Details:

Alternative Title:
Birth Defects Res
Personal Author:
Petersen, Julie M. ; Parker, Samantha E. ; Benedum, Corey M. ; Mitchell, Allen A. ; Tinker, Sarah C. ; ... More +
Petersen, Julie M. ; Parker, Samantha E. ; Benedum, Corey M. ; Mitchell, Allen A. ; Tinker, Sarah C. ; Werler, Martha M. Less -
Description:
Background

Women with a previous neural tube defect (NTD)-affected pregnancy are recommended to consume 4,000 μg daily folic acid (FA) for prevention (10 times the general-population recommendation). Protection from doses between 400 and 4,000 μg for this and other higher risk groups is unclear.

Methods

In the case–control Slone Birth Defects Study (1988–2015), we examined the associations between periconceptional FA doses and NTDs among four higher risk groups: NTD family history, periconceptional antiepileptic drug exposure (AED), pregestational diabetes, and prepregnancy obesity. Mothers completed standardized interviews about pregnancy events and exposures. FA categorizations were based on (a) supplements only and (b) supplements and diet (“total folate”). We estimated odds ratios (ORs) and 95% confidence intervals (CIs) (adjusted for age and study center) using logistic regression.

Results

Cases and controls included: 45 and 119 with family history, 25 and 108 with AED exposure, 12 and 63 with pregestational diabetes, 111 and 1,243 with obesity. Daily FA supplementation was associated with lower NTD risk compared to no supplementation (adjusted ORs were 0.33 [95% CI 0.13, 0.76] for family history, 0.31 [0.09, 0.95] for AED exposure, 0.25 [0.04, 1.05] for pregestational diabetes, 0.65 [0.40, 1.04] for obesity). Though estimates were imprecise, as total folate increased stronger point estimates were observed, notably among family history. No mothers with a prior NTD-affected pregnancy supplemented with 4,000 μg.

Conclusions

Our findings reinforce that all women of childbearing potential should consume at least 400 μg FA/day to protect against NTDs. Higher risk groups may benefit from higher doses.


Subject:
[+]
Adult
Article
Case-Control Studies
Diabetes, Gestational
Dietary Supplements
Female
Folic Acid
Humans
Logistic Models
Mothers
Neural Tube Defects
Obesity
Odds Ratio
Pregnancy
Prevention
Recurrence
Risk Factors
Young Adult
Obesity

Source:
Birth Defects Res. 111(19):1501-1512
Pubmed ID:
31433116
Pubmed Central ID:
PMC7186568
Document Type:
Journal Article
Funding:
CC999999/ImCDC/Intramural CDC HHS/United States ; K01 HL133600/HL/NHLBI NIH HHS/United States ; U01 DD001184/DD/NCBDD CDC HHS/United States ; U01DD001184/ACL/ACL HHS/United States
CC999999/ImCDC/Intramural CDC HHS/United States ; K01 HL133600/HL/NHLBI NIH HHS/United States ; U01 DD001184/DD/NCBDD CDC HHS/United States ; U01DD001184/ACL/ACL HHS/United States Less -
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:ea801e3f4577561ac422bebd34549b90537845959a2930c0e6babdb7bbf1730d
File Type:

Supporting Files

• 	nihms-1577360.nxml	xml
  	NIHMS1577360-supplement-Supp_Figures.xlsx	xlsx
  	NIHMS1577360-supplement-Supp_Info.docx	docx

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