新疆维吾尔、汉、哈萨克族孕妇叶酸、维生素D营养状况及其交互作用对母子健康影响的研究

The contribution rate of nutrition status of pregnant women to national comprehensive qualities and social development can not be replaced. Folic acid and vitamin D may affect homocysteine levels in gestational hypertension, gestational diabetes and other diseases during pregnancy and impact on children. Since 2004, the study found that some minority nationalities rural areas in Xinjiang, such as low level of folic acid, high homocysteine in pregnant women, supplemental folic acid and vitamin D and health promotion effect is still no exact conclusion. Therefore, found out the reason of above many issues and explore the degree and frequency of impact that folic acid and vitamin D on mother and child health is extremely important. Due to the geographical environment and the diet culture characteristics of different nationalities of Xinjiang were different, so chose uygur, han, kazak, pregnant women as the research object, through field investigation and appraisal of clinical and laboratory analysis, observe its nutrition, supplementary folic acid and vitamin D status and effect, serum folate, 25-(OH) D level and influence factors associated with the mother and child health, explore the interaction of folic acid and vitamin D and the possible mechanism. Analysis of the causes and relation, easy to develop the targeted work of maternal and child nutrition health care, health education, health promotion, health management of balanced diet and reasonable nutrition knowledge, and provide a scientific basis about improving the health level and comprehensive quality of all nationalities in the region.

孕妇营养状况对民族综合素质和社会发展的贡献率不可替代。叶酸与维生素D均可影响同型半胱氨酸水平导致妊高症、妊娠期糖尿病等妊娠期疾病并对子代产生影响。自2004年以来研究发现新疆农村少数民族地区孕妇体内叶酸水平低、同型半胱氨酸高，增补叶酸及维生素D推广和健康促进效果仍无确切定论。因此，探明上述众多问题的原因极为重要，查清叶酸和维生素D对母子健康影响的程度和频率势在必行。由于新疆的地理环境和各民族的饮食文化特点迥异，为此，以维吾尔、汉、哈萨克族孕妇为研究对象，通过现场调查、临床鉴定和实验室分析，观察其营养状况、增补叶酸和维生素D情况及效果，血清叶酸、25-（OH）D水平及影响因素与母子健康的关联强度，探讨叶酸与维生素D的交互作用及发生的可能机制。分析原因与关联，以便针对性的开展妇幼营养保健、平衡膳食合理营养知识的健康教育、健康促进、健康管理工作，为提高本地区各民族健康水平和综合素质提供科学依据。

妇女儿童健康是全民健康的基石，是人类可持续发展的基础和前提。我国历来高度重视妇幼健康，随着国家生育政策调整完善、二胎政策出台实行，高危孕产妇比例.有所增加，保障母婴安全压力增大，母婴健康成了社会关心的重大热点，全民在呼吁妇幼卫生工作需要更全面更深入的展开。人们对妊娠期妇女应注重蛋白质、碳水化合物、脂肪的摄入已达成了共识，但却忽略了一些维生素、矿物质等微量营养素的补充，宏量营养素过剩，微量营养素缺乏为主的“隐性饥饿”问题日益突出。孕妇的营养状况直接关系到母体的身心健康和胎儿的正常发育成长。妊娠期是妇女生活中的一个特殊阶段，激素水平和代谢条件的改变导致所需的营养物质显着增加。如果供给孕妇的营养物质不足或孕妇患有营养不良，不仅影响母体自身健康，易于发生妊娠期贫血、妊娠期高血压，妊娠期糖尿病等各种妊娠合并症，还可影响胎儿健康。胎儿从母体吸收营养成分，尤其是妊娠中、晚期，胎儿生长发育速度加快，各种营养素的需要量剧增，当母体营养失衡或某些营养素缺乏时,比如叶酸缺乏时可影响胎盘结构与功能，减弱胎盘向胎儿输送营养成分的作用，可致胎儿宫内发育迟缓，出生体重低，脑发育迟缓等，营养素严重缺乏时可致畸胎。新疆地区孕妇膳食结构不合理，微量营养素缺乏情况较明显，尤其是叶酸等微量营养素缺乏问题较严重。妊娠期合并症和不良妊娠结局的发生不是一种维生素或者矿物质引起，而是与多种营养素相关。因此，合理补充营养是维护孕产妇身心健康和胎儿正常生长发育的关键，尤其是孕期补充维生素和矿物质的重要性不容忽视。