陕西省育龄妇女围孕期叶酸服用状况及其影响因素
Status and influencing factors of folic acid intake by childbearing-aged women in Shaanxi Province

摘要：目的 了解陕西省育龄妇女围产期叶酸服用状况，并分析其影响因素，对相关政策制定与调整提供数据支持。方法 在陕西省10个地级市和杨凌示范区进行随机抽样，选取近3年怀孕或正在怀孕的妇女进行问卷调查，采用非条件Logistic回归模型分析叶酸服用的影响因素。结果 在全省域层面上叶酸服用率为84.1%，叶酸服用率在地域之间有统计学差异，陕南为88.9%，关中为85.7%，陕北为75.5%(χ2=24.011，P<0.001)，城乡之间也有统计学差异(89.5% vs. 80.6%, χ2=19.974，P<0.001)，叶酸服用率还存在显著的年龄差异，高年龄组妇女服用率低于低年龄组(χ2=13.637，P=0.003)。免费领取叶酸率和叶酸服用时间在地域、城乡和各年龄组之间同样有统计学差异(P<0.05)。Logistic回归分析发现，除地区、城乡、年龄和教育程度等因素外，育龄妇女对叶酸的认知是影响围孕期叶酸服用情况的主要因素，其中不知道围孕期需要服用叶酸的育龄妇女不服用叶酸的风险是知道者的14.13倍(95% CI：6.16～32.44)，不知道叶酸可以预防神经管畸形的育龄妇女不服用叶酸的风险是知道者的2.71倍(95% CI：1.43～5.14)；不知道叶酸免费领取政策的育龄妇女围孕期不服用叶酸的风险是知道者的2.88倍(95% CI：1.52～5.47)。 结论 陕西省育龄妇女叶酸服用率较高，但服用时间较短。认知是影响叶酸服用及规范服用的重要因素，强化和提升育龄妇女对叶酸的认知水平是提升叶酸预防神经管畸形的重要方法。
ABSTRACT: Objective To understand the status of perinatal folic acid intake by childbearing-aged women in Shaanxi Province and analyze the influencing factors so as to provide data support for current policy adjustment. Methods We sampled in 10 cities of Shaanxi and Yangling Demonstration area, and chose women who had been pregnant in the past 3 years or were pregnant at the time of the survey to answer questionnaires. The unconditional logistic regression model was used to analyze the influencing factors. Results At the whole provincial level, the intake rate of folic acid was 84.1%. The intake rate of folic acid varied significantly among different regions, being 88.9% in southern Shaanxi, 85.7% in Guanzhong area, and 88.9% in northern Shaanxi (χ2=24.011, P<0.001). It also significantly differed between urban and rural areas (89.5% vs. 80.6%, χ2=19.974, P<0.001). The intake rate of folic acid was different significantly among different age groups, too, being lower in the old-age group than in the young-age group (χ2=13.637, P=0.003). The rate of free access to folic acid and duration of folic acid intake also significantly differed among urban and rural areas, different regions and different age groups (P<0.05). By using logistic regression model we found that the childbearing-aged women’s knowlage of folic acid was the most important influencing factors besides urban/rural area, region, age and education level. Among these factors the odds ratio of awareness intake of folic acid during perinatal period was 14.13 (95% CI: 6.16-32.44), the odds ratio of knowing that folic acid can prevent neural-tube defects was 2.71 (95% CI: 1.43-5.14) and odds ratio of knowing the policy of free distribution of folic acid supplements was 2.88 (95% CI: 1.52-5.47). Conclusion The rate of folic acid intake among childbearing-aged women in Shaanxi Province is relatively high, but the