围孕期叶酸补充情况及其对妊娠结局影响

  目的  了解单胎妊娠围孕期叶酸补充情况和补充剂量, 探讨围孕期叶酸补充与妊娠结局的关系。  方法  以2017年10月-2019年6月期间在广州市花都区妇幼保健院分娩的6 536例单胎活产的孕妇作为研究对象。在分娩前或分娩后回顾性的调查孕妇一般人口学特征、围孕期增补叶酸情况及妊娠结局等信息。  结果  孕前半年服用叶酸坚持1个月以上的孕妇1 345人(20.18%); 围孕期每日叶酸服用剂量正常的孕妇764人(11.69%)。与未补充叶酸相比, 孕前补充叶酸可使新生儿增加74.68 g出生体重, 孕后补充增加55.05 g(P＜0.05)。在控制孕妇年龄、文化水平、孕前BMI、被动吸烟时间等相关因素后, 孕前补充叶酸可以使小于胎龄儿(small for gestational age, SGA)的发生风险降低(aOR=0.66, 95% CI: 0.46~0.95)。低出生体重(low birth weight, LBW)和自发早产与叶酸补充类型无关。围孕期高剂量补充叶酸可能增加自发早产的发生风险(aOR=1.75, 95% CI: 1.02~3.01)。SGA和LBW与叶酸补充剂量无关。  结论  围孕期补充叶酸可以促进胎儿生长, 降低SGA的发生风险。

The study of periconception folic acid supplementation and its relationship with pregnancy outcome

Objective This study aimed to investigate the situation and dosage of penconception folic acid supplementation and to explore the association between periconception folic acid supplementation and pregnancy outcome. Methods A total of 6 526 pregnant women were recruited from October 2017 to June 2019 in Huadu District of Guangzhou. R retrospective surveys before or after delivery were conducted to collect information about general demographic characteristics, periconception folic acid supplementationand pregnancy outcomes. Results There were 1 345 pregnant women(20.18%) taken folic acid for more than one month at half a year before pregnancy. 764(11.69%) pregnant women took normal daily dosage of folic acid during periconception. Preconception folic acid supplementation was associated with 74.68 g higher birth weight and the first-trimester supplementation increased 55.05 g(P<0.05), compared to no folic acid supplementation. After adjusted maternal age, educational level, pre-gestational body mass index(BMI), passive smoking time, periconception folic acid supplementation could reduced the risk of small for gestational age( SGA) infants(aOR=0.66;95% CI:0.46-0.95). Low birth weight(LBW) and spontaneous preterm delivery were not related to the type of folic acid supplementation. High-dose folic acid during periconception may increased the risk of spontaneous preterm(aOR=1.75;95% CI: 1.02-3.01). SGA and LBW were not related to folic acid dose. Conclusions Periconception folic acid supplementation was positively associated with fetal growth resulting in birth weight, and decreased risks of SGA.