摘要
目的了解神经管畸形高发区与低发区农村孕早期妇女血液叶酸状况。方法采用现况调查方法对2003年神经管畸形高发与低发两个地区共688名农村孕早期妇女的血浆叶酸与红细胞叶酸水平进行研究。结果高发区农村孕早期妇女血浆叶酸浓度(10．53 nmol／L)与红细胞叶酸浓度(389．2 nmol/L)中位数明显低于低发区妇女(血浆叶酸30.39 nmol／L,红细胞叶酸926.0 nmol/L),差异有统计学意义;高发区妇女血浆叶酸缺乏率约为50％,红细胞叶酸缺乏率约为43％,远高于低发区妇女(血浆叶酸6％,红细胞叶酸4％),差异有统计学意义;高、低发区服用叶酸组妇女血浆叶酸水平约为不服用组的2倍,红细胞叶酸水平是不服用组的1．4倍,差异有统计学意义;高、低发区服用叶酸组孕早期妇女的血浆缺乏率均低于不服用组,相对危险度(RR)值分别为0.60(95％CI:0.36- 1.01)与0．16(95％CI:0.06-0．44),差异均有统计学意义;高、低发区服用叶酸组与不服用组红细胞叶酸缺乏率之间的RR值分别为0．64(95％CI:0.36-1．13)与0．39(95％CI:0．13-1．13),差异无统计学意义;服用叶酸的孕早期妇女中,低发区血浆叶酸水平约为高发区的1．7-1.9倍,红细胞叶酸水平约为高发区的2倍,差异有统计学意义;服用叶酸的孕早期妇女中,高发区血浆叶酸与红细胞叶酸缺乏率约为低发区的10-14倍,差异有统计学意义。结论神经管畸形高发区农村孕早期妇女血液叶酸水平很低,增补叶酸可有效提高妇女血液叶酸水平、降低妇女叶酸缺乏率,高发区育龄妇女怀孕前后每日服用0．4 mg叶酸的剂量可能不足,建议增加服用剂量。
Objective To compare plasma and red blood cell folate levels among women in their first trimester of pregnancy from rural areas with high or low prevalence of neural tube defects. Methods A cross-sectional study was performed, among women in their first trimester of pregnancy from rural areas with high or low prevalence of neural tube defects in 2003. Non-fasting blood sample were collected and analyzed for plasma and red blood cell folate concentrations for 688 women. Results The median plasma （10.53 nmol/L） and red blood cell folate （389.2 nmol/L） among women from the high prevalence rural area were lower than those of women from the low prevalence rural area （plasma folate： 30.39 nmol/L, red blood cell level folate： 926.0 nmol/L）. Among women from the high prevalence area, about 50% and 43% were respectively, deficient for plasma and red blood cell folate, compared with 6% and 4% respectively, for women from the low prevalence area. The median plasma folate levels among women who took periconceptional folic acid supplements in both high and low prevalence areas were about twice higher than those who did not take the folic acid. The median red blood cell folate level of the folic acid users was 40 % higher than those of the non-users. Among those who took folic acid, women in the low prevalence area had 70%-90% higher plasma folate concentration and twice higher red cell folate concentration than women in the high prevalence area. Conclusion Women from the rural area with a high prevalence of neural tube defects had low plasma and red blood cell folate levels. Periconceptional supplementation with folic acid could substantially improve folate status of reproductive-aged women. However, supplementation with 0.4 mg of folic acid per day might be inadequate for women in the high prevalence rural area.
出处
《中华流行病学杂志》
CAS
CSCD
北大核心
2006年第8期659-663,共5页
Chinese Journal of Epidemiology
基金
国家"十五"科技攻关计划资助项目(2002BA709B11)
关键词
出生缺陷
神经管畸形
孕早期
叶酸
Birth defects
Neural tube defects
First trimester
Folate
