关键词: 围孕期, 叶酸, 增补, 影响因素分析, 云南

Abstract: Background　Periconceptional folic acid supplementation is an effective measure to prevent neural tube defects（NTDs），and the preventive effect is influenced by the dosage and duration of folic acid intake. In 2019，"folic acid supplementation to prevent neural tube defects" has been listed as a national essential public health service in China. Objective　To investigate periconceptional folic acid supplementation prevalence and its associated factors in women of childbearing age in China's Yunnan，to provide evidence for improving the effect of folic acid intervention. Methods　Data used in the study（n=33 173） were collected from an early pregnancy follow-up survey among women of childbearing age from 16 cities and prefectures of Yunnan Province who participated in the National Free Preconception Health Examination Project in 2018，and completed the follow-up. Their periconceptional use of folic acid supplements and associated factors were analyzed. Results　In 2018，93.81%〔95%CI（93.55%，94.07%）〕 of the participants took folic acid supplements during their pregnancy，but only 47.16% 〔95%CI（46.62%，47.70%）〕as recommended. The prevalence of supplementation and appropriate supplementation with folic acid in the periconceptional period varied greatly across the cities and prefectures. But in general，most cities and prefectures had a high prevalence of periconceptional folic acid supplementation（above 85%），and a relatively low prevalence of appropriate supplementation. The lowest prevalence of appropriate supplementation was found in Wenshan Zhuang and Miao Autonomous Prefecture（27.47%）. Multivariate Logistic regression analysis showed that age，education level，occupation and residential areawere associated with periconceptional folic acid supplementation（P<0.05）. Age，education level，history of childbirth，history of abortion，and residential area were associated with appropriate use of folic acid supplements in the periconceptional period（P<0.05）. Conclusion　Overall，the prevalence of periconceptional folic acid supplementation in Yunnan women of child-bearing age was high，but the appropriate use prevalence was relatively low，with significant inter-region or inter-prefecture differences. To improve the situation，it is suggested to give priority to periconceptional folic acid supplementation and health education in younger women，and those with low education level，farming as an occupation，childbirth history or abortion history.

Key words: Periconception, Folic acid, Supplementation, Root cause analysis, Yunnan