北京大学学报（医学版）2025，Vol.57Issue(3)：473-480,8.DOI:10.19723/j.issn.1671-167X.2025.03.010
母亲围受孕期服用叶酸营养素补充剂与围产儿死亡率的关系
Association between maternal periconceptional supplementation of folic acid or multiple micronutrients containing folic acid and perinatal mortality rate
摘要
Abstract
Objective:To describe the prevalence of perinatal death in Tongzhou District of Beijing,and to estimate the association between maternal periconceptional supplementation of folic acid or multiple micronutrients containing folic acid and perinatal mortality rate.Methods:A retrospective cohort study was conducted based on the maternal and child care system in Tongzhou District of Beijing.The subjects were 94 490 perinatal who were born during January 2013 to December 2018.The information on perina-tal outcomes and maternal periconceptional supplementation of folic acid or multiple micronutrients contai-ning folic acid were collected.The Poisson log-linear model was used to estimate the association between maternal periconceptional folic acid or multiple micronutrients supplementation and perinatal mortality rate.Results:The overall perinatal mortality rate was 2.71‰.The perinatal mortality rates for maternal nutrients supplementation containing folic acid and no supplementation during periconceptional period were 2.63‰ and 3.43‰,respectively,and the difference in rates was not statistically significant[crude risk ratio(cRR)=0.77,95％CI:0.54-1.14].After adjusting for potential confounding factors in-cluding ethnicity,age,education level,occupation,household registration,parity,numbers of fetuses,gestational age,pregnant with assisted reproductive technology,delivery year and pre-pregnancy body mass index,the rates remained not statistically significant[adjusted risk ratio(aRR)=0.93,95％CI:0.77-1.13].The perinatal mortality rates were 2.23‰ and 2.99‰ for pure folic acid and multi-nutrients supplements containing folic acid,respectively,and the difference in rates was statistically sig-nificant(cRR=1.34,95％CI:1.02-1.76).The rates difference remained statistically significant after adjusting for potential confounders(aRR=1.31,95％CI:1.06-1.62).Additionally,the peri-natal mortality rates differences among the non-supplementation group and the supplementation group with variate timing of initiation(pre-conception or post-conception)or frequency of supplementation(low-frequency or high-frequency)were not statistically significant,regardless of adjusting for confounders.Conclusion:The overall perinatal mortality rate was lower than the national average level in Tongzhou District of Beijing.Maternal periconceptional supplementation of pure folic acid or micronutrients contai-ning folic acid had no impact on perinatal mortality.The association between maternal periconceptional supplementation of multiple micronutrients containing folic acid and perinatal mortality rate need further research.关键词
围受孕期/营养补充剂/叶酸/围产儿/死亡率Key words
Periconceptional period/Micronutrients supplementation/Folic acid/Perinatal infant/Mortality rate分类
预防医学引用本文复制引用
刘畅,李炤,金蕾,刘春毅,王春静,张杰,靳蕾..母亲围受孕期服用叶酸营养素补充剂与围产儿死亡率的关系[J].北京大学学报（医学版）,2025,57(3):473-480,8.基金项目
国家重点研发计划(2021YFC2700700、2021YFC2700704)Supported by the National Key Research and Development Program of China(2021YFC2700700,2021YFC2700704) （2021YFC2700700、2021YFC2700704）
