摘要
目的探讨个体化叶酸补充对备孕妇女血清叶酸、同型半胱氨酸(Hcy)水平及新生儿结局的影响。方法纳入1 134例健康适龄备孕妇女,均接受甲硫氨酸合成酶还原酶和5,10-亚甲基四氢叶酸还原酶基因检测。根据检测结果进行叶酸利用率风险等级评估后给予个体化叶酸补充。比较叶酸补充前及补充后3个月血清叶酸及Hcy水平。对183名孕妇进行随访,检测其孕早期血清Hcy水平,记录其分娩时孕周、新生儿出生时体重及出生缺陷情况。结果 1 134名备孕妇女叶酸利用率风险等级评估,未发现风险385例,低度风险105例,中度风险387例和高度风险257例。个体化叶酸补充后,各风险等级备孕妇女的血清叶酸及Hcy水平均能维持在正常范围,且与补充前比较,各风险等级孕妇的叶酸水平上升,低度风险、中度风险、高度风险孕妇的Hcy水平下降(均P<0.05),且血清叶酸水平与Hcy水平均呈负相关(均P<0.05)。随访的孕妇孕早期血清Hcy水平均在正常范围内,均未出现高Hcy血症,仅出现早产儿、低体重儿各1例,新生儿均无出生缺陷。结论采用个体化叶酸补充的方法,可以短期内提高备孕妇女的血清叶酸水平,并且控制血清Hcy水平,可预防因叶酸缺乏或高Hcy血症而引起的新生儿不良结局。
Objective To investigate the effects of individualized folic acid supplementation on the serum folic acid and homocysteine(Hcy) levels and neonatal outcome in pre-pregnancy women. Methods A total of 1134 healthy pre-pregnancy women with eligible age were enrolled, and underwent methionine synthase reductase gene and 5,10-methylene tetrahydrofolate reductase gene detection. Individualized folic acid supplementation was conducted after assessment of folic acid utilization capacity according to detection results. Serum folic acid and Hcy levels were measured before and three months after folic acid supplementation. Among 183 pregnant women receiving follow-up, serum Hcy level during early pregnancy was detected, and gestational week at delivery, neonatal birth weight, and birth defect were recorded. Results In assessment of folic acid utilization capacity among the 1134 pre-pregnancy women, no risk, low risk, moderate risk and high risk were found in 385 cases, 105 cases, 387 cases and 257 cases, respectively. After individualized folic acid supplementation, pre-pregnancy women with various levels of risk maintained serum folic acid and Hcy in normal level, those with various levels of risk possessed elevated folic acid level, pregnant women with low risk, moderate risk and high risk experienced decreased Hcy level as compared with pre-supplementation(all P<0.05);besides, serum folic acid level negatively correlated with Hcy level(all P<0.05). Among pregnant women receiving follow-up, serum Hcy level during early pregnancy was within the normal limit, and no hyperhomocysteinemia occurred;besides, premature infant and infant of low-birth weight occurred in one case each, no neonatal birth defect was observed. Conclusion Individualized folic acid supplementation can not only increase serum folic acid level in pre-pregnancy women in short term, but also control serum Hcy level, thus preventing adverse neonatal outcomes due to folic acid deficiency or hyperhomocysteinemia.
作者
张婷睿
余宏杰
陈秋桐
刘明威
何启强
ZHANG Ting-rui;YU Hong-jie;CHEN Qiu-tong;LIU Ming-wei;HE Qi-qiang(School of Health Science,Wuhan University,Wuhan 430071,China;Hubei Biomass-Resource Chemistry and Environmental Biotechnology Key Laboratory,Wuhan University,Wuhan 430071,China)
出处
《广西医学》
CAS
2020年第12期1512-1516,共5页
Guangxi Medical Journal
关键词
叶酸
个体化补充
同型半胱氨酸
备孕
新生儿结局
Folic acid
Individualized supplementation
Homocysteine
Pregnancy preparation
Neonatal outcome
