Prevention of neural-tube defects with folic acid in China. China-U.S. Collaborative Project for Neural Tube Defect Prevention.
Prevention of neural-tube defects with folic acid in China. China-U.S. Collaborative Project for Neural Tube Defect Prevention.
复制标题
DOI：
10.1097/00006254-200004000-00006
复制
发表时间：
2000-04
期刊：
影响因子：
--
通讯作者：
R. Berry;Zhu Li;J. Erickson;Song Li;C. Moore;Hong Wang;J. Mulinare;P. Zhao;Lee-Yang C. Wong-Lee-Yang
中科院分区：
文献类型：
--
作者：
R. Berry;Zhu Li;J. Erickson;Song Li;C. Moore;Hong Wang;J. Mulinare;P. Zhao;Lee-Yang C. Wong-Lee-Yang
背景与方法围孕期服用叶酸可降低孕妇生下神经管缺陷胎儿或婴儿的风险。作为1993年至1995年在中国地区神经管缺陷率较高地区(北部地区)和神经管缺陷率较低地区(南部地区)开展的一项公共卫生活动的一部分，我们评估了从婚前检查时至妊娠早期，每天仅服用400微克叶酸的妇女的妊娠结局。结果在130,142名孕前或孕期任何时候服用叶酸的妇女和117,689名未服用叶酸的妇女的胎儿或婴儿中，我们分别发现102人和173人患有神经管缺陷。在最后一次月经前登记的未服用任何叶酸的妇女的胎儿或婴儿中，神经管缺陷率在北部地区为每1000名怀孕至少20周的孕妇中有4.8人，在南方地区为每1000人中有1.0人。在围产期使用叶酸的孕妇胎儿或婴儿中，北方地区为1.0/1000，南方地区为0.6/1000。风险最大的降低发生在北部地区怀孕期间服用叶酸药片的一小部分妇女的胎儿或婴儿中，他们服用叶酸药片的时间超过80%(与上次月经前登记且不服用叶酸的妇女的胎儿或婴儿相比，风险降低85%；95%的可信区间，62%至94%)[更正]。在南部地区，怀孕期间使用叶酸的孕妇的胎儿或婴儿的风险也显著降低(风险降低了41%；95%的可信区间为3%至)。结论妊娠期每日摄入400微克叶酸可降低神经管畸形高发区和低发区神经管畸形的风险。
BACKGROUND AND METHODS Periconceptional administration of folic acid can reduce a woman's risk of having a fetus or infant with a neural-tube defect. 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 microg 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 (reduction in risk, 85 percent as compared with the fetuses or infants of women who registered before their last menstrual period and who took no folic acid; 95 percent confidence interval, 62 to 94 percent) [corrected]. 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 microg 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.