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目的了解陕西省孕妇叶酸服用状况及其影响因素,为进一步叶酸干预工作提供依据。方法分层随机多阶段抽取陕西省2010—2013年曾经怀孕的育龄妇女,通过问卷调查了解妇女围孕期叶酸使用情况以及影响因素。结果共调查29 818人,66.4%的妇女围孕期服用过叶酸。农村妇女围孕期叶酸服用率为63.4%,城市为72.6%,其中,孕前服用者占25.3%。19.9%围孕期服用叶酸持续时间≤30 d,56.8%持续时间为31~90 d,4.7%持续时间>180 d。影响围孕期服用叶酸的积极因素有产检次数>8次(OR_(调整)=2.25,95%CI=2.09~2.43),第一次产检时间在孕早期(OR_(调整)=1.91,95%CI=1.78~2.03),产检次数5~8次(OR_(调整)=1.68,95%CI=1.57~1.78),丈夫文化程度为大学及以上(OR_(调整)=1.67,95%CI=1.50~1.87),妇女文化程度为大学及以上(OR_(调整)=1.52,95%CI=1.36~1.71)及优生优育咨询(OR_(调整)=1.42,95%CI=1.33~1.51),妇女文化程度为高中(OR_(调整)=1.33,95%CI=1.23~1.44),丈夫文化程度为高中(OR_(调整)=1.26,95%CI=1.17~1.36),有不良孕产史(OR_(调整)=1.22,95%CI=1.10~1.35)和妇女年龄30~35岁(OR_(调整)=1.12,95%CI=1.04~1.20)。消极因素有妇女年龄<20岁(OR_(调整)=0.60,95%CI=0.52~0.70),妇女年龄>35岁(OR_(调整)=0.89,95%CI=0.80~1.00),经产妇(OR_(调整)=0.76,95%CI=0.72~0.81),城市孕妇(OR_(调整)=0.81,95%CI=0.76~0.86)。结论陕西省育龄妇女围孕期叶酸服用率及不规范服用率均较低,未达到国家90%服用率的要求。建议加强对孕期人群管理,特别是高风险人群(如低龄、高龄孕妇、经产妇等人群)孕期系统化管理及宣传教育工作。
Objective To understand the status of folic acid intake and its influencing factors in pregnant women in Shaanxi Province and provide basis for further folic acid intervention. Methods Stratified random multi-stage extraction of women of childbearing age who were pregnant in Shaanxi province from 2010 to 2013, and through questionnaire survey to understand the situation and influencing factors of folic acid in perinatal women. Results A total of 29 818 people were surveyed, 66.4% of women took folic acid during pregnancy. The incidence of folic acid in rural women was 63.4% during pregnancy and 72.6% in urban areas, among which 25.3% were pregnant women. 19.9% of folic acid during pregnancy duration ≤ 30 d, 56.8% of the duration of 31 ~ 90 d, 4.7% of the duration of> 180 d. The positive factors influencing the use of folic acid in perinatal period were as follows: the number of pregnancy tests was> 8 (OR_ (adjusted) = 2.25, 95% CI = 2.09 ~ 2.43) = 1.78 ~ 2.03), the number of births was 5-8 times (OR_ (adjusted) = 1.68, 95% CI = 1.57-1.78) and the husband’s education level was university or above (OR_ (adjusted) = 1.67, 95% CI = 1.87), women’s educational level was university and above (OR_ (adjusted) = 1.52, 95% CI = 1.36-1.71) and eugenics and fertility consultation (OR_ (adjusted) = 1.42, 95% CI 1.33-1.51) (OR_ (adjusted) = 1.33, 95% CI = 1.23 ~ 1.44), and the husband’s education level was high school (OR_ (adjusted) = 1.26,95% CI = 1.17 ~ 1.36) ) = 1.22, 95% CI = 1.10-1.35) and women aged 30-35 years (OR_ (adjusted) = 1.12, 95% CI = 1.04-1.20). The negative factors include the age of women <20 years (OR_ (adjusted) = 0.60, 95% CI = 0.52-0.70), women aged> 35 years (OR adjusted 0.89, 95% CI = 0.80-1.00) OR_ (adjusted) = 0.76, 95% CI = 0.72 ~ 0.81), urban pregnant women (OR_ (adjusted) = 0.81, 95% CI = 0.76 ~ 0.86). Conclusion The women of childbearing age in Shaanxi Province have lower rates of taking folic acid during pregnancy and taking non-standard take-up rate, and have not reached the requirement of 90% of the national take-up rate. It is suggested to strengthen the systematic management and publicity and education during the pregnancy period, especially for the management of pregnant women during pregnancy, especially at high risk groups (such as young people, elder pregnant women and maternal women).