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01-06-2016 | Original Contribution

Folic acid supplementation, dietary folate intake and risk of preterm birth in China

Authors: Xiaohui Liu, Ling Lv, Hanru Zhang, Nan Zhao, Jie Qiu, Xiaochun He, Min Zhou, Xiaoying Xu, Hongmei Cui, Sufen Liu, Catherine Lerro, Xiaojuan Lin, Chong Zhang, Honghong Zhang, Ruifeng Xu, Daling Zhu, Yun Dang, Xudong Han, Haiya Bai, Ya Chen, Zhongfeng Tang, Ru Lin, Tingting Yao, Jie Su, Wendi Wang, Yueyuan Wang, Bin Ma, Huang Huang, Jiaxin Liang, Weitao Qiu, Qing Liu, Yawei Zhang

Published in: European Journal of Nutrition | Issue 4/2016

Abstract

Purpose

Folic acid supplementation has been suggested to reduce the risk of preterm birth. However, results from previous epidemiologic studies have been inconclusive. We investigated the hypothesis that folic acid supplementation and dietary folate intake during pre- and post-conception reduces the risk of preterm birth.

Methods

We analyzed data from a birth cohort study conducted between 2010 and 2012 in Lanzhou, China, including 10,179 pregnant women with live singleton births.

Results

Compared to non-users, folic acid supplement users with >12-week duration had a reduced risk of preterm birth (OR 0.67, 95 % CI 0.55–0.83) with a significant dose–response relationship (P for trend = 0.01). A similar pattern was observed for spontaneous preterm birth. Stronger associations were seen for ever use of folic acid supplement and very preterm birth (OR 0.50, 95 % CI 0.36–0.69) and spontaneous very preterm birth (OR 0.42, 95 % CI 0.29–0.63). Dietary folate intake during preconception and pregnancy were also associated with reduced risk of preterm birth (OR 0.68, 95 % CI 0.56–0.83, OR 0.57, 95 % CI 0.47–0.70 for the highest quartiles, respectively), particularly for spontaneous very preterm (OR 0.41, 95 % CI 0.24–0.72, OR 0.26, 95 % CI 0.15–0.47 for the highest quartiles, respectively). There were also decreased risks of preterm birth observed per 10-µg increase in dietary folate intake, and similar associations were found after stratification by folic acid supplementation status.

Conclusions

Our results suggest that folic acid supplementation and higher dietary folate intake during preconception and pregnancy reduces the risk of preterm birth, and the protective effect varies by preterm subtypes.

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Title: Folic acid supplementation, dietary folate intake and risk of preterm birth in China
Authors: Xiaohui Liu
Ling Lv
Hanru Zhang
Nan Zhao
Jie Qiu
Xiaochun He
Min Zhou
Xiaoying Xu
Hongmei Cui
Sufen Liu
Catherine Lerro
Xiaojuan Lin
Chong Zhang
Honghong Zhang
Ruifeng Xu
Daling Zhu
Yun Dang
Xudong Han
Haiya Bai
Ya Chen
Zhongfeng Tang
Ru Lin
Tingting Yao
Jie Su
Wendi Wang
Yueyuan Wang
Bin Ma
Huang Huang
Jiaxin Liang
Weitao Qiu
Qing Liu
Yawei Zhang
Publication date: 01-06-2016
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nutrition / Issue 4/2016
Print ISSN: 1436-6207
Electronic ISSN: 1436-6215
DOI: https://doi.org/10.1007/s00394-015-0959-1

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Folic acid supplementation, dietary folate intake and risk of preterm birth in China

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