains sold in the U.S. have been fortified with folic acid since 1998. The Arkansas Reproductive Health Monitoring System and the Arkansas Folic Acid Coalition have encouraged use of folic acid and monitored the impact of increased consumption of folic acid among Arkansans. NTDs in Arkansas have declined 40% since intervention programs were implemented. The greatest decline has been observed among white and Hispanic women. Efforts to encourage folic acid consumption should continue to target Arkansas women. NTDs include anencephaly and spina bifida. These birth defects result from incomplete closure of the fetal neural tube during the first month of pregnancy. Infants with anencephaly are born without all or most of their brain and die within a few days of life. Infants with spina bifida have varying degrees of impairment ranging from little noticeable disability to severe, lifelong disability. Folic acid, when taken in supplement form has been shown to reduce the risk of a pregnancy affected by a neural tube defect by as much as 70%. As a result of this finding, the U.S. Federal Drug Administration mandated that cereal grains sold in this country be fortified with at least 140 mcg of folic acid per 100 grams of grain by January 1, 1998. Prior to mandatory fortification, the March of Dimes and the U.S. Public Health Service released statements encouraging all women of reproductive age who are capable of becoming pregnant to take 400 mcg 'of synthetic folic acid daily. The Arkansas Reproductive Health Monitoring System (ARHMS) has monitored rates of NTDs in Arkansas since 1980. ARHMS is the lead agency of the Arkansas Folic Acid Coalition whose mission is to encourage folic acid use among all Arkansas women of reproductive age. In this report, we summarize efforts by ARHMS and the Arkansas Folic Acid Coalition to increase the awareness and use of folic acid in Arkansas, show how the rates of NTDs in the state have declined over the past 10 years, and estimate the direct health care and productivity cost savings to Arkansans over that time.  相似文献   

14.
CONTEXT: Daily consumption of 400 microg of folic acid before conception and during early pregnancy dramatically reduces the occurrence of neural tube defects (NTDs). Before food fortification, however, only an estimated 29% of US reproductive-aged women were taking a supplement containing 400 microg of folic acid daily. The US Food and Drug Administration authorized addition of folic acid to enriched grain products in March 1996, with compliance mandatory by January 1998. OBJECTIVE: To evaluate the impact of food fortification with folic acid on NTD birth prevalence. DESIGN, SETTING, AND POPULATION: National study of birth certificate data for live births to women in 45 US states and Washington, DC, between January 1990 and December 1999. MAIN OUTCOME MEASURE: Birth certificate reports of spina bifida and anencephaly before fortification (October 1995 through December 1996) compared with after mandatory fortification (October 1998 through December 1999). RESULTS: The birth prevalence of NTDs reported on birth certificates decreased from 37.8 per 100 000 live births before fortification to 30.5 per 100 000 live births conceived after mandatory folic acid fortification, representing a 19% decline (prevalence ratio [PR], 0.81; 95% confidence interval [CI], 0.75-0.87). During the same period, NTD birth prevalence declined from 53.4 per 100 000 to 46.5 per 100 000 (PR, 0.87; 95% CI, 0.64-1.18) for women who received only third-trimester or no prenatal care. CONCLUSIONS: A 19% reduction in NTD birth prevalence occurred following folic acid fortification of the US food supply. However, factors other than fortification may have contributed to this decline.  相似文献   

15.
OBJECTIVES: To evaluate a South Australian campaign to promote and implement knowledge that taking adequate folate/folic acid in the periconceptional period can reduce the risk of having a baby with a neural tube defect. DESIGN AND SETTING: The campaign, conducted in October 1994--August 1995, targeted women of reproductive age and health professionals. Evaluation was by computer-assisted telephone interviews undertaken by random dialling throughout the State before and after the campaign, and by self-administered questionnaires to health professionals and women in the postnatal period. PARTICIPANTS: Women of reproductive age and four groups of health professionals. MAIN OUTCOME MEASURES: Knowledge about folate, folate-rich foods and the periconceptional period; participation of health professionals in advising women about folate; use of periconceptional folic acid supplements; sales of folic acid tablets; and prevalence of neural tube defects. RESULTS: Significant increases in knowledge about folate followed the campaign. Health professionals and women in the postnatal period had higher initial levels of knowledge about folate, which also increased significantly. The proportions of women taking periconceptional folic acid supplements, and of health professionals advising women planning a pregnancy about folate, also increased significantly, and folic acid tablet sales doubled. Total prevalence of neural tube defects declined between 1966 and 1999 from a baseline of 2.0 per 1,000 births to 1.1 per 1,000 births (Poisson regression, P= 0.03; average decline of 1.0% per year). CONCLUSIONS: A short educational campaign with a limited budget ($40,000) can promote folate successfully, but alternative strategies such as food fortification are likely to be needed to achieve adequate periconceptional folate intake for a very high proportion of women.  相似文献   

16.
OBJECTIVE: To make recommendations on nutritional interventions and screening manoeuvres to prevent the birth of infants with neural tube defects (NTDs). OPTIONS: Folic acid consumption through diet or supplementation in women at low risk and at high risk of having a fetus with an NTD, and maternal serum alpha-fetoprotein (MSAFP) screening in low-risk pregnancies. OUTCOMES: A reduction in the incidence rate of NTDs and potentially harmful effects of false-positive results of screening tests (i.e., abortion of a normal fetus). EVIDENCE: A MEDLINE search with the use of medical subject headings "neural tube defects," "prenatal diagnosis" and "prevention and control" identified 103 original articles published between January 1979 and March 1993. Two reviewers extracted the data by applying the rules of evidence developed by the Canadian Task Force on the Periodic Health Examination. VALUES: The task force's evidence-based methods and values were used; high value was placed on prevention of NTDs and on limitation of the harmful effects of a pregnancy involving a fetus with an NTD. BENEFITS, HARMS AND COSTS: Evidence suggests that folic acid supplementation can decrease the incidence rate of NTDs in low-risk pregnancies by 40% to 60% with no adverse effects. MSAFP screening between the 16th and 18th weeks of gestation can reach a sensitivity of 83% and a specificity of 98% when it is used as part of an organized program. The effect of screening on the incidence rate of NTDs depends on whether affected fetuses are aborted. RECOMMENDATIONS: All women of childbearing age should be advised to increase their consumption of folic acid through diet or supplementation to 0.4 mg/d beginning 1 month before pregnancy and ending at the start of the second trimester. MSAFP screening is recommended in low-risk pregnancies only when it is part of a screening program that includes access to all necessary diagnostic services. High-risk women should be referred to genetic counselling before they plan a pregnancy. VALIDATION: These recommendations are comparable to the current recommendations of the US Centers for Disease Control and Prevention, the Society of Obstetricians and Gynaecologists of Canada, the Canadian Laboratory Centre for Disease Control and the Canadian College of Medical Geneticists, and they were validated through external review. SPONSOR: These guidelines were developed and endorsed by the Canadian task force, which funded by Health Canada.  相似文献   

17.
目的了解乌鲁木齐市孕期妇女叶酸及神经管畸形相关知识的知晓率及其影响因素,为更好地完成卫生部部署的叶酸项目推广工作提供依据。方法采用自行编制问卷对乌鲁木齐市人民医院、乌鲁木齐市妇幼保健院、新疆医科大学第一附属医院妇产科门诊就诊的300名孕期妇女进行调查,了解乌鲁木齐市孕期妇女对叶酸及神经管畸形相关知识的了解情况。结果叶酸知识的平均知晓率为60.18%,神经管畸形知识平均知晓率为39.74%;其中叶酸正确服用量及正确服用时间知晓率较低,分别为47.7%和46.3%;神经管畸形发生时间知晓率为36.7%,叶酸能够预防神经管畸形的知晓率仅为47.3%。不同年龄、民族、教育程度,家庭经济情况孕妇叶酸知识知晓情况差异有统计学意义(P<0.05)。不同民族、教育程度孕妇对神经管畸形知晓率差别有统计学意义(P<0.05)。结论叶酸预防神经管畸形知识的平均知晓率在乌鲁木齐的目标人群中很低,对少数民族、低文化程度及年龄较低孕妇人群有必要加大叶酸预防神经管畸形知识的宣传力度。  相似文献   

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