云南省用叶酸预防先天出生缺陷的现状和对策

目的：了解用叶酸来预防先天畸形的知识在云南相关人群中的知晓率和行为、及叶酸增补剂在云南的推广应用情况，由此提出进一步在云南推广叶酸预防出生缺陷的对策。方法：（1）在医保人员，来婚检的妇女和孕妇中进行问卷调查，将结果进行X^2检验和方差分析。（2）向叶酸增补剂在云南的销售代理了解叶酸在云南的销售结果。结果：在153名妇幼卫生人员中，66.0％（101/153）知道服用叶酸可以减少先天畸形儿的发生，23.5％（36/153）知道叶酸应当从孕前开始服用，而仅有4.6％（7/153）的人给出叶酸每天适当的摄入范围是0.4mg-1.0mg；194名来婚检的妇女中，仅有4人（2.1％）知道叶酸可以防止胎儿畸形，2人知道要从孕前服用；210名孕妇中，31.9％（67/210）的孕妇知道叶酸与先天畸形的关系，14.3％（30/210）孕妇在服用叶酸增补剂，而仅有4人（1.9％）从孕前开始服用。2002年1-10月，云南叶酸增补剂的销售总量约5000人份，约为同期孕妇总量的1.0％。结论：叶酸预防神经管畸形等出生缺陷的知识还没有得到很好的普及，叶酸增补剂利用率低。建议加强政府行为，加大宣传力度，更新观念，增加叶酸在妇女中的知晓率和利用率。

Current Situations and Countermeasures on Preventing Birth Defects with Folic Acid in Yunnan

OBJECTIVE To assess the knowledge and behaviors of using folic acid for prevention of birth defect among related people in Yunnan. To give suggestions in preventing birth defects using folic acid. METHODS Questionnaires were distributed to maternal and child health (MCH) professionals, women who plan to marry, and pregnant women, respectively, and filled in by them. The data were analyzed in X2 test and ANOVA. Finding out selling volume of folic acid in Yunnan from pharmaceutical representatives. RESULTS Among 153 MCH professionals, 66.0% (103/153)were aware that folic acid could prevent NTD, 23.5% (36/153) knew that folic acid supplement should be used from preconception, only 4.6% (7/153) could give proper dose (0.4mg~ 1mg) of folic acid. Among 194 women planning to marry, only 4 people (2.1%) had the knowledge regarding folic acid and birth defects, 2 knew that taking folic acid should start before pregnancy. For 210 pregnant women, 31.9% (67/210) learned that folic acid could prevent birth defects. 14.3% (30/210) women were taking folic acid supplements, but only 4 (1.9% ) had taken folic acid starting before pregnancy. The total selling volume of folic acid in Yunnan for 10 months was about 5 000 volume, which accounted for 1.0% of the pregnant women in the same period. CONLCLUSION The knowledge regarding prevention of birth defects such as NTD using folic acid has not been popularized yet among related people. Folic acid is not used widely. We suggest to strengthen the government actions in folic acid propaganda and enforce the education campaign for increasing the use of folic acid among people.