[Show abstract][Hide abstract] ABSTRACT: To examine the association between the risk of neural tube defects (NTD) and maternal serum vitamin B12, folate and homocysteine in a high-risk area of China.
A case-control study was carried out in Luliang mountain area of Shanxi Province.
A total of eighty-four NTD pregnancies and 110 matched controls were included in the study; their serum vitamin B12 and folate concentrations were measured by chemiluminescent immunoenzyme assay and total homocysteine concentrations by fluorescent polarisation immunoassay.
Serum vitamin B12 and folate concentrations were lower in NTD-affected pregnant women than in controls (P < 0.01). Serum total homocysteine was higher in the NTD group than in controls at less than 21 weeks of gestation (P < 0.01). Adjusted odds ratios revealed that women with lower vitamin B12 (adjusted OR=4.96; 95 % CI 1.94, 12.67) and folate (adjusted OR=3.23; 95 % CI 1.33, 7.85) concentrations had a higher risk of NTD compared to controls. Based on dietary analysis, less consumption of meat, egg or milk, fresh vegetables and fruit intake would increase the risk of NTD.
Lower serum concentrations of folate and vitamin B12 are related to the increased risk of NTD in high-risk populations. Both folate and vitamin B12 intake insufficiency could contribute to the increased risk of NTD. A dietary supplement, combining folate and vitamin B12, might be an effective measure to decrease the NTD incidence in these areas.
Public Health Nutrition 06/2008; 12(5):680-6. DOI:10.1017/S1368980008002735 · 2.48 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The objective of this study was to assess the prevalence of vitamin A deficiency (VAD) in children under 6 years old in China and to identify risk groups for VAD.
A cross-sectional survey was conducted in 14 provinces from coastal, inland and western geographic areas in China.
One city (urban) and two counties (rural) were randomly selected from each province as survey areas.
About 200 children aged 0-6 years were randomly selected in each survey area. A blood sample was collected from each child. Data on sociodemographics and nutrition were obtained by interview of the mother or principal caregiver. Fluorescence microanalysis was used to analyse serum retinol concentration.
VAD (serum retinol <0.7 micro mol l(-1)) was observed in 957 out of 7,826 children aged 0-6 years (12.2% of the entire study population), whereas severe VAD (serum retinol <0.35 micro mol l(-1)) was found in 39 children (0.5%). The highest prevalences of VAD at >1 year of age were observed among children of mothers with minority ethnicity (22.7%) or poor education (19.8%) and in the poor western area (17.4%).
VAD is a nutritional problem in children in China. Children living in the poor western area, having a mother with minority ethnicity or a mother with poor education have a high risk of VAD.
Public Health Nutrition 12/2007; 9(8):955-60. DOI:10.1017/S136898000600944X · 2.48 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Shanxi Province has historically reported a high prevalence of NTDs. In order to establish baseline rates for NTDs and discuss the risk factors associated with sociodemographic, maternal characteristics, and geographic factors, we performed the present study using an approach combining population and hospital-based methodologies.
We used chi(2) and Fisher's exact tests to evaluate variation in the prevalence by selected covariates and computed crude ORs and 95% CIs. Adjusted odds ratios (AORs) were performed using logistic regression with all the covariates included in the model.
The overall NTD prevalence during the 3 year study period was 199.38 per 10,000 births, with a higher NTD prevalence clustered in 46 villages within this geographic area. However, no statistical significance was found between NTD prevalence and the elevation of the villages or their distance from coal plants. AORs revealed women aged 20 and above had a lower risk of NTDs compared to those younger than 20 (AOR range 0.4-0.5). A higher risk of NTDs was observed among female infants (AOR 1.50; 95% CI: 1.04-2.17), women with four or more previous births (AOR 2.80; 95% CI: 1.20-6.52), and a previous history of birth defects (AOR 3.23; 95% CI: 1.46-7.12).
This study has documented a high prevalence of NTDs in Shanxi. Similar variations to other reports were found in the risk of NTDs by maternal demographic characteristics and a clustering of NTDs in certain villages that require further exploration.
Birth Defects Research Part A Clinical and Molecular Teratology 10/2007; 79(10):702-7. DOI:10.1002/bdra.20397 · 2.21 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To understand the prevalence and spatial distribution of vitamin A deficiency (VAD) in China among children at ages under six years.
About 8,600 children under 6 years of age in 14 cities and 28 counties of 14 provinces were selected with stratified cluster sampling for survey, including interview with questionnaire for their family information and nutritional status. Blood specimens were collected for measuring serum level of VA with fluorescent spectrophotometry in laboratory.
Totally, 8,669 children under 6 (2,877 in urban area and 5,792 in rural area) were surveyed in 14 provinces, with 4,629 males and 4,040 females. Eight cases of night blindness and seven cases of xerophthalmia were found among the children at ages of two to five years. Sixty-one mothers of the children in this group were also found suffering from night blindness. All the cases of night blindness and xerophthalmia both in children and mothers were living in rural areas. Based on their serum levels of VA, 11.7% of the all 1 018 children were diagnosed as VAD, with serum VA concentrations below or equal to 0.70 micro mol/L. Prevalence of VAD was 15.0% and 5.8% in rural (23.3% in the poverty-stricken counties) and urban areas, respectively, and 5.8%, 11.5% and 16.8% in the coastal, inland and remote areas, respectively. The average serum level of VA was 1.20 micro mol/L and 0.99 micro mol/L for urban and rural areas, respectively, with a national average of 1.06 micro mol/L. And, babies under six months of age with an average serum levels of VA < or = 0.70 micro mol/L accounted for 33.4%, and those at ages of four to five years with the same level of VA accounted for 8%. There was significant difference in serum levels of VA between ages, but no significant difference between genders.
VAD did exist in children of China, especially in the remote and poverty-stricken rural areas and VA supplementation is urgently needed for the children in these regions.
Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine] 09/2002; 36(5):315-9.
[Show abstract][Hide abstract] ABSTRACT: To identify the risk factors for low birth weight (LBW) in Chinese newborns with varied characteristics.
A 1:1 matched case-control study, with 999 babies of LBW was performed in 44 counties of 11 provinces in China during July to October, 1998 for identifying their risk factors using simple and multivariate logistic regression models.
The determinants of LBW in China included factors, such as multiparity (OR = 106.9), preterm birth (OR = 18.7), abnormal maternal health status (OR = 2.61) and maternal malnutrition (OR = 3.42), maternal medical conditions during pregnancy (OR = 1.93), maternal schooling (OR = 1.43), et al. Distribution of the risk factors for LBW was significantly different between coastal, inland and remote areas. LBW was mainly attributed to intrauterine growth retardation (IUGR) (71.6%) in the rural areas, and to multiparity and preterm birth, in addition to IUGR, in the urban areas. There was different in the risk factors for LBW with preterm births and IUGR.
It is an effective way to reduce incidence of low birth weight in China that all measures for prevention and control should be relevant to its risk factors.
Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine] 06/2002; 36(3):158-60.
[Show abstract][Hide abstract] ABSTRACT: To study the weight of live births and incidence of low-birth weight (LBW) in China.
A national survey on the weight of live births with gestational ages of 28 weeks or over in 16 cities and 28 counties of 11 provinces in China was carried with stratified sampling during July to October, 1998.
Totally 22 350 live newborns, 11 584 males and 10 766 females, with gestational ages of 28 weeks or more in sampling sites were measured at their birth. Rates of multiple births and preterm birth (< 37 weeks of gestation) were 1.8% and 3.5%, respectively. LBW rates were 4.20% and 6.26% for urban and rural areas, respectively, with a national weighted-average of 5.87%. Full term births (>/= 37 weeks of gestation) accounted for 61.2% and 71.6% of the babies with LBW in national and rural areas, respectively. Their average birth weight was 3 301 g and 3 225 g in urban and rural areas, respectively, with statistically significant difference, and 3 280 g and 3 173 g for boys and girls, respectively, approaching to the values recommended by the World Health Organization (WHO). Live birth weight in the coastal, inland, and remote areas appeared a trend of gradual decrease. Early neonatal mortality of babies with LBW was 50.0 per thousand and 179.4 per thousand in urban and rural areas, respectively, with a national average of 151.5 per thousand, significant higher than those with normal birth weight.
The average birth weight and LBW rate in live births of China were close to those in the developed countries, and there was significant difference in them between varied regions. The majority of LBW in China was attributed to intrauterine growth retardation (IUGR). Early neonatal mortality in babies with LBW was significantly higher than that with normal birth weight. Further intervention measures should be implemented.
Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine] 05/2002; 36(3):149-53.
[Show abstract][Hide abstract] ABSTRACT: The survey will reveal current status of subclinical vitamin A deficiency (SVAD) and explore its affecting factors in children of China.
Totally 8 669 children aged under 6 years were randomly selected from 14 provinces for clinical examination, health and dietary questionnaire and serum level of vitamin A measurement with fluorescence method. The cut-off value for SVAD was defined as </= 0.70 micro mol/L.
Prevalence of SVAD was 11.7% and that of suspected SVAD 39.2% in all subjects, which decreased with the increase of gross domestic product, average annual family income, mother's schooling and children's age. Prevalence of SVAD and suspected SVAD higher in rural areas (15.0%) than in urban areas (5.2%), and higher in children with a minority mother (22.6%) than in those with a Han nationality mother (8.7%). Prevalence of SVAD and suspected SVAD was higher in children whose blood samples were collected within one week in-taking vitamin A-rich food (12.6%-22.6%) than those in-taking vitamin A daily (4.1%-10.0%), and higher in children suffering from respiratory infection, fever and diarrhea two weeks before their blood collection (15.2%-20.3%) than in those without those diseases (10.1%-11.1%). Logistic regression analysis showed that poor family economic status, living in rural areas, children with a minority mother, younger age, no-dairy milk products intake, and respiratory infection and fever all were risk factors for SVAD.
More than half of children under six years old in China (50.9%) had vitamin A nutrition problem. Varied factors played roles to different extent in SVAD in children.
Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine] 05/2002; 36(3):161-3.
[Show abstract][Hide abstract] ABSTRACT: To understand the distribution of live birth weight in China.
A national survey on live birth weight was performed during July-October, 1998 in China, with stratified sampling. Totally, 22 350 live newborns (11 584 males and 10 766 females) with 28 weeks or more of gestation were measured for their birth weight in the sampling sites during 1998.
The ratio of male to female newborns measured was 1.08. The rates of multiple birth and preterm birth (< 37 weeks of gestation) were 1.8% and 3.5%, respectively. Live birth weight was higher in the urban areas (3 301 g) than that in the rural area (3 225 g) (t = 9.4. P < 0.001), the highest in the coastal areas (3 262 g), middle in the inland areas (3 254 g) and the lowest in the remote areas (3 115 g) (F = 177.9, P < 0.001), with a decreasing trend. Live birth weight in the first-class rural areas approximated to that in the urban areas, and that in the second-class, third-class and fourth-class rural areas decreased significantly. The average live birth weight in the fourth-class rural areas was 200 g lower than that in the urban areas.
Generally, the average live birth weight in China was closed to that in the developed countries. But, a big difference in the average live birth weight between regions with varied economic development and health care condition was observed. An intervention measure should be implemented in the poverty-stricken rural areas to increase their average live birth weight.
Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine] 05/2002; 36(3):154-7.