Folic acid supplementation is associated with size at birth in the Screening for Pregnancy Endpoints (SCOPE) international prospective cohort study
Folic acid supplementation is associated with size at birth in the Screening for Pregnancy Endpoints (SCOPE) international prospective cohort study
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DOI：
10.1016/j.earlhumdev.2020.105058
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发表时间：
2020-08-01
影响因子：
2.5
通讯作者：
McCowan, Lesley M. E.
中科院分区：
文献类型：
--
作者：
Bulloch, Rhodi E.;Wall, Clare R.;McCowan, Lesley M. E.
背景资料：小于胎龄儿（SGA）是导致发病率和死亡率的一个重要原因，目前几乎没有预防措施。目的：本研究的目的是调查孕妇在受孕前至孕中期使用叶酸补充剂（FAS）与小于胎龄儿（SGA）和出生大小参数之间的关系。招募女性作为妊娠终点筛查（SCOPE）国际前瞻性多中心队列研究的一部分：新西兰、澳大利亚、英国和爱尔兰。通过访谈问卷收集妊娠前、妊娠早期和妊娠15 +/- 1周时FAS使用的信息。参与者被跟踪到交付。妊娠结局数据和出生测量在出生后72小时内收集。多变量回归分析用于研究FAS和结局之间的关系，调整母亲的社会人口学和生活方式因素。受试者：单胎妊娠的未产妇女。结局指标：SGA（<第10个定制出生体重百分位数）。结果：5606名妇女被纳入。SGA患病率为11.3%。孕前FAS与SGA风险显著降低相关：aOR = 0.82（95% CI：0.67-01.00 p = 0.047）。尽管妊娠15周时FAS与SGA之间的相关性未达到显著性，但15周时FAS与显著更高的定制出生体重百分位数相关（β 2.56（95% CI：0.87-4.26; p = 0.003）。有没有显着的效果FAS对大胎龄出生或头围。结论：在这个国际队列，FAS与胎儿生长呈正相关，没有增加与LGA相关的风险。需要进一步的研究来证实在妊娠早期继续使用FAS是否会降低SGA的风险。
Background: Small-for-gestational-age (SGA) is a significant cause of morbidity and mortality, and there are currently few preventive strategies.Aim: The aim of this study was to investigate the relationship between maternal folic acid supplement (FAS) use pre-conception through to the second trimester, and small-for-gestational age (SGA) and birth size parameters.Study design: Women were recruited as part of the Screening for Pregnancy Endpoints (SCOPE) international prospective multi-centre cohort study: New Zealand, Australia, United Kingdom and Ireland. Information on FAS use pre-conception, during the first trimester and at 15 +/- 1 weeks' gestation was collected via interview administered questionnaire. Participants were followed through to delivery. Pregnancy outcome data and birth measurements were collected within 72 h of birth. Multivariable regression analysis was used to investigate relationships between FAS and outcomes, adjusting for maternal sociodemographic and lifestyle factors.Subjects: Nulliparous women with singleton pregnancies.Outcome measures: SGA (< 10th customised birthweight centile).Results: 5606 women were included. SGA prevalence was 11.3%. Pre-conception FAS was associated with a significantly lower risk of SGA: aOR = 0.82 (95% CI: 0.67-01.00 p = 0.047). Although the association between FAS at 15 weeks' gestation and SGA did not reach significance, FAS at 15 weeks was associated with a significantly higher customised birthweight centile (beta 2.56 (95% CI: 0.87-4.26; p = 0.003). There was no significant effect of FAS on large-for-gestational-age births or head circumference.Conclusions: In this international cohort, FAS was positively associated with fetal growth, without increasing risks associated with LGA. Further studies are required to confirm whether continuing FAS beyond the first trimester might lower the risk of SGA.