The effect of preconceptional multivitamin supplementation on the menstrual cycle

The database of the Hungarian randomised controlled trial of periconceptional multivitamin supplementation for the prevention of neural-tube defects was used to evaluate the length of the pre- and postovulatory phases of the menstrual cycle before and during multivitamin supplementation. The female cycle was more regular (i.e., the variance was lower) during the multivitamin supplementation.     

围孕期营养因素与先天性心脏病发病的关系

先天性心脏病是人体在胚胎发育时期受各种因素影响导致心脏及血管发育异常的先天性畸形.先天性心脏病是人类最常见的先天畸形,是导致婴儿发病和病死的重要原因.即使可以经过外科手术矫治畸形,先天性心脏病患儿也要面临各种手术并发症甚至疾病复发的风险,给社会带来巨大的经济压力.目前普遍认为先天性心脏病的发生受遗传因素和环境因素的共同影响.近年来围孕期营养因素与先天性心脏病的发病关系成为研究热点.研究结果显示,叶酸及其他围孕期营养素与先天性心脏病的发生有密切关系,围孕期母亲适当补充这些营养素可降低子代先天性心脏病的发生风险.该文就叶酸、维生素A、锌、维生素B、维生素E围孕期关键营养因素与先天性心脏病的关系,从病因、发病机制及预防方面进行综述,为疾病的预防提供基础.     

围孕期先天性心脏病危险因素的1：2配比病例对照研究

目的 探讨围孕期环境暴露因素与先天性心脏病(CHD)发生风险之间的关系.方法 采用1∶2配比的病例对照研究方法,于2012年1月至2014年1月对武汉市某区妇幼机构儿童进行“CHD免费筛查”,通过常规听诊、超声心动图初筛,并经市级以上医院确诊.以CHD患儿为病例组,按照年龄、性别、社区配对选择健康的儿童为对照组.用EpiData 3.1软件录入数据,用SPSS 11.5软件进行单因素和多因素的条件logistic回归分析.结果 采集138名患儿和276名对照儿童的父母信息.对27个主要研究因素进行单因素条件logistic回归分析.结果显示,孕早期补钙、孕早期精神刺激、母亲孕期营养、不良孕产史、经产妇、围孕期患病及居住地附近有污染企业与子代CHD发生有一定关联;多因素条件logistic回归分析显示,孕早期精神刺激(HR=3.35,95％CI:1.28 ～ 8.79)、母亲孕期营养不良(HR=1.50,95％CI:1.10 ～ 2.03)及不良孕产史(HR=1.62,95％CI:1.03 ～ 2.57)是子代发生CHD的危险因素,而孕早期适当补钙(HR=0.40,95％CI:0.25～0.65)则可降低CHD发生的风险.结论 CHD的发生可能与孕早期精神刺激、围孕期营养、孕早期补钙及既往不良生育史有一定关系,应加强围孕期保健,降低CHD的发病率.     

Awareness of the benefits of folic acid and prevalence of the use of folic acid supplements to prevent neural tube defects among Thai women

Objective To determine the level of knowledge about the usefulness of periconceptional folic acid supplementation among pregnant women. Materials and methods An anonymous questionnaire was completed by selected subjects to assess folic acid awareness. The questionnaire was administered to pregnant women who were seeking antenatal care at King Chulalongkorn Memorial Hospital May to December 2005. The questions covered their knowledge and use of folic acid supplements, pregnancy intention, and demographic and socioeconomic characteristics. Results Out of 401 women surveyed, 76.1% of them reported that they had heard of folate. Of these, only 24.4% of the total subjects knew that folate was something important. Overall, 9.7% of the total women took folic acid during periconceptional period. The most common information sources on folate were the media. Logistic regression analysis showed that education of mother was the strongest predictor of having taken folic acid during the correct period. Conclusion Although some pregnant women are aware of the need to take folic acid, the actual impact of the present recommendations is almost negligible. Information to specifically inform patients about the need to take folic acid to prevent neural tube defects by medias and healthcare personnel seem to improve the final intake of folic acid during the protective period.     

The effect of periconceptional multivitamin-mineral supplementation on vertigo,nausea and vomiting in the first trimester of pregnancy

Summary Evidence is presented that periconceptional multivitamin-mineral supplementation can help to reduce nausea, vomiting and vertigo in early pregnancy.     

Periconceptional alcohol consumption causes fetal growth restriction and increases glycogen accumulation in the late gestation rat placenta

Introduction

Alcohol consumption is a common social practice among women of childbearing age. With 50% of pregnancies being unplanned, many embryos are exposed to alcohol prior to pregnancy recognition and formation of the placenta. The effects of periconceptional (PC) alcohol exposure on the placenta are unknown.

Methods

Sprague-Dawley rats were exposed to alcohol (12.5% v/v ad libitum) from 4 days prior to 4 days after conception and effects on placental growth, morphology and gene/protein expression examined at embryonic day (E) 20.

Results

PC ethanol (EtOH)-exposed fetuses were growth restricted and their placental/body weight ratio and placental cross-sectional area were increased. This was associated with an increase in cross-sectional area of the junctional zone and glycogen cells, especially in PC EtOH-exposed placentas from female fetuses. Junctional Glut1 and Igf2 mRNA levels were increased. Labyrinth Igf1 mRNA levels were decreased in placentas from both sexes, but protein IGF1R levels were decreased in placentas from male fetuses only. Labyrinth mRNA levels of Slc38a2 were decreased and Vegfa were increased in placentas following PC EtOH-exposure but only placentas from female fetuses exhibited increased Kdr expression. Augmented expression of the protective enzyme 11βHsd2 was found in PC EtOH-exposed labyrinth.

Discussion

These observations are consistent with a stress response, apparent well beyond the period of EtOH-exposure and demonstrate that PC EtOH alters placental development in a sex specific manner.

Conclusion

Public awareness should be increased to educate women about how excessive drinking even before falling pregnant may impact on placental development and fetal health.     

围孕期妇女叶酸水平及其季节变化特征

摘要:目的　描述新婚育龄妇女叶酸水平的人口分布及季节分布特征,为进一步指导增补叶酸提供科学依据。方法　利用婚前医学检查项目,收集合肥地区3个县城（肥东、肥西、长丰）2 040名新婚育龄妇女血标本,其中孕妇731人,非孕妇1 309人;调查研究基本人口统计特征资料。结果　孕妇组叶酸水平（555.84±218.885）nmol/L高于非孕妇组（502.54±187.22）nmol/L,差异有统计学意义（t＝-8.460,P＜0.001）。在孕妇人群中不同季节、不同年龄段叶酸水平差异有统计学意义（P值均＜0.05）。在非孕妇人群中不同地区、受教育程度、年龄段、季节的叶酸水平差异均有统计学意义（P值均＜0.05）。结论　妇与非孕妇红细胞内叶酸水平存在差异;应根据季节给与孕妇补充不同水平叶酸;加强不同人口特征孕妇和非孕妇叶酸相关知识的健康教育。     

Long-term somatic and mental development of children after periconceptional multivitamin supplementation

The preventive effect of periconceptional folic acid-containing multivitamin supplementation compared to placebo-like trace element tablets on the number of first-occurring neural-tube defects was well documented in the Hungarian randomized double-blind trial. The effect of this new primary prevention on the early (first 11 months) postnatal development has also been studied. This follow up was expanded to children at the 2nd and 6th years of age studied previously by a blind examination of their somatic and mental development. Confounding factors and case histories were evaluated and paediatric, ophthalmological, audiological and psychometric examinations were performed on 625 children. Conclusion There were no differences in the rate and distribution of disorders including allergies (except otitis media), ophthalmological and audiological anomalies, anthropometric and mental development between children who belonged to the multivitamin or to the trace element group. Received: 23 May 1997 / Accepted in revised form: 28 January 1998     

中国五城市流动育龄妇女围孕保健服务满意度影响因素研究

目的 了解流动育龄妇女围孕保健服务现状和满意程度,分析其满意度的影响因素,为改善流动育龄妇女的优生健康质量提供依据. 方法 利用2005年北京、南京、厦门、深圳和重庆五城市流动人口生殖健康抽样调查数据,描述分析流动育龄妇女围孕保健服务利用及满意程度分布情况,对影响满意度的有关因素进行多因素分析. 结果 5 399例有效调查问卷中,流动育龄妇女在流入地的围孕保健服务利用率为41.1％,其中对服务满意者占63.3％.多因素Logistic回归分析发现,流动育龄妇女对围孕保健服务的满意度在调查地区间存在差别,差异有统计学意义;自评健康状况一般(OR=1.79,95％ CI:1.43 ～2.25)或身体状况差(0R=1.87,95％CI:1.10～3.16)、检查婚育证明(OR=1.63,95％ CI:1.20～2.22)、未参加计生部门宣教活动(OR=1.28,95％ CI:1.04～1.57)、自行前往参与服务(OR=1.54,95％CI:1.22～1.94)、付费检查(OR=1.36,95％ CI:1.08 ～ 1.72)、服务态度差(OR =2.33,95％ CI:1.81 ～2.99)、设施环境差(OR=1.54,95％CI:1.20～1.97)与较高的不满意度存在统计学关联. 结论 自评健康状况一般或差、无婚育证明、未参加计生部门宣教活动、自行前往孕检、付费检查、服务态度差、设施环境差与较高的不满意度有关,建议将计生服务与围孕保健相结合、积极促进流动育龄妇女社会融入、提供优惠、专业的保健服务,提高流动育龄妇女对围孕保健服务满意度,有助于降低不良妊娠结局发生风险.     

Periconceptional folic acid supplementation among women attending antenatal clinic in Anhui, China: data from a population-based cohort study

Objectives

to examine the rate of periconceptional and optimal folic acid supplementation, and to characterise their patterns and determinants among antenatal women in central China.

Design

data from 4290 women in the Anhui Birth Defects and Child Development Cohort Study recruited between October 2008 and September 2009 were analysed.

Setting

seven Maternal and Child Health Centres of two cities (Hefei and Maanshan) in Anhui province of central China.

Participants

women initiating prenatal care were included and asked to complete a structured questionnaire regarding folic acid supplementation.

Findings

sixty-eight per cent (2905/4290) of pregnant women reported taking folic acid supplementation periconceptionally (i.e. at some point before or during early pregnancy), and 32.8% (1405/4290) and 65.2% (2797/4290) had taken it before or during early pregnancy, respectively. However, only 16.1% (690/4290) used it optimally (i.e. regularly from four weeks before pregnancy throughout four weeks after pregnancy). Use of periconceptional folic acid was significantly associated with educational level, household income, registered residence, age, gestational age at recruitment, and planning of pregnancy.

Conclusion

optimal folic acid supplementation was relatively low.

Implications for practice

further efforts are needed to inform the population and promote the use of folic acid supplementation.