叶酸水平与原因不明习惯性流产的关系

Blood folate levels and risk of unexplained recurrent pregnancy loss

目的探讨妇女血液叶酸水平与原因不明习惯性流产之间的关系。方法采用病例对照研究方法,选取至少有2次连续自然流产史的非孕期妇女作为病例;选取年龄与病例组相近,生育过子女且无自然流产史的未孕妇女作为对照。采用调查问卷收集社会人口学以及其它因素;每名研究对象采集5ml静脉血,用微生物法检测血浆叶酸及红细胞叶酸水平。结果共募集合格病例63例,对照145例。原因不明习惯性流产组血浆叶酸和红细胞叶酸浓度[几何均值分别为(19.0±1.9)nmol/L和(772.1±2.1)nmol/L]低于对照组血浆叶酸和红细胞叶酸浓度[几何均值分别为(20.1±1.6)nmol/L和(815.8±1.8)nmol/L],但差异均无统计学意义(P>0.05);原因不明习惯性流产组血浆叶酸缺乏率和红细胞叶酸缺乏率高于对照组(P<0.05),但控制职业及文化程度后,2组比较,差异无统计学意义(P>0.05);不同临床特征之间习惯性流产妇女血浆叶酸和红细胞叶酸水平比较,差异均无统计学意义(P>0.05)。结论尚不能认为血液叶酸水平低下为习惯性流产的危险因素。

Objective To explore possible association between blood folate levels and the risk of unexplained recurrent pregnancy loss. Methods Cases were women who had at least two consecutive pregnancy losses and controls were healthy women who had at least one live birth and no history of miscarriage. Information on social demographic, environmental and personal attributes was collected with a face-toface interview. 5ml of non-fasting venous blood was collected from each subject. Plasma and red blood cell folate concentrations were measured by microbiological assay. Results 63 cases and 145 healthy controls were recruited. Plasma folate levels and red blood cell folate levels showed no significant differences between the case group [ plasma folate, （ 19. 0 ± 1.9） nmol/L ; red cell folate, （ 772. 1 ± ：2.1 ） nmol/L ] and the control group [plasma folate, （20. 1 ± 1.6） nmol/L; red cell folate, （815.8 ± 1.8） nmol/L]. The percentage of plasma and red blood cell folate deficiency in the case group was significantly higher than that in the control group. However, after controlling for age, occupation and educational level, these differences disappeared, indicating that blood folate deficiency is not an independent risk factor for unexplained recurrent pregnancy loss. Blood folate levels in different age or other clinical subgroups showed no significant differences. Conclusion Blood folate levels are not associated with the risk of unexplained recurrent pregnancy loss in this population.