Folate concentrations and folic acid supplementation among women in their first trimester of pregnancy in a rural area with a high prevalence of neural tube defects in Shanxi, China.
Folate concentrations and folic acid supplementation among women in their first trimester of pregnancy in a rural area with a high prevalence of neural tube defects in Shanxi, China.
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DOI：
10.1002/bdra.20271
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发表时间：
2006-06
期刊：
影响因子：
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通讯作者：
Le Zhang;A. Ren;Zhiwen Li;Ling Hao;Yi-hua Tian;Zhu Li
中科院分区：
文献类型：
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作者：
Le Zhang;A. Ren;Zhiwen Li;Ling Hao;Yi-hua Tian;Zhu Li
背景虽然中国山西省于1998年开展了围孕期补充叶酸的宣传活动，但据报道，2002年农村地区神经管缺陷的患病率高达每万新生儿140例。本文介绍了该省农村地区孕妇的血液叶酸浓度和补充叶酸的做法。方法对山西农村地区483名孕妇（平均妊娠8.1周）进行调查。收集非空腹血样和叶酸补充信息。通过微生物测定法测定血浆和红细胞中的叶酸浓度。结果孕妇血浆和红细胞叶酸的平均浓度分别为10.4 nmol/L和375.8 nmol/L。分别有 20.9% 和 47.6% 的女性缺乏血浆和红细胞叶酸。叶酸缺乏症的患病率存在季节性变化，春季和夏季血浆叶酸浓度显着较低，而除夏季以外的其他季节红细胞叶酸浓度也较低。在孕妇中，<10% 的人报告曾服用或正在服用叶酸，几乎没有女性 (0.6%) 按照建议服用叶酸。结论 农村地区妇女血浆和红细胞叶酸水平较低，叶酸缺乏在该地区非常普遍。很少有女性遵循有关补充叶酸的建议，山西的宣传活动并不成功。这些发现表明，农村地区迫切需要采取综合策略，用叶酸强化谷物，并促进育龄妇女补充叶酸。
BACKGROUND Although an information campaign concerning periconceptional folic acid supplementation was launched in 1998 in Shanxi Province, China, the prevalence of neural tube defects in rural areas was reported as high as 140 per 10,000 births in 2002. The blood folate concentrations and the practice of folic acid supplementation among pregnant women in rural areas of the province are described. METHODS A total of 483 pregnant women (mean gestation, 8.1 weeks) in a rural area of Shanxi were interviewed. Nonfasting blood samples and information on folic acid supplementation were collected. Folate concentrations in plasma and erythrocytes were determined by a microbiological assay. RESULTS The mean concentrations of plasma and erythrocyte folate for pregnant women was 10.4 nmol/liter and 375.8 nmol/liter, respectively. Deficiencies of plasma and erythrocyte folate were observed in 20.9% and 47.6% of women, respectively. Seasonal variations were noted in the prevalence of folate deficiency, with significantly lower plasma folate concentrations in spring and summer and lower erythrocyte folate concentrations in seasons other than summer. Among pregnant women, <10% reported having taken or currently taking folic acid, and virtually no women (0.6%) took folic acid as recommended. CONCLUSIONS Women in rural areas had low plasma and erythrocyte folate levels, and folate deficiency was highly prevalent in the area. Few women followed the recommendations regarding folic acid supplementation, and the information campaign in Shanxi was unsuccessful. These findings suggest the urgent need for combined strategies in rural areas to fortify grain with folic acid and promote folic acid supplements for childbearing-age women.