孕前及孕后补充小剂量叶酸对孕妇血压及血清HCY、VitB_(12)水平的影响

Effects of Folic Acid Supplementation before and after Pregnancy on Blood Pressure,Serum HCY and VitB_(12) Levels in Pregnant Women

【目的】探讨孕前及孕后补充小剂量叶酸(FA)对孕妇血压和血清同型半胱氨酸(HCY)、维生素B12(VitB_(12))水平的影响。【方法】选择2018年3月至2022年3月渭南市中心医院收治的320例待产期孕妇,根据小剂量FA开始补充时机分为孕前开始补充组(A组,n=100)和孕后开始补充组220(B组,n=220)。比较两组生产情况、计划妊娠情况、孕期习惯(不饮酒、不抽烟和不饮茶情况)、补充FA剂量情况和结束补充时间分布情况等基线资料,比较两组血清HCY、VitB_(12)、FA水平和妊娠期高血压疾病发生率及产前、产后收缩压(SBP)、舒张压(DBP),Pearson分析血清VitB_(12)、HCY、FA水平的相关性以及上述血清指标与孕妇产前及产后血压的相关性。【结果】两组计划妊娠情况、孕期习惯情况、补充FA剂量情况和结束补充时间分布情况等基线资料比较,差异无统计学意义(P>0.05)。A组血清FA水平明显高于B组(P<0.05);两组血清HCY、VitB_(12)水平比较,差异无统计学意义(P>0.05)。血清VitB_(12)水平与血清HCY水平呈负相关(r=-0.143,P<0.05),与血清FA水平呈正相关(r=0.254,P<0.05);血清HCY水平与血清FA水平呈负相关(r=-0.318,P<0.05)。A组妊娠期高血压疾病发生率为4.00%,与B组的3.64%比较,差异无统计学意义(P>0.05)。产前,两组SBP、DBP比较,差异无统计学意义(P>0.05);产后,两组SBP、DBP较产前明显降低(P<0.05),但两组比较差异无统计学意义(P>0.05)。血清VitB_(12)、HCY、FA水平与产前及产后血压无明显相关性(P>0.05)。【结论】相较于孕后开始补充小剂量FA,孕前开始补充小剂量FA对孕妇妊娠期高血压疾病发生风险、血压和血清HCY、VitB_(12)水平并无明显影响。

【Objective】To investigate the effects of folic acid(FA)supplementation before and after pregnancy on blood pressure,serum levels of homocysteine(HCY)and vitamin B12(VitB_(12))in pregnant women.【Methods】A total of 320 expectant pregnant women who were admitted to Weinan Central Hospital from March 2018 to March 2022 were selected.According to the timing of low dose FA supplementation,the patients were divided into pre-pregnancy supplementation group(group A,n=100 cases)and post-pregnancy supplementation group(group B,n=220 cases).The baseline data of the two groups were compared,including initial labor,planned pregnancy,pregnancy habits(non-drinking,non-smoking and non-drinking tea),FA supplemental dose and the distribution of time to end supplementation.Serum HCY,VitB_(12) and FA levels,incidence of hypertensive diseases during pregnancy,prenatal and postnatal systolic blood pressure(SBP)and diastolic blood pressure(DBP)of the two groups were analyzed.Pearson correlation analysis among serum levels of VitB_(12),HCY and FA was performed;And the correlation between the above serum indexes and the blood pressure of prenatal and postnatal pregnant women was analyzed.【Results】There was no significant difference in baseline data such as initial labor,planned pregnancy,pregnancy habits,FA dosage and time to end supplementation between the pre-pregnancy supplementation group and the post-pregnancy supplementation group(P>0.05).The serum FA level in pre-pregnancy supplementation group was significantly higher than that in post-pregnancy supplementation group(P<0.05).However,the serum HCY and VitB_(12) levels were not statistically significant in both pre-pregnant and post-pregnant supplementation groups(P>0.05).Serum VitB_(12) level was negatively correlated with serum HCY level(r=-0.143,P<0.05);Serum VitB_(12) level was positively correlated with serum FA level(r=0.254,P<0.05);Serum HCY level was negatively correlated with serum FA level(r=-0.318,P<0.05).The incidence of pregnancy-induced hypertension was 4.00%in the pre-pregnancy group and 3.64%in the post-pregnancy group,which was no significant difference between the two groups(P>0.05).Before delivery,there were no significant differences in SBP and DBP between the two groups(P>0.05);After delivery,SBP and DBP were significantly decreased in the two groups,if compared to the prenatal situation(P<0.05),but there were no statistical differences between the two groups(P>0.05).There was no significant relationship of serum VitB_(12),HCY and FA levels with prenatal and postpartum blood pressure(P>0.05).【Conclusion】Compared to the supplementation of low dose FA after pregnancy,the supplementation of low dose FA before pregnancy has no significant effect on the risk of hypertension,blood pressure,serum HCY and VitB_(12) levels,which is worthy of clinical verification.