Folic Acid Supplementation in Chinese Peri-conceptional Population: Results from the SPCC Study / 生物医学与环境科学（英文）

Objective@#To determine the prevalence and determinants of folic acid (FA) supplementation in Chinese couples planning for pregnancy and in women during early pregnancy.@*Methods@#This was a cross-sectional study based on the Shanghai PreConception Cohort (SPCC) study. Data on FA supplementation and socio-demographic features were collected using questionnaires. Couples visiting clinics for pre-pregnancy examination and pregnant women at < 14 gestational weeks were recruited in Shanghai, China, between March 2016 and September 2018.@*Results@#Among the pregnancy planners, 42.4% (4,710/11,099) women and 17.1% (1,377/8,045) men used FA supplements, while 93.4% (14,585/15,615) of the pregnant women used FA supplements. FA supplement use was higher in female pregnancy planners who were older ( : 1.13, 95% : 1.08-1.18), had higher education ( : 1.71, 95% : 1.53-1.92), and were residing in urban districts ( : 1.06, 95% : 1.01-1.11) of FA supplementation; female pregnancy planners with alcohol consumption ( : 0.95, 95% : 0.90-0.99) had lower odds of FA supplementation. In early pregnancy, women with higher educational level ( : 1.04, 95% : 1.03-1.06), who underwent pre-pregnancy examination ( : 1.02, 95% : 1.01-1.03) had higher odds of using an FA supplement; older aged ( : 0.99, 95% : 0.98-0.99), and multigravida ( : 0.97, 95% : 0.96-0.98) had lower odds of FA supplementation.@*Conclusion@#Although the majority of pregnant women took FA supplements, more than half of the women planning for pregnancy did not. Urgent strategies are needed to improve pre-conception FA supplementation.

Maternal periconceptional folic acid supplementation and its effects on the prevalence of fetal neural tube defects / 北京大学学报(医学版)

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.

Periconceptional Folic Acid Supplementation in Chinese Women: A Cross-sectional Study / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate the status of folic acid (FA) supplementation and determinants of its use in pregnant Chinese women.</p><p><b>METHODS</b>In this cross-sectional study, questionnaires were used to collect information of participants and FA supplementation. Women were recruited between 6 and 12 weeks postpartum in Tianjin, China, between July 2015 and July 2016.</p><p><b>RESULTS</b>A total of 1,921 women were recruited in the study. Approximately 93.1% of the study participants used FA, while 14.4% of the women taking FA from three months prior to preconception to three months post-conception. Women who took FA for three months prior to preconception through at least three months into their pregnancy were more likely to be between 30 and 34 years old (OR = 2.91, 95% CI: 1.15, 7.33), employed (OR = 2.07, 95% CI: 1.17, 3.67), primigravida (OR = 5.20, 95% CI: 3.02, 8.96), married to spouses with an intermediate education level (OR = 2.92, 95% CI: 1.45, 5.89), and earn a high family income (OR = 3.19, 95% CI: 1.57, 6.49).</p><p><b>CONCLUSION</b>The prevalence of periconceptional FA intake was far below the requirements of the National Health and Family Planning Commission of China; therefore, knowledge of FA supplementation should be strengthened among women who are or planning to become pregnant.</p>

Association between birth defects and special risk exposures during peri-conception period / 西安交通大学学报(医学版)

Objective To analyze the effect of special risk exposures during periconception period on birth defects of newborns.Methods From Jul.to Dec.2013,the multi-stage stratified random sampling method was adopted.Women of childbearing age between 15 and 49 who were pregnant during 2010 to 2013 in Shaanxi Province were selected as study subjects for investigation on special risk factors exposed during periconception period.The Logistic regression model was adopted to analyze the association between newborns' birth defects and special risk exposures.Results The study included 30 010 women of childbearing age and 29 550 newborns with 572 (193.57/ 10 000) cases of birth defects.After adjusting for demographic factors,the risk factors for birth defects were drinking [OR=2.29,95％ CI (1.22,4.29)] and passive smoking [OR=1.25,95％ CI (1.02,1.53)] during periconception.There was a higher risk of birth defects when exposure to medicine [OR =1.64,95％ CI (1.04,2.61)],pesticides [OR =2.41,95％ CI (1.09,5.35)],biological risk factors [OR-1.64,95％ CI (1.05,2.56)],physical risk factors [OR=1.15,95％ CI (1.13,2.34)] and chemical risk factors [OR =2.36,95％ CI (1.36,4.11)] 3 months both before and after pregnancy.Similarly,after adjusting for demographic factors and behaviors,we found that birth defects were related to antibiotics,salicylates,and antitussive,which could increase the risk of birth defects (P＜0.05).Conclusion Exposure to passive smoking and drinking during periconception and exposure to medicines and pesticides,as well as biological,physical and chemical risk factors 3 months before and after pregnancy could increase the risk of birth defects in newborns.

Investigation and Analysis of Knowledge,Attitude and Behavior about Drug Use Safety among Periconcep-tional Women in Yongchuan District of Chongqing / 中国药房

OBJECTIVE:To provide reference for the development of pharmaceutical care for periconceptional women. METH-ODS:Probability proportionate to size sampling(PPS)method was adopted to select participants from periconceptional women in Yongchuan District. The participants were investigated by questionnaires about drug use safety knowledge,attitude and behavior. Ep-idata 3.0 software was used to establish database. The data were analyzed with SPSS 15.0 software. RESULTS:Totally 800 ques-tionnaires were distributed and then 779 valid questionnaires were collected with effective rate of 97.38%. The total awareness rate of knowledge about drug use safety was 57.69%. The awareness rate rise with the increase of educational level (P<0.01). The awareness rate was higher in pregnant women than in prepregnant ones,with statistical significance in most of the questions(P<0.05 or P<0.01). For questions about attitude for drug use safety,the positive answer rate was higher in pregnant women than in prepregnant ones,with statistical significance in most of the questions (P<0.01). Among 385 pregnant women,only 56.88% re-ceived folic acid following the WHO recommendation. Of 181 pregnant women who had taken medicine,8.29% indicated that the physicians or pharmacists did not inform that whether the medicine affected pregnancy. CONCLUSIONS:Among periconceptional women,awareness rate of drug use safety is in low level and varied by their educational levels. There are difference in awareness rate of drug use safety and attitude between prepregnant women and pregnant woman. Drug use behavior of pregnant woman is to be modified.

Does Periconceptional Fish Consumption by Parents Affect the Incidence of Autism Spectrum Disorder and Intelligence Deficiency? A Case-control Study in Tianjin, China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>This study aimed to explore the association between periconceptional fish consumption by parents and autism spectrum disorder (ASD) and intelligence deficiency (ID).</p><p><b>METHODS</b>A case-control study was conducted through a questionnaire with 108 ASD cases, 79 ID cases, and 108 controls. The ASD and ID cases were students from special educational schools in Tianjin from 2012 to 2014. The age- and sex-matched controls were from a high school, three primary schools, and a kindergarten in Tianjin. Multivariate logistic regression was performed.</p><p><b>RESULTS</b>Paternal habit of eating hairtail before fertilization, maternal preference for fruits during pregnancy, and maternal habit of eating grass carp during pregnancy were preventive factors for ASD. Paternal habit of drinking alcohol before fertilization was a risk factor for ID, whereas maternal preference for fruits during pregnancy and maternal habit of eating crucian carp during pregnancy were protective factors for ID.</p><p><b>CONCLUSION</b>Parental fish consumption is beneficial for the prevention of ASD and ID. Meanwhile, the protective effects of fish consumption on ASD and ID differ. More attention should be paid to the combined effect of other food when eating fish.</p>