兵团已婚育龄妇女产前检查情况分析

目的:了解新疆生产建设兵团2005年7月1日～2010年6月30日有活产儿的妇女产前检查情况。方法:资料来源于第三次兵团卫生服务调查,采取四阶段分层、整群随机抽样方法,共调查近5年有生育史的妇女627人;对影响产前检查的因素进行单因素χ2检验和非条件Logistic逐步回归分析。结果:兵团近5年有生育史的妇女产前检查率93.3%,孕早期检查率70.7%;汉族、文化程度高的妇女产前检查率高,汉族、文化程度高、有生育史的妇女孕早期检查率高。结论:针对文化程度低的妇女加强孕期保健知识健康教育,提高孕早期产前检查率。     

新疆生产建设兵团育龄妇女叶酸知识知晓情况调查

目的:了解新疆生产建设兵团育龄妇女叶酸知识知晓情况。方法:采取整群分层、四阶段、概率比例抽样方法随机抽样,共调查育龄妇女7333人;对影响兵团育龄妇女叶酸知晓率的因素进行单因素和非条件Logistic逐步回归分析。结果:兵团育龄妇女的叶酸知晓率为31.37%;居住在师直、年龄25～34岁、汉族、受教育程度高、已婚、从事非农业、家庭年收入高、经常看书报杂志、近2年收到过生殖健康宣传材料的妇女叶酸知晓率高。结论:应积极采取叶酸增补干预措施,加强健康教育,重点加强农村、未婚和少数民族妇女叶酸知识的普及,促进经济发展,提高妇女受教育程度是提高育龄妇女叶酸知晓率的根本途径。     

延安育龄妇女出生缺陷KAP调查及其影响因素分析

目的 了解陕西省延安市育龄妇女掌握出生缺陷和优生知识的水平、对此的态度和行为(KAP)以及对预防出生缺陷服务的相关需求及获取方式,从而为本市进一步提高出生缺陷服务质量、制定优生优育服务策略及出生缺陷干预措施的整体方案提供科学依据.方法 采用分阶段随机抽样法,于2015年11月至2017年1月在延安市13个区县中随机抽取4个区县共471名18~45岁准备妊娠及妊娠期妇女进行访谈及问卷式调查.结果 延安市育龄妇女出生缺陷知识总体掌握程度欠缺,平均得分仅(8.00±2.22)分(13分制),其中40.3%不及格,26.3%良好,对"预防出生缺陷的叶酸增补方案"、"围孕妇女的个体化营养素补充"知晓度最低,回答正确频度分别仅为26.9%、5.0%.经比较分析发现高年龄、城市、受教育程度的增加、高收入、有妊娠史的妇女对相关知识点得分普遍高于低年龄、郊区和农村、低文化程度、低收入、初次妊娠妇女.态度方面,76.6%的育龄妇女经计划生育部门开展的宣传途径来获取优生相关知识,大部分育龄妇女对"优生优育"方面的知识表现出相对积极的态度.行为方面,接受过或有意愿接受婚前医学检查、孕前优生检查及孕期常规产检者分别占63.1%、75.8%和90.0%.对其中339名受孕妇女进行妊娠期不良因素调查发现,孕早期经常长时间用电脑及看电视者(每天累计超过4小时)占47.5%,怀孕前3个月丈夫未戒烟、戒酒者达到近50.0%左右.0.4mg叶酸服用率达到87.9%,从开始服用叶酸到现在坚持每天服用者占67.6%,而从怀孕前三个月开始并坚持每天服用者仅占25.4%;受教育程度越高,叶酸服用率也越高(P=0.021,OR=0.646),而有妊娠史的妇女对叶酸进行正确的增补频率较无妊娠史妇女反而变低(P=0.001, OR=2.760).结论 延安市育龄妇女出生缺陷相关知识掌握不够,但态度积极,有较大提高空间;影响出生缺陷的不良因素发生频率较高,叶酸服用不规范,应根据相关影响因素认真开展多种渠道的健康教育宣传,以提高育龄妇女预防出生缺陷知识的知晓率,有效降低出生缺陷发生的风险.     

甘肃省项目县育龄妇女叶酸知识及服用情况调查

目的:了解甘肃省育龄妇女叶酸知识的知晓及服用状况。方法:对甘肃省5个县(市)2008年10月01日～2010年09月30日孕≥28周分娩的妇女进行问卷调查,统计分析其对叶酸知识的知晓率、叶酸服用率及规范服用率等指标。结果:调查21962名妇女,收回有效问卷20723份,有效应答率为94.36%。妇女叶酸知晓率为93.85%,服用率为84.92%,规范服用率为22.19%;其了解叶酸的主要途径是人口计生系统宣传教育。结论:甘肃省育龄期妇女的叶酸知识知晓率较高,围孕期叶酸的服用率也较高,但规范服用率低。     

新《婚姻登记条例》实施前后孕早期妇女叶酸知识和增补率的变化

目的:了解新《婚姻登记条例》实施前后孕早期妇女叶酸知信行变化状况。方法:采用横断面调查与对比研究,对无锡市新《婚姻登记条例》实施前登记结婚的75例和实施后52例孕早期妇女的叶酸知识的了解情况、服用叶酸增补剂的态度及叶酸增补剂服用情况进行了问卷调查。结果:实施后组孕早期妇女对于叶酸增补剂最佳服用时期的知晓率为42.31%,低于实施前的66.67%(P<0.01);实施后组妇女叶酸增补剂服用率为44.23%,低于实施前的62.67%(P<0.05);实施后组从卫生保健机构获得叶酸知识的构成比例为28.95%,低于实施前的82.76%(P<0.01);实施后组孕早期妇女听说过叶酸的比例(73.08%)、知道叶酸预防神经管畸形作用的比例(55.77%)和有必要服用叶酸增补剂的比例(65.38%),均低于实施前组妇女(分别为77.33%、66.67%和73.33%),但差别无统计学意义。结论:新《婚姻登记条例》实施后,无锡市孕早期妇女叶酸相关知识、叶酸增补剂服用率呈现下降趋势。应积极探索新的知识传播途径,增加育龄妇女的叶酸知识,提高叶酸增补剂服用率。     

吐鲁番市妇女孕期叶酸和维生素D服用情况调查

目的调查新疆维吾尔自治区吐鲁番市孕妇对叶酸和维生素D的知晓程度及服用情况,为今后更好地进行营养健康教育、提升孕妇健康知识提供科学依据,提高当地孕妇健康水平。方法采用自行设计的"孕妇健康综合调查表",对2018年1月～2月期间在吐鲁番市第二人民医院产科门诊和病房产检的280例孕中晚期孕妇进行问卷调查,有效问卷为266例(95%),孕妇年龄在18～45岁,调查孕妇年龄、孕次等基本情况以及叶酸和维生素D知晓程度及服用情况,分析不同年龄、文化程度、职业和家庭月收入的孕妇对叶酸和维生素D的知晓程度及服用情况。结果孕妇叶酸知晓率及服用率分别为93.9%和85.3%,不同年龄、教育程度、家庭月收入和职业的孕妇对叶酸的知晓率及服用率差异有统计学意义;维生素D知晓率及服用率分别为53.0%和31.5%,不同教育程度、家庭月收入和职业的孕妇对维生素D的知晓率及服用率差异有统计学意义;孕妇叶酸和维生素D知识主要来自医务人员,其次是媒体宣传和其他来源。结论新疆维吾尔自治区吐鲁番市孕妇叶酸知晓率及服用率较高,维生素D知晓率及服用率较低,孕妇叶酸和维生素D的知识来源主要来自于医务人员。     

孕妇增补微量营养素状况及其与妊娠结局关联的队列研究

目的:了解安徽地区孕妇增补微量营养素的现况,探讨增补微量营养素与妊娠结局的关系。方法:以2008年10月～2010年10月在安徽省合肥、马鞍山、芜湖3个市的妇幼保健机构首次进行孕期保健体检的孕妇为对象,调查孕早期增补微量营养素的情况,通过孕妇保健手册了解妊娠结局情况。结果:至2011年5月分娩单胎活产儿的孕妇共10 269人。孕早期服用复合维生素、复合微量元素、钙剂、铁剂、叶酸坚持1个月以上的孕妇分别为660人(6.4%)、520人(5.1%)、384人(3.7%)、208人(2.0%)、5 358人(52.2%),孕前半年服用叶酸坚持1个月以上的孕妇2 021人(19.7%)。在控制母亲年龄、文化程度、家庭人均月收入、孕前BMI、自然流产史、人工流产史及胎儿性别后,孕早期持续服用复合微量元素(RR=0.25,95CI%=0.09～0.69)和叶酸(RR=0.72,95CI%=0.55～0.96)都会减少发生小于胎龄儿的风险。多元线性回归模型显示,控制母亲年龄、文化程度、家庭人均月收入、孕前BMI、自然流产史、人工流产及胎儿性别后,孕早期补充复合维生素、复合微量元素、叶酸均能增加胎儿出生体重,孕早期服用叶酸可增加胎儿出生胸围,差异具有统计学意义(P<0.05),而孕前半年增补叶酸与妊娠结局指标无显著关联(P>0.05)。结论:孕妇孕早期补充微量营养素可促进胎儿宫内生长,减少小于胎龄儿的发生。     

1635例山西省出生缺陷高发地区孕早期妇女服用叶酸情况及影响因素分析

目的调查山西省出生缺陷高发地区孕早期妇女的叶酸服用情况,评价近年叶酸预防神经管缺陷的工作效果。方法2010年5月—2012年6月对平定县妇幼保健院建立《孕产期保健档案》的孕早期妇女进行问卷调查,了解是否服用叶酸等信息,并对其影响因素进行分析。结果1 635例孕妇叶酸服用率为54.1%(885/1 635),孕前开始服用者仅129例,占14.6%(129/885),规律服用者(每周至少服用6天)占94.1%(833/885)。受教育程度、产次及意外妊娠是影响叶酸服用的主要因素。受教育程度为保护因素(OR=O.82,95%CI:0.69~0.98),即受教育程度越高,叶酸服用率越高;产次(OR=1.35,95%CI:1.12~1.62)和意外妊娠(OR=1.88,95%CI:1.25~2.82)为危险因素。结论平定县的叶酸服用率较低,亟需通过健康教育和宣传,提高育龄妇女对叶酸的增补率。     

云南省农村育龄妇女出生缺陷预防服务利用状况调查

目的:了解云南省农村育龄妇女出生缺陷预防服务利用情况。方法:自制调查问卷由统一培训的调查员逐个入户对2538名育龄妇女进行调查,共回收有效问卷2500份。结果:51.7%的妇女服用过叶酸,其中有41.0%在妊娠前服用。36.5%的妇女接受了孕前咨询;24.8%的妇女做过孕前健康检查,69.4%接受过产前检查,孕12周以前检查者有32.3%,孕中期为49.5%;有75.6%的妇女做过孕期B超检查,其中孕早期检查者为17.9%,孕中期为39.4%;仅有7.57%的妇女接受过产前唐氏综合征筛查,住院分娩率为66.5%。结论:云南省农村育龄妇女出生缺陷预防服务的利用率不高,所利用的服务仅限于一些基本的常规检查项目,大部分育龄妇女在妊娠后才开始接受一些出生缺陷预防措施。     

甘肃省农村孕产妇叶酸增补知信行现状调查

目的 了解甘肃省农村地区孕产妇叶酸相关知识认知水平、态度及服用现状,为制定干预措施提供依据.方法 采用整群随机抽样方法抽取与甘肃省兰州市毗邻的2县共2 094名孕产妇,对其增补叶酸的知、信、行现状进行问卷调查.结果 2 094名孕产妇中,62.18%的孕产妇听说过叶酸,26.17%知晓叶酸可以预防神经管畸形;9.83%知晓叶酸的正确服用时间;认为妊娠前、后以及妊娠前后有必要增补叶酸的孕产妇分别占6.26%、10.17%和36.29%;自述服用叶酸,服用叶酸,怀孕前、后服用叶酸的孕产妇分别占38.44%、25.36%、4.87%和17.81%;与乙县孕产妇比较,甲县知晓叶酸可预防神经管畸形、认为妊娠前后均有必要增补叶酸的孕产妇较多,差异均有统计学意义(P＜0.05);甲县听说过叶酸、知晓叶酸的正确服用时间、认为妊娠前、后有必要增补叶酸、自述服用叶酸、服用叶酸和怀孕后开始服用叶酸的孕产妇较少,差异均有统计学意义(P＜0.05).结论 甘肃省农村地区孕产妇叶酸知识缺乏,增补叶酸的孕产妇较少.     

Joint association of alcohol and folate intake with risk of major chronic disease in women

Alcohol interferes with folate metabolism and has opposing effects on the risks of cardiovascular disease and cancer. The authors examined the joint association of alcohol and folate intake with risk of major chronic disease, defined as fatal or nonfatal cardiovascular disease or cancer, or other nontraumatic death. This study included 83,929 women aged 34-59 years with no previous history of cardiovascular disease or cancer who provided dietary data in 1980. During 16 years of follow-up, the authors documented 10,666 new cases of major chronic disease. Overall, heavy drinkers (>30 g/day) with a lower total folate intake (<180 micro g/day) had the highest risk; in comparison with abstainers with a folate intake of 400-599 micro g/day, the multivariate relative risk was 1.36 (95% confidence interval: 1.10, 1.70). However, the increased risk of major chronic disease associated with heavy drinking was largely diminished among women with a higher folate intake (p for interaction = 0.02). The positive association between heavy alcohol/low folate intake and risk of major chronic disease was most apparent among women younger than age 60 years. Adequate folate intake may be important in the primary prevention of overall major chronic disease in women, especially among younger women consuming more than two alcoholic drinks per day.     

Folate and the prevention of neural tube defects: evaluation of a health promotion project in Western Australia

The objectives of this study were: to inform health professionalsand women of childbearing age about the prevention of neuraltube defects by folate; to recommend that all women of childbearingage increase their intake of folate; and to evaluate the effectivenessof the strategies used to achieve these aims. The study tookplace in Western Australia. The Folate and Neural Tube DefectsPrevention Project is a health promotion project using writtenmaterial, presentations and unpaid media. Surveys were carriedout of general practitioners, child health nurses and womenof childbearing age before the project began and 12 months later.The main outcome measures were: knowledge of folate and preventionof neural tube defects and exposure to and effectiveness ofpromotional material. Knowledge of folate and the preventionof neural tube defects increased amongst general practitionersand child health nurses, and most displayed the promotionalmaterial and made changes in their practice to promote an increasedfolate intake for women planning a pregnancy. In women of childbearingage, the knowledge of folate, of spina bifida, and of the associationbetween the two, increased over the study period. Women whohad seen the promotional pamphlet were over seven times morelikely to know that increased folate helps prevent spina bifida.The Project has been effective in raising awareness amongsthealth professionals and women of the prevention of neural tubedefects by folate. Further evaluation is needed to determinethe extent to which folate intake has increased, and its effectivenessin reducing the birth prevalence of neutral tube defects.     

The increasing knowledge of the role of periconceptional folate in Victorian women of child-bearing age: follow-up of a randomised community intervention trial

OBJECTIVES: To determine the changes since 1996 in knowledge of folate for the prevention of neural tube defects (NTDs) among women of child-bearing age and measure the residual effect of an earlier consumer-directed information campaign. DESIGN: A community, randomised trial with three matched pairs of geographically distinct local government areas in Victoria. INTERVENTION: Printed information recommending folate intake to decrease the risk of NTDs was disseminated in 1997 to women of child-bearing age. MAIN OUTCOME MEASURE: The proportion of women aware of the association between folate and spina bifida was established in 1996, 1997 and 2000 (approximately 200 respondents per local government area in each survey). RESULTS: 12.5% (adjusted for population sampling fraction) of 1,196 women interviewed in 1996, prior to the intervention, were aware of folate and NTDs. Independent surveys after the intervention in 1997 and again in 2000 showed that this had increased to 17.4% (n=1204) and 30.2% (n=1227) respectively. The intervention had a significant impact on folate awareness (a 4% difference in 1997 and a residual 3.3% in 2000, ORadj=1.24, 95% CI 1.19-1.37, p=0.007). CONCLUSIONS AND IMPLICATIONS: There has been a continuing increased awareness of folate in women of child-bearing age since 1996. Within this setting, the provision of printed educational material in a brief intervention in 1997 has caused enduring increased awareness of the association between folate and NTDs. The need for ongoing health promotion action on folate remains.     

Dietary folate intake during pregnancy and birth weight in Japan

BACKGROUND: Inadequate folate status has been associated with many negative reproductive outcomes, such as neural tube defects (NTD), low birth weight and placental abruption. AIM OF THE STUDY: The objectives of this study were to evaluate the levels of dietary folate intake during pregnancy in Japanese women and the subsequent birth weight of their babies. METHODS: A longitudinal prospective study was conducted with 197 women with a singleton pregnancy in 2005. Dietary folate was investigated 3 times: in the first trimester at 12 weeks, in the second trimester at 20 weeks and in third trimester at 32 weeks using a diet history questionnaire (DHQ). Non fasting blood samples were collected from the women for measurement of homocysteine, hemoglobin, ferritin, unbound iron-binding capacity (UIBC) and total iron-binding capacity (TIBC). RESULTS: Energy intake increased as pregnancy advanced, but not significantly. The daily intake of folate increased from 248.5 +/- 113.1 microg/d in the first trimester to 275.4 +/- 100.2 microg/d in the third trimester (P = 0.04). This was well below the recommended level of 440 microg/d and only 10% of mothers were above the levels. In the third trimester, plasma homocysteine concentration was significantly higher in the low folate group of less than 250 microg/d (P = 0.02), but not the first and second trimesters. Dietary folate intake and plasma homocysteine concentrations were not likely to be predictors of birth weight in our subjects. CONCLUSIONS: Our study shows that Japanese women's energy and folate intakes do not meet their energy needs during pregnancy and are at an extremely low recommended dietary allowance level throughout pregnancy.     

Status of plasma folate after folic acid fortification of the food supply in pregnant African American women and the influences of diet, smoking, and alcohol consumption

BACKGROUND: African American women and socioeconomically challenged women are at risk of compromised folate status and, thus, of folate-related birth defects. Data are limited on circulating folate concentrations in pregnant African American women after folic acid fortification of the food supply was implemented. OBJECTIVE: The objective was to determine the influence of smoking and alcohol consumption on plasma 5-methyltetrahydrofolic acid (5-MTHFA) concentrations in pregnant African American women. DESIGN: Alcohol consumption, smoking exposure, and other characteristics of pregnant African American women reporting to an inner-city antenatal clinic were assessed. At 24 wk of gestation, blood samples and food-frequency intake data were collected. Plasma 5-MTHFA concentrations were determined by liquid chromatography-mass spectrometry for 116 subjects and examined in a correlational study design. RESULTS: Dietary folate and markers of alcohol consumption were positively associated, whereas exposure to smoke was negatively associated with plasma 5-MTHFA. More than one-half of the participants in this population failed to meet the recommended dietary allowance for dietary folate equivalents of 600 microg/d during pregnancy. CONCLUSIONS: Most inner-city African American women are not meeting the recommended dietary allowance for dietary folate during pregnancy, and smoking may further compromise their folate status. Programs to reduce smoking and raise awareness about the importance of folate and multivitamin supplementation during pregnancy need to target this population.     

Folate intake, alcohol and risk of breast cancer among postmenopausal women in Denmark

OBJECTIVE: There is consistent evidence that alcohol increases the risk of breast cancer. It has been suggested that the increased risk associated with alcohol intake may be reduced by adequate intake of folate. Since many women consume alcohol, detection of a risk-reducing mechanism would have major public health implications. DESIGN: We therefore evaluated the possible interaction between alcohol and folate in a paired nested case-control study among postmenopausal women. SETTING: A total of 24 697 postmenopausal women were included in the 'Diet, Cancer and Health' follow-up study between December 1993 and May 1997. The cohort was followed until December 2000. The study included 388 cases of breast cancer and 388 randomly selected controls were used to estimate the breast cancer incidence rate ratio (IRR) in conditional logistic regression analysis. RESULTS: A previously established association between alcohol intake and risk of breast cancer was present mainly among women with low folate intake. An IRR of 1.19 (95% CI: 0.99-1.42) per 10 g average daily alcohol intake was found for women with a daily folate intake below 300 mug, while among women with a folate intake higher than 350 mug, we could not show an association between the alcohol intake and the breast cancer incidence rate (e.g. folate intake >400 mug; IRR of 1.01 (95% CI: 0.85-1.20)). CONCLUSION: The findings support the evidence that adequate folate intake may attenuate the risk of breast cancer associated with high alcohol intake. SPONSORSHIP: The Danish Cancer Society.     

Use of periconceptional folic acid supplements in Victoria and New South Wales, Australia

OBJECTIVES: To determine the proportion of women who took folate supplementation prior to conception and in the first three months of pregnancy and/or increased folate dietary intake; to determine how folate supplementation varied with socio-demographic factors; and to describe the ways women had seen or heard about folate prior to pregnancy. METHODS: Two population-based surveys were used: the Victorian Survey of Recent Mothers 2000 and the 2001 NSW Child Health Survey. RESULTS: Thirty-six per cent of women in Victoria reported taking periconceptional folate supplements compared with 46% in NSW. In Victoria, 8%, and in NSW, 28% of women had increased dietary folate intake. In both surveys younger women, women with less education, less income, of non-English speaking background and women who were not married were less likely to take folate supplements in the recommended period. In Victoria, multiparous women were significantly less likely to take supplements. In NSW, women with an unplanned pregnancy and those living in rural areas were significantly less likely to take periconceptional folate supplements. Fifty-three per cent of women cited a general practitioner or obstetrician as a source of folate information and 45% cited family or friends; both of these sources were significantly associated with periconceptional folate supplementation. CONCLUSIONS: Less than 50% of women took periconceptional folate supplements. Among socially disadvantaged groups, the proportion was significantly lower. IMPLICATIONS: Since women are unlikely to achieve adequate folate intake periconceptionally without deliberate action, there remains the need for a multifaceted approach to providing women with information about folate. Future surveys are needed to monitor usage and knowledge.