中国妇女妊娠前后单纯服用叶权对神经管畸形的预防效果

目的 评价妇女在妊娠前后服用单纯４００μｇ叶酸增补剂对胎／婴儿神经管畸形（ＴＮＤｓ）的预防效果。方法 １９９３￣１９９５年在中国北方的ＴＮＤｓ高发地区和南方的ＮＴＤｓ低发地区妇女增补叶酸的推广项目中，共募集从孕前或孕后任何时间开始服药的妇女１１７６８９名；设计的服药方法从婚栓时开始到孕满３个月为止，每天服用单纯叶酸片４００μｇ；最后对妇女的分娩结局进行监测并进行预防效果的对比评价研究。结果 服药组

Preventing neural tube defects with periconceptional folic acid supplementation: a population based intervention program in the China

OBJECTIVES: To evaluate the effectiveness of periconceptional use of 400 microgram folic acid only on the prevention of neural tube defects (NTDs). METHOD: As part of a public health campaign in areas of high (North) and low (South) NTDs prevalence in the China during 1993 and 1995, 130 142 pill takers and 117 689 non-pill takers were recruited. Women were asked to begin taking a pill containing only 400 microgram of folic acid daily from the time of their premarital examination until the end of the first trimester of pregnancy. The outcomes of these pregnancies were ascertained through 1996. RESULTS: We identified 102 NTDs among offspring of pill takers and 173 NTDs among offspring of non-pill takers. The NTDs rate in offspring of non-pill takers was 4.8 per thousand (16/3 318) and 1.0 per thousand (28/28 625) in the south; while the rate in pill takers was 1.0 per thousand (13/13 012) in the north and 0.6 per thousand in the south. The greatest reduction in risk occurred among the fetuses or infants of a subgroup of women in the northern region with periconceptional use who took pills more than 80 percent of the time (reduction in risk, 85 percent as compared with the fetuses or infants of women who registered before their last menstrual period and who took no folic acid; 95 percent confidence interval, 62 to 94 percent). In the southern region the reduction in risk among the fetuses or infants of women with periconceptional use of folic acid was also significant (reduction in risk, 41 percent; 95% confidence interval, 3 to 64 percent). CONCLUSION: Periconceptional intake of supplements containing only 400 microgram folic acid can reduce the risk for NTDs in areas of high and low NTDs prevalence.