妊早期妇女血清叶酸水平与胎儿出生缺陷发病关系的队列研究

目的:探讨孕妇血清叶酸水平与胎儿出生缺陷发病的关系。方法:选择2007年4月～2010年4月在开封市妇产医院进行产检的、符合纳入标准的孕妇为调查对象,按其服用叶酸的情况分为A组(孕前、孕期从未口服叶酸)、B组(孕后口服叶酸)、C组(孕前、孕后均口服叶酸),比较三组血清叶酸水平;对其进行随访至胎儿出生6个月,调查出生结局,比较三组出生缺陷发生情况。结果:A组的血清叶酸平均水平明显低于B组和C组,C组的血清叶酸平均水平高于B组(P<0.05)。A组孕妇娩出出生缺陷胎儿发生率明显高于B组和C组(P<0.05)。与围孕期规律服用叶酸相比,不服用叶酸组娩出出生缺陷胎儿的相对危险度为3.48(2.02/0.58),其风险增加了2.48倍。结论:妊早期孕妇叶酸水平与出生缺陷有关系,围孕期服用叶酸增补剂可以降低出生缺陷的发生风险。

A cohort study on the relationship between serum folic acid of pregnant women during the first trimester of pregnancy and onset of fetal birth defects

Objective:To explore the relationship between serum folic acid of pregnant women and onset of fetal birth defects.Methods:The pregnant women who received prenatal examination and met the inclusion criteria in the hospital from April 2007 to April 2010 were selected as respondents,then they were divided into group A(never taking folic acid before and during pregnancy),group B(taking folic acid after pregnancy),and group C(taking folic acid before and after pregnancy),the serum levels of folic acid in the three groups were compared;all the pregnant women were followed up till six months after birth,the pregnancy outcome was surveyed,and the incidences of birth defects in the three groups were compared.Results:The serum level of folic acid in group A was significantly lower than those in group B and group C,the mean serum level of folic acid in group C was higher than that in group B(P<0.05).The incidence of fetal birth defects in group A was significantly higher than those in group B and group C(P<0.05).Compared with pregnant women taking folic acid regularly during pregnancy,the relative risk ratio of fetuses with birth defects in the pregnant women not taking folic acid regularly was 3.48(2.02/0.58),increasing by 2.48 times.Conclusion:The folic acid level of pregnant women during the first trimester of pregnancy is related to birth defects,taking folic acid during pregnancy can reduce the risk of birth defects.