妇女增补叶酸预防神经管畸形发生的最佳时点

目的:调查经过10年后,在结婚登记日期增补叶酸预防神经管畸形的发生是否依旧适用现在的育龄妇女人群。方法:选择河北、浙江及江苏3省部分农村和城市地区为调查研究现场,对研究地区在1994～1995年和2004～2005年两个时期内,围绕结婚登记日期前后,不同阶段(婚前,婚后0～3个月,0～6个月,0～12个月,婚后12个月以上)内初产妇的百分率及两个时期内妇女的结婚登记日期与末次月经日期的时间间隔(怀孕时间)情况进行评估分析。结果:10年前后相比,农村和城市地区的育龄妇女在民族构成上没有显著差异,而在怀孕年龄、教育程度和职业分布等方面存在明显差异。无论是在10年之前或之后,大多数妇女在结婚后1年内怀孕。10年后,研究地区育龄妇女的怀孕率无论是婚前,还是婚后1年内的各个阶段(0～3个月,0～6个月,0～12个月)均有不同程度的降低;而妇女的平均怀孕年龄、婚后1年以上的怀孕率、结婚登记日期与末次月经日期的时间间隔(怀孕时间)中位数则较10年前有所上升。结论:10年后,无论是在城市还是在农村,更多的年轻育龄妇女倾向于晚育,这也表明在全国大范围推广孕前保健的重要性。10年后结婚登记日期依然可作为妇女开始增补叶酸预防神经管畸形发生的最佳时点。

The optimal time for women to take a folic acid supplement to prevent NTDs after a decade

Objective:To investigate whether the timing of a registered marital date is still optimal or not after a decade for women to take a 400 μg folic acid supplement to prevent Neural Tube Defects (NTDs).Methods:By using the China's unique surveillance system,data was collected from Hebei,Jiangsu and Zhejiang provinces during 1994~1995 and 2004~2005.Cases included all pregnant women without having a given birth.Cases were excluded with having parity or unknown conditions.Results:For both periods during 1994~1995 and 2004~2005,the distribution of women's ethnic was similar,but there were significant difference at their pregnant age,level of education and occupation.Most of newly married women became pregnant within one year after marriage.After a decade,percentage of pregnant women decreased at pre-marriage and several periods of post-marriage ( 0~3 month,0~6 month,and 0~12 month).However,there were significantly increased at the mean of pregnant age,the women pregnant percentage of more than one year after marriage,and the median of the interval between the last menstrual period and the registered marital date.Conclusion:After a decade,more women are trend to getting pregnancy late.Therefore,preconception care may play an important role in reducing risks and improve health outcomes.The timing of a registered marital date is still optimal for women to take folic acid supplement to prevent NTDs.