摘要
目的 了解孕早期增补叶酸预防先天性心脏病（先心病）的作用。方法 调查1994年6月1日至1998年12月31日出生的先心病患儿的母亲和1996年8月1日至1998年10月31日出生的全部活婴的母亲孕前1月至孕后3月增补叶酸情况与先心病发生率的关系。结果 （1）1996年8月1日至1998年10月31日出生的8332例新生儿的母亲妊娠初期增补叶酸与新生儿先心病发病关系显示，先心病患病率增补组为8．71％。（正规增补组为2．54％0），未补组为16．61％。两组患病率差异经显著性检验，U=3．2584，P〈0．01相对危险度（RR）0．5244，归因危险度（AR）0．0079，归因危险度比数（ARP）47．6％，归因危险度百分比（ARe）90．7％。RR值95％可信区间（C／）0．2992～0．7496。严重复杂先心病患病率未补组为增补组的5．3倍。（2）1994年6月1日至1998年12月31日出生的活婴中检得先心病221例，增补叶酸组62例、未补组159例，严重复杂先心病42例，不正规组为6例、未补组36例。新生儿期死亡18例、未补组17例，不正规组2例为21-三体综合征。先心病伴心外畸形11例，未补组9例。不正规组2例为21-三体综合征和先天性风疹综合征。结论孕前1月至孕后3月增补叶酸可减少先心病，尤其是严重复杂先心病的发生。
Objective To investigate the effect of supplementing folic acid in early pregnancy on preventing congenital heart diseases （CHD） in infants. Methods The infants born with CHD between June 1, 1994 and Dec 31, 1998 and all live birth between Aug 1, 1996 and Oct 31, 1998 were included in this study. Their mothers＇intake of folic acid as supplement between 1 month prior to pregnancy and 3 month after pregnancy was studied. Results There were 8 332 live birth between Aug 1, 1996 and Oct 31, 1998; the incidence of CHD for the group of mother with supplement of folic acid was 8.71‰, in which the group with regular supplement of folic acid was 2. 54‰ and the group without supplement of fo- lic acid was 16. 61‰. The difference between the groups with and without supplement of folio acid was significant by U test （ U = 3.258 4, P 〈 0. 01 ）, relative risk （RR） was 0. 524 4, AR was 0. 007 9, ARP was 47.6%, ARe was 90. 7%. The confidence interval （CI） of RR 95% was 0.299 2 - 0. 749 6. The incidence of severe CHD in the group without supplement of folic acid was 5.3 times higher than those with supplement. There were 221 cases of CHD were detected in infants who were born between June 1, 1994 and Dec 31, 1998; in which 62 cases were in the group with supplement of folic acid, in which 15 cases were in regular supplement group and 159 cases were in the group of without supplement of folic acid. There were 42 cases of severe complex CHD ; in which 36 cases were in the group of without supplement and 6 cases in the group with supplement of folic acid. There were 18 death within 28 days after birth; in which 17 cases were in the group of without supplement of folic acid and one case was in the group of irregular supplement of folic acid who was diagnosed of CHD with other congenital anomalies, among them 9 cases cases were irregularly supplemented with folic acid （one was with Down syndrome. There were 11 cases were not supplemented with folic acid and 2 diagnosed with Down syndrome and the other was congenital rebulla sydrome）. Conclusions Supplementing folic acid in early pregnancy can reduce the incidence of CHD, especially sever and complex CHD.
出处
《中国新生儿科杂志》
CAS
2007年第3期129-132,共4页
Chinese Journal of Neonatology
基金
浙江省计生委科研课题项目(1995-107)
关键词
叶酸
心脏病
化学预防
Folic acid
Heart disease
Chemoprevention
