陕西省孕妇叶酸服用状况分析

邱惠桢; 袁淑怡; 党少农; 杨姣梅; 曾令霞; 颜虹

doi:10.11847/zgggws2017-33-02-06

摘要: 目的了解陕西省孕妇叶酸服用状况及其影响因素，为进一步叶酸干预工作提供依据。方法分层随机多阶段抽取陕西省2010-2013年曾经怀孕的育龄妇女，通过问卷调查了解妇女围孕期叶酸使用情况以及影响因素。结果共调查29 818人，66.4%的妇女围孕期服用过叶酸。农村妇女围孕期叶酸服用率为63.4%，城市为72.6%，其中，孕前服用者占25.3%。19.9%围孕期服用叶酸持续时间≤30 d，56.8%持续时间为31~90 d，4.7%持续时间>180 d。影响围孕期服用叶酸的积极因素有产检次数>8次（OR_调整=2.25，95%CI=2.09~2.43），第一次产检时间在孕早期（OR_调整=1.91，95%CI=1.78~2.03），产检次数5~8次（OR_调整=1.68，95%CI=1.57~1.78），丈夫文化程度为大学及以上（OR_调整=1.67，95%CI=1.50~1.87），妇女文化程度为大学及以上（OR_调整=1.52，95%CI=1.36~1.71）及优生优育咨询（OR_调整=1.42，95%CI=1.33~1.51），妇女文化程度为高中（OR_调整=1.33，95%CI=1.23~1.44），丈夫文化程度为高中（OR_调整=1.26，95%CI=1.17~1.36），有不良孕产史（OR_调整=1.22，95%CI=1.10~1.35）和妇女年龄30~35岁（OR_调整=1.12，95%CI=1.04~1.20）。消极因素有妇女年龄<20岁（OR_调整=0.60，95%CI=0.52~0.70），妇女年龄>35岁（OR_调整=0.89，95%CI=0.80~1.00），经产妇（OR_调整=0.76，95%CI=0.72~0.81），城市孕妇（OR_调整=0.81，95%CI=0.76~0.86）。结论陕西省育龄妇女围孕期叶酸服用率及不规范服用率均较低，未达到国家90%服用率的要求。建议加强对孕期人群管理，特别是高风险人群（如低龄、高龄孕妇、经产妇等人群）孕期系统化管理及宣传教育工作。

Abstract: Objective To examine the prevalence and determinants of folic acid supplement among pregnant women in Shaanxi province and to provide evidences for related interventions.Methods Using stratified multistage random sampling,we selected 32 400 women with pregnancy between 2010 and 2013 from 10 urban districts and 20 counties in Shaanxi province and then conducted a face-to-face survey from August to November 2013 with a self-designed questionnaire on folic acid supplement before and during the pregnancy.Results Of the 29 818 pregnant women with complete data,66.4%(63.4% for rural women and 72.6% for urban women) used folic acid for 3 months before and during the pregnancy.Of the women with maternal folic acid supplement,25.3% had folic acid before the pregnancy and 19.9%,56.8%,and 4.7% took folic acid continuously for 30,31-90,and >180 days,respectively.Among the women surveyed,the facilitating factors for folic acid supplement included having prenatal examination 8 times or more (adjusted odds ratioOR_adj=2.25,95% confidence interval95% CI:2.09-2.43),having the first prenatal examination during early pregnancy (OR_adj=1.91,95% CI:1.78-2.03),having prenatal examination 5 to 8 times (OR_adj=1.68,95% CI:1.57-1.78),with a husband having the education of college and above (OR_adj=1.67,95% CI:1.50-1.87),with the education of college and above (OR_adj=1.52,95% CI:1.36-1.71),having eugenic counseling (OR_adj=1.42,95% CI:1.33-1.51),with the education of senior high school (OR_adj=1.33,95% CI:1.23-1.44),with a husband having the education of senior high school (OR_adj=1.26,95% CI:1.17-1.36),with abnormal obstetrical history (OR_adj=1.22,95% CI:1.10-1.35),and at ages of 30-35 years (OR_adj=1.20,95% CI:1.04-1.20);while the hindering factors were younger than 20 years (OR_adj=0.60,95% CI:0.52-0.70),elder than 35 years (OR_adj=0.89,95% CI:0.80-1.00),with once or more deliveries (OR_adj=0.76,95% CI:0.72-0.81),and being permanent urban resident (OR_adj=0.81,95% CI:0.76-0.86).Conclusion The rate of folic acid supplementation and the rate of adequate folic acid supplementation are lower than the national requirement among pregnant women in Shaanxi province;the results suggested that health management should be strengthened among the pregnant women,particularly among those of young,elder and with multiple delivery history.

陕西省孕妇叶酸服用状况分析

Folic acid supplement and its influencing factors in pregnant women in Shaanxi province: a cross-sectional study