北京地区孕早期妇女红细胞叶酸水平及适宜叶酸补充时间剂量

Concentration of red blood cell folate and the analysis of folic acid supplement optimum time and dose in first trimester

目的了解北京地区孕早期妇女红细胞叶酸水平,探讨叶酸制剂适宜补充时间及剂量。方法以孕早期在北京市海淀区妇幼保健院营养门诊就诊孕妇作为调查对象,共3458人,末次月经2014年2月1日至2016年1月31日采用横断面调查方法,收集孕妇人口学特征数据、叶酸补充相关信息及相关临床数据。采用竞争结合受体测定方法测定红细胞叶酸水平。结果孕妇红细胞叶酸水平为(806.5±273.7)ng/mL,不同年龄组间红细胞叶酸水平差异有统计学意义(P<0.001);大学及以上文化程度组孕妇叶酸水平更高(P=0.030);家庭月收入>10 000元组孕妇显著高于其他各组(P<0.001);夏秋季较冬春季红细胞叶酸水平高(P<0.001);孕妇红细胞叶酸水平随着叶酸补充剂量、时间逐渐升高(P均<0.001)。以参考值1180nmol/L(521 ng/mL)评价,孕早期叶酸水平达标率为84.3%,且补充剂量400μg需要16周,而补充剂量≥600μg需要8周,即可有90%以上孕妇可达此标准。结论不同年龄、文化程度、家庭月收入间,孕妇红细胞叶酸水平不同。应依据不同红细胞叶酸水平指导叶酸补充时间及剂量。

Objective To have a knowledge of prevalent red blood cell folate concentration in Beijing and analyzes optimum time and dose of folic acid supplement. To provide the basis data for making public health policy and clinical consultation. Methods This study included 3458 pregnant women who visited nutrition outpatient of the Haidian Maternal and Child Health Hospital in Beijing in first trimester. Their last menstrual period is between 1st Feb 2014 and 31 st Jan 2016. Using the method of cross sectional study to collect their demographic information, folic acid supplementation, clinical information and venous blood samples. Competitive binding receptor assay was used for detecting the red blood cell folate concentration. Results The mean of red blood cell folate concentration was（ 806. 5 ± 273. 7） ng/mL. The red blood cell folate concentration differences between age groups were significant（ P〈0. 001）. Women with graduate and above had higher red blood cell folate concentration than others（ P = 0. 030）. Women whose family income 〉10000 had higher red blood cell folate concentration than other groups（ P〈0. 001）. Red blood cell folate concentration in summer and autumn higherthan other season（ P〈0. 001）. Red blood cell folate concentration level increased with folic acid supplementation dose and time. 84. 3% the pregnant women reached 1180nmol/L（ 521 ng/mL） and 90. 0% could reach the reference if used 400 μg folic acid supplemented for 16 weeks or ≥600 μg more than 8 weeks. Conclusion Age,education level and family income are associated with red blood cell folate concentration. Depending on red blood cell folate concentration to advise the time and dose of folic acid supplementation.