Periconceptional multivitamin use reduces the risk of preeclampsia
Periconceptional multivitamin use reduces the risk of preeclampsia
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DOI：
10.1093/aje/kwj218
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发表时间：
2006-09-01
影响因子：
5
通讯作者：
Roberts, James M.
中科院分区：
文献类型：
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作者：
Bodnar, Lisa M.;Tang, Gong;Roberts, James M.
目的是评估常规围孕期使用复合维生素对子痫前期风险的独立影响。参与“妊娠暴露和先兆子痫预防研究”（1997-2001年，宾夕法尼亚州匹兹堡）的孕妇（n = 1835）被问及在过去6个月内是否定期服用复合维生素或产前维生素。女性被分为使用者和非使用者。未经调整的先兆子痫患病率在非使用者中为4.4%，在使用者中为3.8%。在多元logistic回归模型中对种族/民族、婚姻状况、胎次、孕前体力活动和收入进行调整后，与不使用复合维生素相比，定期使用复合维生素可使子痫前期风险降低45%(优势比（OR) = 0.55, 95%可信区间（CI）： 0.32, 0.95）。孕前超重改变了这种影响。经混杂因素调整后，瘦肉复合维生素服用者与瘦肉非服用者相比，子痫前期风险降低71% （OR = 0.29, 95% CI: 0.12, 0.65）。相反，在超重妇女中，复合维生素的使用与子痫前期没有关系（OR = 1.08, 95% CI: 0.52, 2.25）。一项对未测量的水果和蔬菜摄入混淆的敏感性分析支持了这些结论。如果得到其他人的证实，这些结果表明，在围孕期定期服用复合维生素补充剂可能有助于预防子痫前期，特别是对瘦女性。
The objective was to assess the independent effect of regular periconceptional multivitamin use on the risk of preeclampsia. Pregnant women (n = 1,835) enrolled in the Pregnancy Exposures and Preeclampsia Prevention Study (Pittsburgh, Pennsylvania, 1997-2001) at less than 16 weeks' gestation were asked whether they regularly used multivitamins or prenatal vitamins in the past 6 months. Women were classified as users or nonusers. The unadjusted prevalence of preeclampsia was 4.4% in nonusers and 3.8% in users. After adjustment for race/ethnicity, marital status, parity, prepregnancy physical activity, and income in a multiple logistic regression model, regular use of multivitamins was associated with a 45% reduction in preeclampsia risk compared with nonuse (odds ratio (OR) = 0.55, 95% confidence interval (CI): 0.32, 0.95). Prepregnancy overweight modified this effect. After confounder adjustment, lean multivitamin users had a 71% reduction in preeclampsia risk compared with lean nonusers (OR = 0.29, 95% CI: 0.12, 0.65). In contrast, there was no relation between multivitamin use and preeclampsia among overweight women (OR = 1.08, 95% CI: 0.52, 2.25). A sensitivity analysis for unmeasured confounding by fruit and vegetable intake supported these conclusions. If confirmed by others, these results suggest that regular use of a multivitamin supplement in the periconceptional period may help to prevent preeclampsia, particularly among lean women.