【摘要】 目的探讨叶酸服用时机对妊娠孕妇血同型半胱氨酸、血压及母婴预后的影响。方法选取2012年6月至2014年6月于延安大学附属医院产科进行产检及分娩的387例孕妇为研究对象,按是否服用叶酸及叶酸服用时间分为未服用组(148例)、孕早期服用组(135例)及孕晚期服用组(104例),对比三组的妊娠高血压疾病发生率、产前叶酸及同型半胱氨酸水平,统计顺产率、早产率及初生儿生后5 min的Apgar评分。结果孕早期服用组妊娠高血压疾病发生率低于未服用组[3.0%(4/135)比11.5%(17/148)],差异有统计学意义(P<0.01)。孕早期服用组和孕晚期服用组叶酸水平高于未服用组[(9.8±1.9)μg/L、(9.0±1.6)μg/L比(6.4±1.4)μg/L],同型半胱氨酸低于未服用组[(7.5±1.9)μmol/L、(9.1±2.1)μmol/L比(12.2±2.1)μmol/L],差异有统计学意义(P<0.05)。孕早期服用组和孕晚期服用组的顺产率高于未服用组[91.9%(124/135)、89.4%(93/104)比64.9%(96/148)],孕早期服用组和孕晚期服用组早产率、胎儿窘迫发生率低于未服用组[早产:0.7%(1/135)1.0%(2/104)比3.4%(5/148);胎儿窘迫:0%、0%比8.1%(12/148)],孕早期服用组和孕晚期服用新生儿生后5 min Apgar评分正常者的比例高于未服用组[96.3%(130/135),88.5%(92/104)比80.4%(119/148)],差异均有统计学意义(P<0.05)。结论对于妊娠期孕妇而言,及早服用叶酸对降低妊娠高血压疾病风险,改善母婴预后具有重要作用。更多还原

【Abstract】 Objective To investigate the effect of folic acid taking timing on homocysteine( Hcy),blood and pregnancy outcome in pregnant women. Methods Total of 387 pregnant women for check-ups and delivery in the Obstetrics of Yan’an University Affiliated Hospital from Jun. 2012 to Jun. 2014 were included in the study,according to folic acid taking condition they were divided into a non-taken group( 148 cases),early pregnancy-taken group( 135 cases) and late pregnancy-taken group( 104 cases). The pregnancy induced hypertension incidence,prenatal folate and homocysteine levels,natural birth rate,preterm birth rate and neonatal 5 min Apgar score of the two groups were recorded and compared. Results The pregnancy hypertension incidence of the early pregnancy-taken group was lower than the non-taken group[3. 0%( 4 /135) vs 11. 5%( 17 /148) ],with statistically significant difference( P < 0. 01). The folic acid levels of the early pregnancy-taken and late pregnancy-taken group were higher than the non-taken group[( 9. 8 ± 1. 9)μg /L,( 9. 0 ± 1. 6) μg /L vs( 6. 4 ± 1. 4) μg /L],Hcy level was lower than the non-taken group[( 7. 5 ±1. 9) μmol / L,( 9. 1 ± 2. 1) μmol / L vs( 12. 2 ± 2. 1) μmol / L],the differences were statistically significant( P < 0. 05). The natural birth rate of the early pregnancy-taken group and late pregnancy-taken group were higher than the non-taken group[91. 9%( 124 /135),89. 4%( 93 /104) vs 64. 9%( 96 /148) ],while the incidence of preterm birth,fetal distress of the early pregnancy-taken group and late pregnancy-taken group were lower than the non-taken group[preterm birth: 0. 7%( 1 /135),1. 0%( 2 /104) vs 3. 4%( 5 /148);fetal distress: 0%,0% vs 8. 1%( 12 /148) ],the proportion ofnormal newborns 5 min Apgar score of the early pregnancy-taken group and late pregnancy-taken group were higher than the non-taken group[96. 3%( 130 /135),88. 5%( 92 /104) vs 80. 4%( 119 /148) ],the differences were statistically significant( P <0. 05). Conclusion For pregnant women,taking folic acid at an early stage of preganancy can significantly reduce the risk of pregnancy induced hypertension and improve the maternal and neonatal prognosis.更多还原