Article

Possible Association of Folic Acid Supplementation During Pregnancy With Reduction of Preterm Birth: A Population-Based Study EDITORIAL COMMENT

Semmelweis University, Budapeŝto, Budapest, Hungary
European journal of obstetrics, gynecology, and reproductive biology (Impact Factor: 1.63). 11/2009; 148(2):135-40. DOI: 10.1016/j.ejogrb.2009.10.016
Source: PubMed

ABSTRACT Periconceptional folic acid or multivitamin supplementation is recommended for prospective pregnant women to prevent neural-tube defects. The question is whether it is worth continuing these supplementations after the first trimester of pregnancy or not. Thus the possible fetal growth promoting and/or preterm birth reducing effect of vitamin supplements in the second and mainly in the third trimester was studied.
Comparison of birth outcomes of singletons born to primiparous pregnant women with prospectively and medically recorded vitamin supplement in the population-based data set of the Hungarian Case-Control Surveillance of Congenital Abnormalities (HCCSCA), 1980-1996 contained 6293, 169, and 311 primiparae with folic acid alone, multivitamins and folic acid+multivitamin supplementation, respectively, and their data were compared to the data of 7319 pregnant women without folic acid and folic acid-containing multivitamin supplementation as reference.
Mean gestational age was 0.3 week longer and mean birth weight was by 37 g higher in the group of folic acid alone, than in the reference group (39.2 weeks; 3216 g). The rate of preterm births (7.6%) was significantly lower compared with the reference sample (11.8%), but the rate of low birth weight newborns did not show significant reduction. Folic acid alone in the third trimester associated with 0.6 week longer gestational age and a more significant reduction in the rate of preterm births (4.8%).
Minor increase in mean birth weight after high dose of folic acid supplementation during pregnancy would not be expected to result in too large babies; however, the significant reduction in the rate of preterm births may have great public health benefit.

Download full-text

Full-text

Available from: Andrew E. Czeizel, Jun 28, 2015
1 Follower
 · 
101 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Good clinical practice recommends folic acid supplementation 1 month prior to pregnancy and during the first trimester to prevent congenital malformations. However, high rates of fetal growth and development in later pregnancy may increase the demand for folate. Folate and vitamins B12 and B6 are required for DNA synthesis and cell growth, and are involved in homocysteine metabolism. The primary aim of this study was to determine if maternal folate, vitamin B12, vitamin B6 and homocysteine concentrations at 18–20 weeks gestation are associated with subsequent adverse pregnancy outcomes, including pre-eclampsia and intrauterine growth restriction (IUGR). The secondary aim was to investigate maternal B vitamin concentrations with DNA damage markers in maternal lymphocytes. A prospective observational study was conducted at the Women's and Children's Hospital, Adelaide, South Australia. One hundred and thirty-seven subjects were identified prior to 20 weeks gestation as at high or low risk for subsequent adverse pregnancy outcome by senior obstetricians. Clinical status, dietary information, circulating micronutrients and genome damage biomarkers were assessed at 18–20 weeks gestation. Women who developed IUGR had reduced red blood cell (RBC) folate (P < 0.001) and increased plasma homocysteine concentrations (P < 0.001) compared with controls. Maternal DNA damage, represented by micronucleus frequency and nucleoplasmic bridges in lymphocytes, was positively correlated with homocysteine (r = 0.179, P = 0.038 and r = 0.171, P = 0.047, respectively). Multivariate regression analysis revealed RBC folate was a strong predictor of IUGR (P = 0.006). This study suggests that low maternal RBC folate and high homocysteine values in mid pregnancy are associated with subsequent reduced fetal growth.
    Maternal and Child Nutrition 10/2011; DOI:10.1111/j.1740-8709.2011.00364.x · 2.97 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Adherent Technologies' development of a novel conversion process for the recycling of electronic scrap has led to the investigation of separation technologies for the products produced directly from this process. An economic model of the entire process has also been developed based on the latest findings. This process will handle complex mixtures of plastics, metals, ceramics and fiberglass or reinforcing components such as those that make up electronic scrap without labor-intensive separation before processing. Products from the process include valuable recycled materials: chemicals, metals, ceramics and fiberglass, which have ready available markets. Operation and maintenance of the process requires a minimum labor force. Little or no segregation is required for the feedstock before processing, thus reducing labor costs and dramatically increasing the economics of the process over existing recycling techniques. This process provides an economical and environmentally conscious solution to the problem of electronic scrap today and in the future
    Electronics and the Environment, 1999. ISEE -1999. Proceedings of the 1999 IEEE International Symposium on; 02/1999
  • [Show abstract] [Hide abstract]
    ABSTRACT: Women's diets are of interest as they not only impact on wellbeing and risk of chronic disease in women themselves, but also influence pregnancy outcomes and infant health. UK dietary surveys show that, while some improvements have occurred, intakes of key micronutrients, particularly iron, vitamin D, calcium and folate remain below recommended levels. Women's diets are also too high in saturated fat and salt, and low in fibre, oily fish and fruits and vegetables. Evidence suggests that certain chronic conditions are influenced by dietary components, e.g. inadequate calcium and vitamin D intakes reduce bone density, salt and saturated fat increase cardiovascular disease risk, excessive alcohol intakes increase cancer risk, low intakes of long chain n-3 fatty acids may adversely affect fetal development and mental health, while adequate folic acid reduces the risk of birth defects. Focused health initiatives are needed to improve diet quality in women, particularly school-aged girls, women planning a pregnancy, those living in areas of deprivation and elderly women. Vitamin and mineral supplements, and fortified foods may have a role to play alongside dietary improvements in helping women to achieve optimal diet quality.
    Nutrition Bulletin 05/2010; 35(2):126 - 137. DOI:10.1111/j.1467-3010.2010.01828.x