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目的探讨神经管畸形(neural tube defects,NTDs)的发生与孕产妇相关知识行为的关系。方法采用1∶1配比的病例对照研究,对210例神经管缺陷儿的母亲和210例非神经管缺陷儿母亲进行基本情况、NTDs相关知识认知及相关行为情况的问卷调查。结果产妇预防NTDs知识得分与NTDs关系的t检验显示,对照组知识得分(54.42±25.47)分高于病例组(42.17±26.61)分,差异有统计学意义(P<0.001)。进一步对其知识水平调查发现,本次孕前或孕期听说过叶酸、知道食物中含有叶酸在两组间差异有统计学意义(P分别为<0.001和0.001)。对进行婚前医学检查、接受健康教育、进行遗传优生咨询分别进行条件Logistic回归分析,发现3项在两组间差别均有统计学意义(OR分别为0.525、0.247、0.545;P分别为0.017、<0.001、0.039)。多因素分析结果显示,接受健康教育和孕前或孕期听说过叶酸进入模型(P<0.001)。结论对照组产妇预防NTDs知识水平高于病例组,有自主保健行为者和预防NTDs知识水平高者生育NTDs患儿的风险小。应通过多种途径提高育龄期妇女的保健意识,使其主动接受健康教育,提高知识水平,以降低NTDs发生率,提高出生人口质量。
Objective To investigate the relationship between the occurrence of neural tube defects (NTDs) and maternal knowledge and behaviors. Methods A case-control study of 1: 1 ratio was conducted to investigate the basic situation of 210 mothers with neural tube defects and 210 mothers with non-neural tube defects and the related knowledge of NTDs and their related behaviors. Results t-test showed that the knowledge score of the control group (54.42 ± 25.47) was higher than that of the case group (42.17 ± 26.61), the difference was statistically significant (P <0.001). Further investigation of their level of knowledge found that folic acid was known before or during pregnancy, and that there was a significant difference between the two groups in the content of folic acid in foods (P <0.001 and 0.001, respectively). Pre-marital medical examination, health education, genetic counseling were conducted conditional Logistic regression analysis, found that the three were statistically significant differences between the two groups (OR were 0.525,0.247,0.545; P were 0.017, < 0.001, 0.039). Multivariate analysis showed that receiving health education and pre-pregnancy or during pregnancy had heard of folate into the model (P <0.001). Conclusion The maternal NTDs knowledge level in the control group is higher than that in the case group. The risk of having children with NTDs is very low in those who have self-care behaviors and have high level of knowledge in preventing NTDs. Awareness of women’s health care should be enhanced in many ways to enable them to take the initiative to receive health education and improve the level of knowledge to reduce the incidence of NTDs and improve the quality of the birth population.