妊娠早期血清叶酸水平与婴儿体格及智能发育的关联研究

Association between serum folic acid level in early pregnancy and infant physical and intellectual development

目的探讨妊娠早期孕妇血清叶酸水平与婴儿体格及智能发育的关系。方法依据合肥市行政区域经济发展水平和地理位置情况选取四个区,2018年12月至2019年8月在各区随机抽取1个孕产妇保健手册办理单位,选取妊娠早期(12~12+6周)496例孕妇作为研究对象,采集3~5mL肘静脉血检测血清叶酸含量,分别于6、12月龄进行体格测量及智能发育的评估。结果6月龄时低叶酸水平组头围发育低下率高于正常叶酸组和高叶酸组(χ^(2)=9.585,P<0.05),身长和体重发育无统计学差异(P>0.05);12月龄时低叶酸水平组体重和头围发育低下率均高于正常叶酸组和高叶酸组(χ^(2)值分别为12.858、18.449,P<0.05),身长发育各组之间差异无统计学意义(P>0.05);多因素Logistic回归分析显示,6月龄叶酸在(16.66~19.30)ng/mL范围时,智力发育异常率较低,其OR值及95%CI为0.103(0.011~0.961);12月龄时未发现叶酸水平与婴儿智力及精神发育的关联(P>0.05)。结论妊娠早期血清叶酸水平与6月龄婴儿体格及智力发育有关,与12月龄婴儿体格发育有关,今后仍要加强指导育龄妇女补充叶酸,使叶酸含量保持较高水平,促进婴幼儿生长发育。

Objective To explore the relationship between serum folic acid level in early pregnancy and infant physical and intellectual development.Methods Four districts were selected according to the economic development level and geographic location of the Hefei administrative region,and one unit that handled the Maternal Health Handbook was randomly selected from each district from December 2018 to August 201.496 pregnant women in the first trimester(12-12+6 weeks)were selected as the research objects.3-5mL elbow vein blood was collected to detect the serum folic acid content.Physical measurement and intelligence development were assessed for the offspring at 6 and 12 months of age.Results At 6 months of age,the stunted rate of head circumference in low folic acid group was higher than that in normal folic acid group and high folic acid group(χ^(2)=9.585,P<0.05),there was no statistical difference in body length and body weight(P>0.05).At 12 months of age,the body weight and low head circumference growth rate in the low folic acid group were higher than those in the normal folic acid group and the high folic acid group(x values were 12.858 and 18.449,respectively,P<0.05),there was no significant difference in body length development among all groups(P>0.05).Multivariate logistic regression analysis showed that when folic acid was in the range of(16.66-19.30)ng/mL,the abnormal rate of intellectual development was lower,and the OR and 95%CI were 0.103(0.011-0.961).There was no statistically significant difference between folic acid level and infant(mental development or psychomotor development at 12 months of age(P>0.05).Conclusion The serum folic acid level in early pregnancy is related to the physical development of infants at 6 and 12 months and the intelligence development of infants at 6 months.It is necessary to strengthen the guidance of folic acid supplementation in women of childbearing age in the future to maintain a high level of folic acid to promote the growth and development of infants.