中国全科医学 ›› 2021, Vol. 24 ›› Issue (25): 3221-3226.DOI: 10.12114/j.issn.1007-9572.2021.00.243

所属专题: 女性健康最新文章合集

• 专题研究 • 上一篇    下一篇

云南省育龄妇女围孕期服用叶酸状况及其影响因素研究

吴俣1,袁彦玲2,孔彩2,马秋月1,景文展1,叶汉风2,刘珏1,刘民1*   

  1. 1.100191北京市,北京大学公共卫生学院 2.650021云南省昆明市,云南省人口和计划生育科学技术研究所
    *通信作者:刘民,教授,博士生导师;E-mail:liumin@bjmu.edu.cn
  • 出版日期:2021-09-05 发布日期:2021-09-05
  • 基金资助:
    基金项目:国家自然科学基金资助项目(71874003)

Prevalence and Associated Factors of Periconceptional Folic Acid Supplementation in Yunnan Women of Childbearing Age 

WU Yu1,YUAN Yanling2,KONG Cai2,MA Qiuyue1,JING Wenzhan1,YE Hanfeng2,LIU Jue1,LIU Min1*   

  1. 1.School of Public Health,Peking University,Beijing 100191,China
    2.Yunnan Population and Family Planning Research Institute,Kunming 650021,China
    *Corresponding author:LIU Min,Professor,Doctoral supervisor;E-mail:liumin@bjmu.edu.cn
  • Published:2021-09-05 Online:2021-09-05

摘要: 背景 妇女围孕期增补叶酸是预防神经管缺陷的有效干预措施之一,并且预防效果受到叶酸服用量和服用时间的影响。2019年我国将“增补叶酸预防神经管缺陷项目”纳入基本公共卫生服务内容。目的 了解我国云南省育龄妇女围孕期叶酸增补情况及其影响因素,为提高叶酸干预效果提供依据。方法 利用云南省16个市(自治州)2018年参加“国家免费孕前优生项目”妇女数据,对完成了孕早期随访且叶酸服用状况完整的33 173例育龄妇女的叶酸服用状况及其影响因素进行分析。结果 2018年云南省育龄妇女围孕期叶酸服用率为93.81%〔95%CI(93.55%,94.07%)〕,叶酸规范服用率为47.16%〔95%CI(46.62%,47.70%)〕。不同市(自治州)妇女围孕期叶酸服用率和叶酸规范服用率差异较大,多数市(自治州)的叶酸服用率在85%以上,但叶酸规范服用率相对较低,文山壮族苗族自治州的育龄妇女围孕期叶酸规范服用率最低,仅为27.47%。多因素Logistic回归分析结果显示,年龄、受教育程度、职业、居住地区是育龄妇女叶酸服用率的影响因素(P<0.05);年龄、受教育程度、分娩史、流产史、居住地区是育龄妇女叶酸规范服用率的影响因素(P<0.05)。结论 云南省育龄妇女围孕期叶酸服用状况良好,但叶酸规范服用率相对较低,各市(自治州)差异较大。因此,要关注年龄较小、受教育程度较低、职业为农民、有分娩史及流产史的妇女围孕期叶酸服用状况,加强健康教育,进一步提高妇女围孕期叶酸服用率和规范服用率。

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