ABSTRACT
OBJECTIVE@#To find out the status of folic acid supplementation among women, to evaluate the prevention effects on neural tube defects (NTDs), and to explore the factors impact on folic acid supplementation compliance.@*METHODS@#Based on the routine data of 92 121 women in prenatal health care and birth defect surveillance system in Tongzhou District of Beijing from 2013 to 2018, we described the prevalence of periconceptional folic acid supplementation, pre-pregnancy folic acid supplementation and regularly folic acid supplementation (compliance supplementation). Trend χ2 tests were used to evaluate the change of folic acid supplementation prevalence. The prevalence difference among the women with folic acid supplementation and without supplementation were tested with Fisher's exact test. Factors asso-ciated with folic acid supplementation compliance rate were analyzed with univariate and multivariate Logistic regression model.@*RESULTS@#The prevalence of periconceptional folic acid supplementation during the six years was 90.08% and it was increased from 2013 to 2018, but the rate of pre-pregnancy and regular supplementation was only 41.5% and declined from 2013 to 2018, especially 2013 to 2015. The prevalence of NTDs among the fetuses whose mothers took folic acid during periconceptional period was 5.5/10 000, while the prevalence for the fetuses whose mothers did not take folic acid was 19.7/10 000 (P < 0.001), the rates ratio was 27.9% (χ2=23.74, P < 0.001). The difference between the prevalence of NTDs among the fetuses whose mothers took folic acid only and multiple micronutrients was not statistically significant. After controlling the confounding factors, it was found that the compliant folic acid supplementation rates in women, whose household registrations were outside Beijing and whose education levels were junior high school or below, and who were younger than 25 years old, and who were multiparas and who were pre-pregnancy underweight or obese, were lower than those of the corresponding control groups (P < 0.05).@*CONCLUSION@#The rate of folic acid supplementation among women in Tongzhou District of Beijing was relatively high, but their compliance was poor. Women who did not take folic acid during periconception seriously affected the prevention effect of NTDs. We should focus on women who are younger than 25 years old, lower educated, pre-pregnancy underweight or obese, multiparas and nonlocal household registers, in order to improve the periconceptional folic acid supplementation compliance and improve the effects of NTDs prevention.
Subject(s)
Adult , Female , Humans , Pregnancy , Beijing , Dietary Supplements , Fetus , Folic Acid , Neural Tube Defects/epidemiology , PrevalenceABSTRACT
Objective To observe the effect of electrical stimulation combined with bladder function training on autonomic bladder pa-tients after S2-4spinal cord injury or cauda equina and pelvic nerve injury.Methods From January,2016 to August,2017,76 patients with au-tonomic bladder after spinal cord injury were divided into control group(n=29)and observation groups(n=47)in real world study.The con-trol group received routine bladder function training,and the observation group received bladder muscle stimulation therapy in addition.The micturition diary and urodynamic indexes were assessed before and three months after treatment.Results After treatment,the frequency of urinary incontinence and the number of micturition in 24 hours,and residual urine volume significantly reduced(t>3.251,P<0.01),the urine output every time significantly increased (t>5.000, P<0.001), the maximum bladder capacity and urine flow rate increased (t>1.922, P<0.05),and the detrusor pressure in the end of filling period significantly reduced(t>8.302,P<0.001).All the indexes above were better in the observation group than in the control group(t>1.919,P<0.05). Conclusion Electrical muscular stimulation combined with the bladder func-tional training could improve the urination function in the patients with autonomic bladder after spinal cord injury.