孕期服用叶酸可降低孩子语言障碍

    孕妇在受孕前４周及受孕后８周内服用叶酸补充剂，可以降低孩子在３岁时出现严重语言发育迟缓的风险。

　　这项研究始于１９９９年，研究数据包括约３．９万名２００８年前出生的孩子，他们的母亲在２０１０年６月交回了为期３年的跟踪问卷。那些母亲在特定时期内（受孕前４周及受孕后８周）没有服用包括叶酸在内的食物补充剂的孩子被归为对照组；母亲服用补充剂的孩子分为３组：服用其他补充剂但不服用叶酸组；只服用叶酸组；服用叶酸加其他补充剂组。

　　研究人员发现，所有的孩子中，共有２０４人（约占０．５％）被诊断患有严重语言发育迟缓的疾病。其中，在对照组和服用其他补充剂但不服用叶酸的组中，约有０．９％的孩子患严重语言发育迟缓；而在只服用叶酸组和服用叶酸加其他补充剂的组中，孩子出现严重语言发育迟缓的比例仅为０．４％，为前者的一半不到。

　　研究结果表明，母亲在受孕前４周至受孕后８周的这段时期服用叶酸补充剂，与孩子在３岁时出现严重语言发育迟缓的风险显著降低有关联。

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Folic Acid Supplements in Pregnancy and Severe Language Delay in Children

Context  Prenatal folic acid supplements reduce the risk of neural tube defects and may have beneficial effects on other aspects of neurodevelopment.

Objective  To examine associations between mothers' use of prenatal folic acid supplements and risk of severe language delay in their children at age 3 years.

Design, Setting, and Patients The prospective observational Norwegian Mother and Child Cohort Study recruited pregnant women between 1999 and December 2008. Data on children born before 2008 whose mothers returned the 3-year follow-up questionnaire by June 16, 2010, were used. Maternal use of folic acid supplements within the interval from 4 weeks before to 8 weeks after conception was the exposure. Relative risks were approximated by estimating odds ratios (ORs) with 95% CIs in a logistic regression analysis.

Main Outcome Measure Children's language competency at age 3 years measured by maternal report on a 6-point ordinal language grammar scale. Children with minimal expressive language (only 1-word or unintelligible utterances) were rated as having severe language delay.

Results  Among 38 954 children, 204 (0.5%) had severe language delay. Children whose mothers took no dietary supplements in the specified exposure interval were the reference group (n = 9052 [24.0%], with severe language delay in 81 children [0.9%]). Adjusted ORs for 3 patterns of exposure to maternal dietary supplements were (1) other supplements, but no folic acid (n = 2480 [6.6%], with severe language delay in 22 children [0.9%]; OR, 1.04; 95% CI, 0.62-1.74); (2) folic acid only (n = 7127 [18.9%], with severe language delay in 28 children [0.4%]; OR, 0.55; 95% CI, 0.35-0.86); and (3) folic acid in combination with other supplements (n = 19 005 [50.5%], with severe language delay in 73 children [0.4%]; OR, 0.55; 95% CI, 0.39-0.78).

Conclusion  Among this Norwegian cohort of mothers and children, maternal use of folic acid supplements in early pregnancy was associated with a reduced risk of severe language delay in children at age 3 years.

来源：医学论坛报