孕前及孕期叶酸摄入与早产的相关性研究

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目的探讨孕前及孕期叶酸摄入与早产的相关性,为早产干预措施及策略的制定提供科学依据。方法以2011年1月-2012年12月在该院建卡并随访到分娩结局的6 631例孕妇为研究对象,用Logistic回归模型分析孕前及孕期叶酸补充和膳食叶酸摄入与早产的相关性。结果在控制潜在的混杂因素后,与未服用叶酸补充剂的孕妇相比,在孕前及整个孕期服用叶酸补充剂超过3个月是早产的保护因素(OR=0.85,95%CI:0.77~0.95);按早产等级分层后,类似的保护作用仅对早期与极早期早产(<32孕周)有效;按早产亚型分层后,在孕前及整个孕期服用叶酸补充剂超过3个月的孕妇发生不伴胎膜早破的自发性早产的可能性降低17%(OR=0.83,95%CI:0.70~0.97);孕期膳食中叶酸摄入量较低(<156.58μg/d),孕妇分娩早产儿的危险性增加39%(OR=1.39,95%CI:1.15~1.69)。结论孕前及孕期叶酸摄入不足增加早产的发生风险,因此孕前及孕期适量服用叶酸补充剂以及增加膳食中叶酸的摄入量能有效降低早产的发生风险。 Objective To explore the correlation between pre-pregnancy and post-pregnancy folic acid intake and preterm delivery, and to provide a scientific basis for the formulation of interventions and strategies for premature delivery. Methods From January 2011 to December 2012 in the hospital and follow-up to the delivery of 6 631 pregnant women as the research object, using Logistic regression model before and during pregnancy folic acid supplementation and dietary folate intake and preterm birth correlation . Results After controlling for potential confounders, the use of folic acid supplementation for more than 3 months before and throughout pregnancy was a protective factor for preterm birth (OR = 0.85, 95% CI: 0.77 to 0.95) as compared with pregnant women who did not take folic acid supplements ); Stratified by preterm birth, a similar protective effect is only effective for early and very early preterm births (<32 weeks of gestation); folic acid supplementation for more than 3 months before and throughout pregnancy after stratification of the preterm birth The risk of spontaneous preterm birth without premature rupture of membranes in pregnant women was reduced by 17% (OR = 0.83, 95% CI: 0.70-0.97); the intake of folate in pregnant women was lower (<156.58μg / d) The risk of premature delivery of labor increased 39% (OR = 1.39, 95% CI: 1.15 to 1.69). Conclusions Insufficient pre-pregnancy and post-pregnancy folic acid intake may increase the risk of preterm birth. Therefore, proper intake of folic acid supplements and pre-pregnancy folic acid supplementation before and during pregnancy can effectively reduce the risk of preterm birth.
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