Neural Tube Defects and Maternal Folate Intake Among Pregnancies Conceived After Folic Acid Fortification in the United States
Neural Tube Defects and Maternal Folate Intake Among Pregnancies Conceived After Folic Acid Fortification in the United States
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DOI：
10.1093/aje/kwn331
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发表时间：
2009-01-01
影响因子：
5
通讯作者：
Hobbs, Charlotte A.
中科院分区：
文献类型：
--
作者：
Mosley, Bridget S.;Cleves, Mario A.;Hobbs, Charlotte A.
自从美国在食品供应中添加叶酸以来，神经管缺陷率已经下降。作者的目的是评估神经管缺陷与孕妇叶酸摄入量之间的关系。这是一项多中心的病例对照研究，使用了1998-2003年全国出生缺陷预防研究的数据。使用Logistic回归计算病例和对照组之间的粗略和调整后的优势比，评估母亲孕周叶酸的使用和饮食叶酸的摄入量。在180例无脑儿中，385例脊柱裂患者和3963例对照组分别报告了围产期使用叶酸补充剂的比例，分别为21.1%、25.2%和26.1%。围产期补充剂的使用并不能降低因神经管缺陷而怀孕的风险。母亲饮食中叶酸的摄入量与神经管畸形之间没有明显的相关性。在这项在强制性叶酸强化后怀孕的孕妇中进行的研究中，作者发现几乎没有证据表明神经管缺陷和母亲叶酸摄入量之间存在联系。一个可能的解释是，叶酸强化减少了叶酸敏感神经管缺陷的发生。有必要进行进一步的调查，以可能确定哪些女性仍处于可预防的神经管缺陷的更高风险中。
Rates of neural tube defects have decreased since folic acid fortification of the food supply in the United States. The authors' objective was to evaluate the associations between neural tube defects and maternal folic acid intake among pregnancies conceived after fortification. This is a multicenter, case-control study that uses data from the National Birth Defects Prevention Study, 1998-2003. Logistic regression was used to compute crude and adjusted odds ratios between cases and controls assessing maternal periconceptional use of folic acid and intake of dietary folic acid. Among 180 anencephalic cases, 385 spina bifida cases, and 3, 963 controls, 21.1%, 25.2%, and 26.1%, respectively, reported periconceptional use of folic acid supplements. Periconceptional supplement use did not reduce the risk of having a pregnancy affected by a neural tube defect. Maternal intake of dietary folate was not significantly associated with neural tube defects. In this study conducted among pregnancies conceived after mandatory folic acid fortification, the authors found little evidence of an association between neural tube defects and maternal folic acid intake. A possible explanation is that folic acid fortification reduced the occurrence of folic acid-sensitive neural tube defects. Further investigation is warranted to possibly identify women who remain at increased risk of preventable neural tube defects.