Folic Acid Supplement Use and Increased Risk of Gestational Hypertension
Folic Acid Supplement Use and Increased Risk of Gestational Hypertension
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叶酸补充剂的使用和妊娠高血压风险增加
DOI：
10.1161/hypertensionaha.119.14621
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发表时间：
2020-07-01
期刊：
影响因子：
8.3
通讯作者：
Yang, Nianhong
中科院分区：
文献类型：
--
作者：
Li, Qian;Xu, Shangzhi;Yang, Nianhong
目前关于叶酸（FA）补充剂对妊娠期高血压（GH）和先兆子痫的影响的研究结果有限且不一致。我们的目的是调查FA补充剂的使用是否与生长激素和子痫前期有关。来自同济妇幼健康队列的参与者被纳入了有关围孕期FA补充使用和GH/先兆子痫诊断的信息（n=4853）。稳健泊松回归用于评估FA补充剂的使用与生长激素和子痫前期的关系。在本研究的4853名参与者中，分别有1161名（23.9%）和161名（3.3%）女性被诊断为生长激素和子痫前期。妊娠前至妊娠中期使用>= 800 μ g/d FA补充剂的妇女发生生长激素的风险比高于未使用的妇女（风险比为1.33[1.08-1.65]）。在调整了社会人口统计学、生殖、生活方式因素、高血压家族史、其他补充剂使用和妊娠期体重增加等因素后，不良关联仍然显著（风险比为1.32[1.06-1.64]）。限制体重正常、无高血压家族史、无妊娠期糖尿病的女性，FA-GH阳性相关性仍然存在。我们没有发现FA补充剂的使用与子痫前期有任何显著的关联。从孕前到妊娠中期使用高剂量（>= 800 μ g/d） FA补充剂与生长激素的风险增加有关。应注意避免因计划怀孕或有能力怀孕的妇女不适当使用FA补充剂而产生生长激素的潜在风险。
Current results regarding the effect of folic acid (FA) supplement use on gestational hypertension (GH) and preeclampsia are limited and inconsistent. We aimed to investigate whether FA supplement use was associated with GH and preeclampsia. Participants from the Tongji Maternal and Child Health Cohort with information on periconceptional FA supplement use and diagnosis of GH/preeclampsia were included (n=4853). Robust Poisson regression was used to assess the association of FA supplement use and GH and preeclampsia. Among the 4853 participants in this study, 1161 (23.9%) and 161 (3.3%) women were diagnosed with GH and preeclampsia, respectively. The risk ratio of developing GH was higher in women who used >= 800 mu g/d FA supplement from prepregnancy through midpregnancy than nonusers (risk ratio, 1.33 [1.08-1.65]). After adjusting for social-demographic, reproductive, lifestyle factors, family history of hypertension, other supplement use, and gestational weight gain, the adverse association remained significant (risk ratio, 1.32 [1.06-1.64]). Restricting the analysis among women with normal weight, without family history of hypertension, and without gestational diabetes mellitus, the positive FA-GH association still existed. We did not find any significant association between FA supplement use and preeclampsia regardless of adjustment. High-dose (>= 800 mu g/d) FA supplement use from prepregnancy through midpregnancy was associated with increased risk of GH. Attention should be given to avoid the potential risk of GH due to inappropriate FA supplement use in women who are planning or capable of pregnancy.