背景:本研究旨在探讨母亲仅接受叶酸(FAO)或含有叶酸的多种微量营养素(MMFA)与后代非综合征性唇腭裂之间的关系。
方法:数据来自北京的产前保健系统和出生缺陷监测系统,中国,从2013年到2018年。在孕早期,通过问卷调查收集了有关孕产妇粮农组织/MMFA补充的信息,唇裂/腭裂的数据在分娩或终止妊娠时收集。通过倾向评分的逆概率加权(IPW)来调整混杂因素,使用泊松回归模型来估计风险比(RR)及其95%置信区间(CI)。
结果:总共63,969名参与者被纳入研究。与不补充组相比,补充组的校正RR为0.51(95%CI:0.40,0.64).与不补充组相比,FAO和MMFA的调整后RR分别为0.56(95%CI:0.40,0.76)和0.48(95%CI:0.35,0.65),分别。与补充粮农组织和MMFA的10天中不到8天相比,10天中有8天或更多天的FAO和MMFA的调整后RR为1.17(95%CI:0.78,1.75),和2.05(95%CI:1.37,3.31),分别。
结论:母亲补充微量营养素,粮农组织或MMFA,在感知期间可以降低后代非综合征性唇腭裂的风险。然而,女性在补充MMFA时应更加谨慎.
This study aimed to explore the relationship between maternal periconceptional supplementation with folic acid only (FAO) or with multiple micronutrients containing folic acid (MMFA) and non-syndromic cleft lip/palate in offspring.
The data came from a prenatal health care system and a birth defects surveillance system in Beijing, China, from 2013 to 2018. Information on maternal FAO/MMFA supplementation was collected by questionnaire in the first trimester, and data on cleft lip/palate were collected at delivery or termination of pregnancy. Inverse probability weighting (IPW) by the propensity score to adjust for the confounders and Poisson regression model was used to estimate risk ratios (RRs) and their 95% confidence intervals (CIs).
A total of 63,969 participants were included in the study. Compared to the no-supplementation group, the adjusted RR for the supplementation group was 0.51 (95% CI: 0.40, 0.64). And the adjusted RRs for FAO and MMFA compared to the no-supplementation group were 0.56 (95% CI: 0.40, 0.76) and 0.48 (95% CI: 0.35, 0.65), respectively. Compared to supplement FAO and MMFA with less than 8 days out of 10 days, the adjusted RRs for FAO and MMFA with 8 or more days out of 10 days were 1.17 (95% CI: 0.78, 1.75), and 2.05 (95% CI: 1.37, 3.31), respectively.
Maternal supplementation with micronutrients, either FAO or MMFA, during the periconceptional period can reduce the risk for non-syndromic cleft lip/palate in offspring. However, women should be more cautious with MMFA supplementation.