Association of Periconceptional Multivitamin Use With Reduced Risk of Preeclampsia Among Normal-Weight Women in the Danish National Birth Cohort
Association of Periconceptional Multivitamin Use With Reduced Risk of Preeclampsia Among Normal-Weight Women in the Danish National Birth Cohort
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DOI：
10.1093/aje/kwp052
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发表时间：
2009-06-01
影响因子：
5
通讯作者：
Olsen, Jorn
中科院分区：
文献类型：
--
作者：
Catov, Janet M.;Nohr, Ellen A.;Olsen, Jorn
妊娠期服用多种维生素的时间和频率可能与先兆子痫的风险有关。丹麦国家出生队列（1997-2003年）中的妇女报告在12周的围受孕期（从末次月经前4周至末次月经后8周）使用复合维生素或仅叶酸补充剂。先兆子痫病例采用国际疾病分类第十次修订版编码确定。采用考克斯回归分析来评估使用频率（使用周数）和使用时间（孕前和孕后）与先兆子痫风险的相关性。总体而言，有668例先兆子痫病例（2.3%），18，551名女性（65%）报告在妊娠期使用多种维生素。经过调整后，正常体重的女性中，定期使用（12周中的12周）与先兆子痫风险降低有关。与体重指数为22 kg/m2的非服用者相比，体重指数相同的经常服用复合维生素者发生先兆子痫的风险降低20%（风险比= 0.78，95%置信区间：0.60，0.99）。此外，仅在受孕后定期使用与风险降低相关，这种关系似乎也仅限于体重指数< 25 kg/m2的女性（风险比= 0.63，95%置信区间：0.42，0.93）。仅使用叶酸补充剂与先兆子痫风险无关。在正常体重的妇女中，围受孕期定期服用多种维生素与降低先兆子痫的风险有关，而受孕后立即服用多种维生素似乎是相关的暴露窗口。
The timing and frequency of periconceptional multivitamin use may be related to the risk of preeclampsia. Women in the Danish National Birth Cohort (1997-2003) reported multivitamin or folate-only supplement use during a 12-week periconceptional period (from 4 weeks prior to 8 weeks after the last menstrual period). Preeclampsia cases were identified by using International Classification of Diseases, Tenth Revision, codes. Cox regression was used to estimate the association of frequency (weeks of use) and timing (preconception and postconception) of use with preeclampsia risk. Overall, there were 668 cases of preeclampsia (2.3%), and 18,551 women (65%) reported periconceptional multivitamin use. After adjustment, regular use (12 of 12 weeks) was related to a reduced risk of preeclampsia among normal-weight women. Compared with nonusers with a body mass index of 22 kg/m(2), regular multivitamin users with the same body mass index had a 20% reduced risk of preeclampisa (hazard ratio = 0.78, 95% confidence interval: 0.60, 0.99). In addition, regular use in the postconception period only was associated with reduced risk, a relation that also appeared to be limited to women with a body mass index of < 25 kg/m(2) (hazard ratio = 0.63, 95% confidence interval: 0.42, 0.93). Folate-only supplement use was unrelated to preeclampsia risk. Regular periconceptional multivitamin use was associated with a reduced risk of preeclampsia among normal-weight women, and the immediate postconception period appeared to be the relevant exposure window.