Effects Of Folic Acid Supplementation On Pregnancy Anemia, Pregnancy Outcome And Neonatal Physical Growth

PART1: THE AFFECTIONS OF FOLIC ACIDSUPPLEMENT ON ANEMIA, PLASMA IMPORTANTMICRONUTRIENTS IN EARLY PREGNANCY WOMENObjective To understand the impact on plasma importantmicronutrients of folic acid supplement on women in early pregnancy.Subjects and Methods RandomLy select309cases of pregnantwomen who have filled in obstetric examination forrms in TongliangMaternal and Children Health Care Hospital of Chongqing, China fromApril2012to March2013. Study participants were local (Tongliang County)women in early pregnancy (gestational age <12weeks) and18–35years old.No medical, surgical, gynecological diseases.5mL fasting blood was drawnfrom299cases for Ca, Mg, Cu, Fe, Zn, VA, plasma folate, RBC folate,vitamin B12micronutrients and hemoglobin detection in the early term.And the Plasma folate, RBC folate and vitamin B12were measured with acompetitive receptor binding immunoassay (Chemilumi-nescentImmunoenzyme Assay Access Immunoassay system; Beckman Coulter,Krefeld, Germany), Vitamin A and trace elements (Ca, Fe, zinc, Mg, Cu)concentration detection respectively by high performance liquidchromatography and atomic absorption spectrometry to determine, usingautomatic blood analyzer determination of hemoglobin. Finally309eligibleconsenting women were recruited and299of them completed the interviewand contributed a blood sample in early pregnancy.Results1. Among the299Pregnant women, Ca deficiency rate was 7.4%(22/299), Zn deficiency rate was15.4%(46/299), Mg deficiency ratewas5.0%(15/299), Fe deficiency rate was5.7%(17/299), Cu deficiencyrate was2.7%(8/299), vitamin B12deficiency rate was0.3%(1/299), the rateof vitamin A deficiency (serum retinol concentration<0.7umol/L) andmarginal vitamin A deficiency (serum retinol concentration0.7-1.04umol/L)were11.0%(33/299),43.8%(131/299), respectively.2. The incidence ofanemia in early pregnancy was8.7%(22/253).3. Out of the total299subjects,249(83.3%) reported having taken FAS, including49(16.4%)before conception and200(66.9%) during the first trimester.4. Theconcentration of plasma folate and the RBC folate supplementation groupswere obviously higher than that of the no-supplementation group (, p<0.01).The mean plasma folate and vitamin B12levels in FAS before conceptionwere significantly higher than those in FAS during the first trimester(p<0.05). We did not find any significant difference on other micronutrientsamong those groups.Conclusions The micronutrients deficiency is higher in early Pregnantwomen in the county, with vitamin A and zinc deficiency is moreprominent; Pregnancy folic acid supplementation can effectively improvethe level of folic acid in pregnant women, to improve the nutritional statusof folic acid during pregnancy, free folic acid project in China to carryout successful. To ensure the maternal and child health, the dietary guidanceto should be strengthened in pregnant and childbearing women. PART2: THE RELEVANCE OF PREGNANT WOMENWITH FOLIC ACID SUPPLEMENTATION ANDPREGNANCY RELATED ANEMIA, PREGNANCYOUTCOMES AND NEONATAL PHYSICALDEVELOPMENT.Objective To investigation the relevance of pregnant women indifferent period of folic acid supplementation and pregnancy related anemia,pregnancy outcomes and neonatal physical development.Subjects and Methods RandomLy select309cases of pregnantwomen who have filled in obstetric examination forrms in TongliangMaternal and Children Health Care Hospital of Chongqing, China fromApril2012to March2013. Study participants were local (Tongliang County)women in early pregnancy (gestational age <12weeks) and18–35years old.No medical, surgical, gynecological diseases. Then, we assessed theresponses in each study participant’s completed questionnaire and drew5mL of blood from each participant. Information on birth outcomes wasretrieved from medical records after delivery.Result1. Out of the total299subjects, the prevalence of anemiawas24.5%during pregnancy, and8.7%in early pregnancy,12.3%in thesecond trimester,15.8%in the late pregnancy. Folic acid supplement andcomplement group two groups of hemoglobin in pregnant women withpregnancy increases have a downward trend, but the two groups at earlyand mid pregnancy and late pregnancy had no statistical difference between haemoglobin. We also find that between the FAS before conception groupand the FAS during the first trimester group. The mean maternal plasmairon and vitamin A levels was significant lower in anemia group compared tonon-anemia group in early pregnancy (p<0.05). The infants birth weight andbody length in anemia group was statistically higher than that in non-anemiagroup during the third trimester (p<0.05). Pregnant women that had occurredanemia compared those never happened anemia during pregnancy theinfants had a lower birth weight.2. The risk of developing SGA andprematurity was substantially higher in women with no FAS than that ofwomen who took FAS. Women who delivered SGA or premature infants hadreduced plasma folate levels (p<0.05) compared with controls. The meanplasma folate in women who delivered SGA and premature infants weresignificantly lower than those in women who delivered.3. There wereliner-regression relationship between Ca, Mg and birthweight(P<0.05), thesame between Fe, RBC folate(P<0.05). The micro-nutrient levels in LBW,NBW, LBG show no significant difference (P>0.05).Conclusion FAS can significantly improve plasma folate and RBCfolate levels in childbearing-age women and reduce the risk of subsequentadverse pregnancy outcomes. Ca, Mg, Fe and red blood cell folate levels inpregnant women have a certain degree of effects on newborn physicaldevelopmental. To ensure maternal and child health, maternal micronutrientlevel should be monitored and reasonable supplement. The prevalence ofanemia and the lack of vitamin A, iron were still high in the country duringpregnancy; The dietary guidance to the pregnant women should bestrengthened and timely treatment of anemia in pregnant and childbearingwomen to guarantee maternal and child health.