2015-2016年马拉维全国微量营养素调查中非怀孕育龄妇女的叶酸和维生素B12状况与预测的神经管缺陷风险。

IF 1.6 4区 医学 Q4 DEVELOPMENTAL BIOLOGY
Yan Ping Qi, Krista S. Crider, Anne M. Williams, Katie Tripp, Carine Mapango, Elizabeth C. Rhodes, Eunice Nyirenda, Felix Phiri, Mindy Zhang, Shameem Jabbar, Christine M. Pfeiffer, Helena Pachón, Sarah Zimmerman, Jennifer L. Williams
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引用次数: 0

摘要

背景:孕产妇叶酸和维生素 B12 缺乏可导致严重的不良妊娠结局。关于马拉维育龄妇女(WRA)的叶酸和维生素 B12 状态,目前还没有具有全国代表性的估计数据:我们评估了马拉维未孕育龄妇女的叶酸和维生素 B12 状况,并预测了她们怀孕后患叶酸敏感性神经管缺陷(NTD)的风险:利用具有全国代表性的 2015-2016 年马拉维微量营养素调查的横断面数据,我们按人口特征计算了 778 名未怀孕 WRA(15-49 岁)中叶酸和维生素 B12 缺乏和不足的比例。我们利用红细胞叶酸分布和已发表的红细胞叶酸与 NTD 风险之间关系的贝叶斯模型预测了 NTD 的发病率。分析考虑了复杂的调查设计:在 WRA 中,8.5%(95% CI:6.2, 11.6)和 13.3%(10.0, 17.4)的人血清叶酸缺乏(每 10,000 名新生儿中有 8 例),而在全国范围内,81.4%(75.0, 86.4)的人血清叶酸缺乏(每 10,000 名新生儿中有 8 例)。全国预测的新生儿非畸形风险为每万名活产婴儿 24.7 例。生活在城市地区或受过高等教育的妇女死亡率较高,红细胞叶酸不足和预测的NTD风险也较高:这些发现凸显了马拉维营养和NTD监测的重要性,以及改善马拉维WRA叶酸和维生素B12营养状况的机会。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Folate and vitamin B12 status and predicted neural tube defects risk among nonpregnant women of reproductive age from the Malawi National Micronutrient Survey, 2015–2016

Background

Maternal folate and vitamin B12 deficiency can lead to serious adverse pregnancy outcomes. There are no nationally representative estimates on folate and vitamin B12 status among women of reproductive age (WRA) in Malawi.

Objective

We assessed folate and vitamin B12 status among nonpregnant WRA in Malawi and predicted the risk of folate-sensitive neural tube defects (NTDs) were they to become pregnant.

Methods

Using data from the cross-sectional, nationally representative 2015–2016 Malawi Micronutrient Survey, we calculated the proportion of folate and vitamin B12 deficiency and insufficiency by demographic characteristics among 778 nonpregnant WRA (15–49 years). We predicted NTD prevalence using red blood cell (RBC) folate distributions and a published Bayesian model of the association between RBC folate and NTD risk. Analyses accounted for complex survey design.

Results

Among WRA, 8.5% (95% CI: 6.2, 11.6) and 13.3% (10.0, 17.4) had serum (<7 nmol/L) and RBC folate (<305 nmol/L) deficiency, respectively. The proportion of vitamin B12 deficiency (<148 pmol/L) and insufficiency (≤221 pmol/L) was 11.8% (8.6, 16.0) and 40.6% (34.1, 47.4), respectively. RBC folate insufficiency (<748 nmol/L, defined as the concentration associated with the threshold for elevated NTD risk: >8 cases per 10,000 births) was widespread: 81.4% (75.0, 86.4). The predicted NTD risk nationally was 24.7 cases per 10,000 live births. RBC folate insufficiency and higher predicted NTD risk were more common among WRA living in urban areas or with higher education.

Conclusions

These findings highlight the importance of nutritional and NTD surveillance in Malawi and the opportunity for improving folate and vitamin B12 nutrition among Malawian WRA.

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来源期刊
Birth Defects Research
Birth Defects Research Medicine-Embryology
CiteScore
3.60
自引率
9.50%
发文量
153
期刊介绍: The journal Birth Defects Research publishes original research and reviews in areas related to the etiology of adverse developmental and reproductive outcome. In particular the journal is devoted to the publication of original scientific research that contributes to the understanding of the biology of embryonic development and the prenatal causative factors and mechanisms leading to adverse pregnancy outcomes, namely structural and functional birth defects, pregnancy loss, postnatal functional defects in the human population, and to the identification of prenatal factors and biological mechanisms that reduce these risks. Adverse reproductive and developmental outcomes may have genetic, environmental, nutritional or epigenetic causes. Accordingly, the journal Birth Defects Research takes an integrated, multidisciplinary approach in its organization and publication strategy. The journal Birth Defects Research contains separate sections for clinical and molecular teratology, developmental and reproductive toxicology, and reviews in developmental biology to acknowledge and accommodate the integrative nature of research in this field. Each section has a dedicated editor who is a leader in his/her field and who has full editorial authority in his/her area.
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