盐业体制改革前后北京市顺义区孕妇尿碘水平监测及其影响因素分析

Monitoring of urinary iodine level in pregnant women in Shunyi District of Beijing before and after salt industry system reform and analysis on its influencing factors

目的通过对北京市顺义区盐业改革前后孕妇碘营养水平情况进行调查,评估顺义区盐业改革前后孕妇人群碘营养状况变化,分析孕妇碘营养水平的影响因素,为适时采取针对性防治措施和科学调整干预策略提供依据。方法采用多阶段分层随机抽样方法,于2013—2020年抽取北京市顺义区400名孕妇作为调查对象,收集调查对象的一般资料,观察孕妇碘营养状况,并对数据进行分析。结果2013—2020年北京市顺义区孕妇人群尿碘中位数为122.10μg/L,总体处于碘营养缺乏状态。盐改前后顺义区孕妇人群尿碘中位数分别121.6和123.1μg/L,均处于碘营养缺乏状态,盐改后高于盐改前,差异有统计学意义(Z=4.13,P<0.05)。过去24 h是否食用海鲜、知晓怀孕期间碘的需求量增加、知晓怀孕期间碘缺乏症的不良影响和监测样本来源机构对尿碘值有影响(均P<0.05);最近1周服用碘补充剂、最近24 h食用海鲜和属地来源的孕妇尿碘水平较高(均P<0.05)。结论北京市顺义区盐业改革前后孕妇人群缺碘风险一直存在,建议将孕妇尿碘纳入常规产检监测,同时对孕妇人群加强碘营养状况监测及健康宣教,指导其科学补碘,确保该人群碘营养处于适宜水平。

Objective By the investigation on iodine nutrition level of pregnant women in Shunyi District of Beijing before and after salt industry system reform,to evaluate the iodine nutritional status of pregnant women in Shunyi District before and after salt industry system reform,analyze the influencing factors of iodine nutrition level in pregnant women,and provide basis for opportunely taking targeted prevention and control measures and scientifically adjusting intervention strategies.Methods A total of 400 pregnant women in Shunyi District in Beijing from 2013 to 2020 were selected as survey objects by using multi-stage stratified random sampling,to collect the general data of the respondents,observe the iodine nutritional status of pregnant women,and analyze the data.Results The median urinary iodine of pregnant women in Shunyi District of Beijing from 2013 to 2020 was122.10μg/L,which was generally in the state of iodine deficiency.The median urinary iodine of pregnant women in Shunyi District before and after salt industry system reform was 121.6 and 123.1μg/L respectively,both of which were in iodine deficiency state.It was higher after salt system reform than before reform,and the difference was statistically significant(Z=4.13,P<0.05).Whether seafood has been consumed in the past 24 hours,knowing the increased iodine demand during pregnancy,knowing the adverse effects of iodine deficiency during pregnancy and source organization of monitoring samples had the effects on the urinary iodine value(all P<0.05).Pregnant women who had taken iodine supplements in the last week,had consumed seafood in the last24 hours,and from territorial sources had the higher levels of urinary iodine(all P<0.05).Conclusion The risk of iodine deficiency has always existed in pregnant women in Shunyi District of Beijing before and after the salt industry system reform,and it is suggested that maternal urine iodine should be included in the routine monitoring of obstetric examination,at the same time,iodine nutrition monitoring and health education should be strengthened for pregnant women to guide them to supplement iodine scientifically,so as to ensure that the iodine nutrition of the population is at an appropriate level.