Prevention of neural-tube defects with folic acid in China
Prevention of neural-tube defects with folic acid in China
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DOI：
10.1056/nejm199911113412001
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发表时间：
1999-11-11
影响因子：
158.5
通讯作者：
Correa, A
中科院分区：
文献类型：
--
作者：
Berry, RJ;Li, Z;Correa, A
围产期使用含叶酸的多种维生素可降低妇女生育神经管缺陷婴儿的风险。方法作为1993 - 1995年在中国神经管缺陷高发地区开展的公共卫生运动的一部分（北方地区）和一个低利率（南部地区），我们评估了女性的怀孕结果，这些女性被要求从婚前检查到婚前检查结束每天单独服用含有400微克叶酸的药丸。结果在130，142名孕前或孕期服用叶酸的妇女和117，689名未服用叶酸的妇女的胎儿或婴儿中，我们分别确定了102名和173名神经管缺陷。在末次月经前登记且未服用任何叶酸的妇女的胎儿或婴儿中，北方地区每1000例妊娠至少20周的胎儿或婴儿中神经管缺陷率为4.8例，南方地区为1.0例。妊娠期使用叶酸妇女的胎儿或婴儿中，北方地区为1.0/1000，南方地区为0.6/1000。在北方地区，一个妇女亚组的胎儿或婴儿在孕期服用叶酸片的时间超过80%，其风险降低最大。在南部地区，围受孕期使用叶酸的妇女的胎儿或婴儿的风险降低也是显着的（风险降低，41%; 95%的置信区间，3至64%）。结论围受孕期每天摄入400毫克叶酸可以降低神经管缺陷的风险，在这些缺陷的高发病率和低发病率的地区。（N Engl J Med 1999;341：1485-90.）(C)1999年，马萨诸塞州医学会。
Background Periconceptional use of multivitamins containing folic acid can reduce a woman's risk of having a baby with a neural-tube defect.Methods As part of a public health campaign conducted from 1993 to 1995 in an area of China with high rates of neural-tube defects (the northern region) and one with low rates (the southern region), we evaluated the outcomes of pregnancy in women who were asked to take a pill containing 400 mu g of folic acid alone daily from the time of their premarital examination until the end of their first trimester of pregnancy.Results Among the fetuses or infants of 130,142 women who took folic acid at any time before or during pregnancy and 117,689 women who had not taken folic acid, we identified 102 and 173, respectively, with neural-tube defects. Among the fetuses or infants of women who registered before their last menstrual period and who did not take any folic acid, the rates of neural-tube defects were 4.8 per 1000 pregnancies of at least 20 weeks' gestation in the northern region and 1.0 per 1000 in the southern region. Among the fetuses or infants of the women with periconceptional use of folic acid, the rates were 1.0 per 1000 in the northern region and 0.6 per 1000 in the southern region. The greatest reduction in risk occurred among the fetuses or infants of a subgroup of women in the northern region with periconceptional use who took folic acid pills more than 80 percent of the time. In the southern region the reduction in risk among the fetuses or infants of women with periconceptional use of folic acid was also significant (reduction in risk, 41 percent; 95 percent confidence interval, 3 to 64 percent).Conclusions Periconceptional intake of 400 mg of folic acid daily can reduce the risk of neural-tube defects in areas with high rates of these defects and in areas with low rates. (N Engl J Med 1999;341:1485-90.) (C) 1999, Massachusetts Medical Society.