Folic Acid Supplementation, Dietary Folate Intake and Risk of Preterm Birth in China

Overview

Journal Eur J Nutr

Specialty Nutritional Sciences

Date 2015 Jul 4

PMID 26138063

Citations 19

Authors

Xiaohui Liu

Ling Lv

Hanru Zhang

Nan Zhao

Jie Qiu

Xiaochun He

Min Zhou

Xiaoying Xu

Hongmei Cui

Sufen Liu

Catherine Lerro

Xiaojuan Lin

Chong Zhang

Honghong Zhang

Ruifeng Xu

Daling Zhu

Yun Dang

Xudong Han

Haiya Bai

Ya Chen

Zhongfeng Tang

Ru Lin

Tingting Yao

Jie Su

Wendi Wang

Yueyuan Wang

Bin Ma

Huang Huang

Jiaxin Liang

Weitao Qiu

Qing Liu

Yawei Zhang

Affiliations

Soon will be listed here.

Abstract

Purpose: Folic acid supplementation has been suggested to reduce the risk of preterm birth. However, results from previous epidemiologic studies have been inconclusive. We investigated the hypothesis that folic acid supplementation and dietary folate intake during pre- and post-conception reduces the risk of preterm birth.

Methods: We analyzed data from a birth cohort study conducted between 2010 and 2012 in Lanzhou, China, including 10,179 pregnant women with live singleton births.

Results: Compared to non-users, folic acid supplement users with >12-week duration had a reduced risk of preterm birth (OR 0.67, 95 % CI 0.55-0.83) with a significant dose-response relationship (P for trend = 0.01). A similar pattern was observed for spontaneous preterm birth. Stronger associations were seen for ever use of folic acid supplement and very preterm birth (OR 0.50, 95 % CI 0.36-0.69) and spontaneous very preterm birth (OR 0.42, 95 % CI 0.29-0.63). Dietary folate intake during preconception and pregnancy were also associated with reduced risk of preterm birth (OR 0.68, 95 % CI 0.56-0.83, OR 0.57, 95 % CI 0.47-0.70 for the highest quartiles, respectively), particularly for spontaneous very preterm (OR 0.41, 95 % CI 0.24-0.72, OR 0.26, 95 % CI 0.15-0.47 for the highest quartiles, respectively). There were also decreased risks of preterm birth observed per 10-µg increase in dietary folate intake, and similar associations were found after stratification by folic acid supplementation status.

Conclusions: Our results suggest that folic acid supplementation and higher dietary folate intake during preconception and pregnancy reduces the risk of preterm birth, and the protective effect varies by preterm subtypes.

Citing Articles

Vitamin C Alleviates the Risk of Gestational Diabetes Mellitus Associated With Exposure to Metals.

Wang Y, Wu W, Zhang P, Chen X, Feng Y, Yang H J Diabetes Res. 2024; 2024:1298122.

PMID: 39035682 PMC: 11260216. DOI: 10.1155/2024/1298122.

Folate deficiency in pregnancy and the risk of preterm birth: A nested case-control study.

Lazar V, Rahman S, Chowdhury N, Hasan T, Akter S, Islam M J Glob Health. 2024; 14:04120.

PMID: 38991209 PMC: 11239188. DOI: 10.7189/jogh.14.04120.

The association of preconceptional folic acid supplementation with gestational age and preterm birth risk in twin pregnancies: a prospective cohort study in China.

Xia Y, Huang L, Long Z, Chen Y, Gao L, Hua R Eur J Nutr. 2023; 63(1):107-119.

PMID: 37733259 DOI: 10.1007/s00394-023-03223-8.

Nonlinear Relationship Between Maternal and Cord Blood Vitamin B and Folate from a Chinese Population-Based Study.

Du Y, Li J, Qu P, Dang S Int J Womens Health. 2023; 15:1405-1415.

PMID: 37701181 PMC: 10493199. DOI: 10.2147/IJWH.S420206.

Elevated Maternal Folate Status and Changes in Maternal Prolactin, Placental Lactogen and Placental Growth Hormone Following Folic Acid Food Fortification: Evidence from Two Prospective Pregnancy Cohorts.

Jankovic-Karasoulos T, Smith M, Leemaqz S, Williamson J, McCullough D, Arthurs A Nutrients. 2023; 15(7).

PMID: 37049394 PMC: 10097170. DOI: 10.3390/nu15071553.

References

Liu L, Johnson H, Cousens S, Perin J, Scott S, Lawn J . Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet. 2012; 379(9832):2151-61. DOI: 10.1016/S0140-6736(12)60560-1. View

Fekete K, Berti C, Trovato M, Lohner S, Dullemeijer C, Souverein O . Effect of folate intake on health outcomes in pregnancy: a systematic review and meta-analysis on birth weight, placental weight and length of gestation. Nutr J. 2012; 11:75. PMC: 3499376. DOI: 10.1186/1475-2891-11-75. View

Li Z, Ye R, Zhang L, Li H, Liu J, Ren A . Periconceptional folic acid supplementation and the risk of preterm births in China: a large prospective cohort study. Int J Epidemiol. 2014; 43(4):1132-9. PMC: 4258769. DOI: 10.1093/ije/dyu020. View

Blencowe H, Cousens S, Oestergaard M, Chou D, Moller A, Narwal R . National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet. 2012; 379(9832):2162-72. DOI: 10.1016/S0140-6736(12)60820-4. View

Scholl T, Hediger M, Schall J, Khoo C, Fischer R . Dietary and serum folate: their influence on the outcome of pregnancy. Am J Clin Nutr. 1996; 63(4):520-5. DOI: 10.1093/ajcn/63.4.520. View

Qiu J, He X, Cui H, Zhang C, Zhang H, Dang Y . Passive smoking and preterm birth in urban China. Am J Epidemiol. 2014; 180(1):94-102. PMC: 4070933. DOI: 10.1093/aje/kwu092. View

Charles D, Ness A, Campbell D, Davey Smith G, Whitley E, Hall M . Folic acid supplements in pregnancy and birth outcome: re-analysis of a large randomised controlled trial and update of Cochrane review. Paediatr Perinat Epidemiol. 2005; 19(2):112-24. DOI: 10.1111/j.1365-3016.2005.00633.x. View

Timmermans S, Jaddoe V, Hofman A, Steegers-Theunissen R, Steegers E . Periconception folic acid supplementation, fetal growth and the risks of low birth weight and preterm birth: the Generation R Study. Br J Nutr. 2009; 102(5):777-85. DOI: 10.1017/S0007114509288994. View

Catov J, Bodnar L, Ness R, Markovic N, Roberts J . Association of periconceptional multivitamin use and risk of preterm or small-for-gestational-age births. Am J Epidemiol. 2007; 166(3):296-303. DOI: 10.1093/aje/kwm071. View

10.

Goldenberg R, Hauth J, Andrews W . Intrauterine infection and preterm delivery. N Engl J Med. 2000; 342(20):1500-7. DOI: 10.1056/NEJM200005183422007. View

11.

Greenberg J, Bell S, Guan Y, Yu Y . Folic Acid supplementation and pregnancy: more than just neural tube defect prevention. Rev Obstet Gynecol. 2011; 4(2):52-9. PMC: 3218540. View

12.

Hillier S, Nugent R, Eschenbach D, Krohn M, Gibbs R, Martin D . Association between bacterial vaginosis and preterm delivery of a low-birth-weight infant. The Vaginal Infections and Prematurity Study Group. N Engl J Med. 1995; 333(26):1737-42. DOI: 10.1056/NEJM199512283332604. View

13.

Czeizel A, Puho E, Langmar Z, Acs N, Banhidy F . Possible association of folic acid supplementation during pregnancy with reduction of preterm birth: a population-based study. Eur J Obstet Gynecol Reprod Biol. 2009; 148(2):135-40. DOI: 10.1016/j.ejogrb.2009.10.016. View

14.

Sengpiel V, Bacelis J, Myhre R, Myking S, Pay A, Haugen M . Folic acid supplementation, dietary folate intake during pregnancy and risk for spontaneous preterm delivery: a prospective observational cohort study. BMC Pregnancy Childbirth. 2013; 13:160. PMC: 3751653. DOI: 10.1186/1471-2393-13-160. View

15.

Pennell C, Jacobsson B, Williams S, Buus R, Muglia L, Dolan S . Genetic epidemiologic studies of preterm birth: guidelines for research. Am J Obstet Gynecol. 2007; 196(2):107-18. DOI: 10.1016/j.ajog.2006.03.109. View

16.

Zhao Y, Hao L, Zhang L, Tian Y, Cao Y, Xia H . Plasma folate status and dietary folate intake among Chinese women of childbearing age. Matern Child Nutr. 2009; 5(2):104-16. PMC: 6860894. DOI: 10.1111/j.1740-8709.2008.00172.x. View

17.

Rolschau J, Kristoffersen K, Ulrich M, Grinsted P, Schaumburg E, Foged N . The influence of folic acid supplement on the outcome of pregnancies in the county of Funen in Denmark. Part I. Eur J Obstet Gynecol Reprod Biol. 1999; 87(2):105-10; discussion 103-4. View

18.

Czeizel A, Dudas I, Metneki J . Pregnancy outcomes in a randomised controlled trial of periconceptional multivitamin supplementation. Final report. Arch Gynecol Obstet. 1994; 255(3):131-9. DOI: 10.1007/BF02390940. View

19.

Selhub J . Homocysteine metabolism. Annu Rev Nutr. 1999; 19:217-46. DOI: 10.1146/annurev.nutr.19.1.217. View

20.

Christian P, Jiang T, Khatry S, LeClerq S, Shrestha S, West Jr K . Antenatal supplementation with micronutrients and biochemical indicators of status and subclinical infection in rural Nepal. Am J Clin Nutr. 2006; 83(4):788-94. DOI: 10.1093/ajcn/83.4.788. View