叶酸预防妊娠期妇女巨幼红细胞性贫血和胎儿神经管缺陷的调查分析

目的:探讨妊娠期叶酸预防孕妇巨幼红细胞性贫血和胎儿神经管缺陷的效果。方法:随机抽取产科门诊常规产检的孕妇1 041例作为调查对象,初检孕周12~14周,根据妊娠前3个月和妊娠后3个月有无口服叶酸分为2组;其中A组614例为妊娠前3个月(至少1个月)至妊娠后3个月口服叶酸者,B组427例为妊娠前后从未口服叶酸者。于妊娠15~20周开始对孕妇行血细胞分析,血清叶酸含量测定及系统B超检测,比较2组孕妇妊娠期巨幼红细胞性贫血和胎儿神经管缺陷的发生情况。结果:A组孕妇平均红细胞叶酸和血清叶酸水平均明显高于B组(P0.01),A组妊娠期巨幼红细胞性贫血发生率明显低于B组(P0.01),胎儿神经管缺陷的发生率与B组差异无统计学意义(P0.05)。结论:妊娠前至妊娠后3个月服用小剂量叶酸增补剂可降低孕妇巨幼红细胞性贫血和胎儿神经管缺陷的发生率。

The investigation of the preventive effect of folic acid on gravide megaloblastic anemia and fetus neural tube defect during gestational period

Objective： To explore the relationship between the deficiency of folic acid during gestational period and gravida megaloblastic anemia and fetus neural tube defect. Methods：One thousand and forty-one gravidas from out-patients clinic for regular prenatal care were investigated, whose first identification were from 12 to 14 weeks of pregnancy. All gravidas were divided into two groups（A and B group） according to oral folic acid administrate or not 3 months befor and after pregnancy. Group A（614 cases） took folic acid by oral from 3 months（ at least 1 month） before pregnancy to 3 months after pregnancy. Group B（427 cases） did not take folic acid by oral. Blood analysis,the serum content of folic acid and B ultrasound of two groups were investigated to compare the occurrence of gravida megaloblastic anemia and fetus neural tube defect. Results： The levels of red cells and serum folic acid of group A were significantly higher than that in group B （ P 〈 0.01 ）. The incidence of megaloblastic anemia of gravida taking folic acid by oral in 3 months （ at least 1 month） before pregnancy was obviously lower than that in B group （ P 〈 0.01 ）. Compared with B group, the incidence of fetus neural tube defect of A group was decreased. Conclusions ： Gravida who takes folic acid by oral 3 months befor and after pregnancy can reduce the incidence of gravida megaloblastic anemia and fetus neural tube defect.