不同孕期服用叶酸与婴幼儿喘息相关性的病例对照研究

Correlation Between Folic Acid Supplement in Different Stages of Pregnancy and Wheezing of Infants: A Case-control Study

目的探讨不同孕期服用叶酸与婴幼儿喘息发生的关系,为孕期服用叶酸选择合适时机提供依据。方法选取2011年4月—2012年4月于连云港市妇幼保健院出生的婴幼儿1 320例为研究对象。以电话或门诊问卷调查的方式收集婴幼儿及其母亲临床资料,包括婴幼儿性别、出生体质量、胎次、出生季节及出生2年内是否发生婴幼儿喘息;母亲受教育程度、吸烟史、喂养方式、孕期是否服用维生素A或维生素D、是否为特应性体质及服用叶酸的时期。根据婴幼儿是否发生喘息分为病例组(397例)和对照组(923例)。结果两组婴幼儿性别、出生体质量、第一胎比例、出生季节及其母亲受教育程度、母亲吸烟率、喂养方式、孕期服用维生素A或维生素D率比较,差异均无统计学意义(P>0.05)。特应性体质母亲中,两组婴幼儿的母亲开始服用叶酸时期比较,差异有统计学意义(P<0.05);其中,孕中后期开始服用叶酸的母亲的婴幼儿发生喘息的风险是未服用叶酸母亲的婴幼儿的1.95倍。非特应性体质母亲中,两组婴幼儿的母亲开始服用叶酸时期比较,差异无统计学意义(P>0.05)。结论特应性体质母亲孕中后期开始服用叶酸可能使婴幼儿喘息的发生风险增加。

Objective To investigate the relation between folic acid supplement at different stages of pregnancy and wheezing of infants, in order to provide references for the choice of good timing of folic acid supplement during pregnancy.Methods We enrolled 1 320 infants who were born in Lianyungang Maternal and Child Health-care Center from April 2011 to April 2012. By phone calls and questionnaire survey in clinics, the data about the infants and their mothers were collected,including infants＇ gender,birth weight,first child or not,birth season and whether wheezing occurred within 2 years after birth,mother＇ s education degree, smoking history, feeding method, whether vitamin A or vitamin D was complemented during pregnancy,family-specific constitution or not,and stages of pregnancy supplying folic acid. According to whether wheezing occurred,the infants were divided into case group（ n = 397） and control group（ n = 923）. Results The two groups were not significantly different（ P 0. 05） in gender,birth weight,proportion of infants being first child,birth season,education level of the mothers,proportion of smoking,feeding method,proportion of mothers who had supplement of vitamin A and vitamin D during pregnancy. For their mothers with family-specific constitution,two groups were significantly different in the pregnancy stage when began to take folic acid（ P 0. 05）; the infants whose mothers began to take folic acid in middle and late stages of pregnancy had a risk of wheezing 1. 95 times greater than the that of infants whose mothers didn＇ t take folic acid. For their mothers without family-specific constitution,two groups were not significantly different in the pregnancy stage when the mothers began to take folic acid（ P 0. 05）. Conclusion Mothers with family-specific constitution begin to take folic acid in middle and late stages of pregnancy may increase the risk of wheezing in infants.