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目的了解安徽省增补叶酸预防神经管缺陷项目的实施效果。方法收集叶酸项目工作报表和出生缺陷监测报表中的部分数据,以及2015年孕妇叶酸知信行调查数据。结果 2009-2015年,全省叶酸服用人数、依从人数均逐年上升。叶酸服用率从2011年的76.9%上升到2015年的89.9%,有逐步提高的趋势(χ~2趋势=318 861.96,P<0.001)。叶酸服用依从比2011年后在70%上下波动。在监测的23类出生缺陷中,神经管畸形的构成比从开始监测时的10.96%逐渐下降到4.62%,明显下降的转折点在2010和2011年。神经管畸形占围生儿比从2011年开始出现降低,从项目实施前的9.09/万降低到项目实施后的6.66/万,下降约1/3,农村地区下降更为显著,约1/2。孕妇叶酸5题知晓率为59.8%、服用率为86.2%、依从率为77.7%,城乡孕妇差异均无统计学意义(均P>0.05)。城乡孕妇叶酸获取途径构成不同(P<0.05),农村孕妇领取免费叶酸的比例为76.7%,城区孕妇领取免费叶酸的比例为51.4%。结论安徽省增补叶酸预防神经管缺陷项目的效果显著,项目实施前后比较,全省神经管畸形下降约1/3。但是,叶酸项目和叶酸的健康教育仍有待进一步改进和加强。
Objective To understand the effect of folic acid supplementation in prevention of neural tube defects in Anhui Province. Methods The data of folic acid project work report and birth defects monitoring report were collected, and the data of the investigation of the women’s knowledge of folic acid in 2015 were collected. Results From 2009 to 2015, the number of folic acid users in the province, the number of compliance have increased year by year. The rate of taking folic acid increased from 76.9% in 2011 to 89.9% in 2015, with a gradual increase tendency (χ ~ 2 trend = 318 861.96, P <0.001). Folic acid taking compliance than in 2011 after 70% fluctuation. Among the 23 types of birth defects monitored, the proportion of neural tube defects gradually declined from 10.96% at the beginning of monitoring to 4.62%, with marked declines turning in 2010 and 2011. The incidence of neural tube defects in perinatal children decreased from 2011 to 2009, down from 9.09 / million before the implementation of the project to 6.66 / 10,000 after the implementation of the project, with a decrease of about 1/3. The decline in rural areas was even more pronounced, accounting for about 1/2 . The awareness rate of pregnant women with folic acid 5 was 59.8%, the taking rate was 86.2% and the compliance rate was 77.7%. There was no significant difference between pregnant women in urban and rural areas (all P> 0.05). There was a difference in the way of obtaining folic acid between urban and rural pregnant women (P <0.05). The proportion of pregnant women receiving free folic acid was 76.7% in rural areas and 51.4% in urban areas. Conclusion The effect of adding folic acid supplementation in prevention of neural tube defects in Anhui Province is remarkable. Before and after the project was implemented, the incidence of neural tube defects in the province decreased by about 1/3. However, the health education on folic acid and folic acid remains to be further improved and strengthened.