Folic acid supplementation and risk for congenital hydrocephalus in China

Abstract

Objective: We examined whether folic acid (FA) supplementation prevented congenital hydrocephalus (CH) in more than 200,000 births in China. Design: A large population-based cohort study. Setting: All births at 20 complete gestational weeks, including live births, stillbirths, and pregnancy terminations, and all structural birth defects regardless of gestational week were recorded. The prevalence of births with CH was classified by maternal characteristics and FA supplementation. CH was diagnosed in accordance with code 742.3 of the International Classification of Diseases, Ninth Revision, Clinical Modification., while non-NTDs CH refers to CH without anencephaly (740), spina bifida (741), or encephalocele (742.0). Participants: A total of 247,831 pregnant women who delivered with known outcomes were included. Results: A total of 206 cases of CH (0.83 per 1,000 births) and 170 cases of non-NTDs CH (0.69 per 1,000 births) were recorded in the study. The prevalence of CH and non-NTDs CH was higher in women in the no supplementation group than those in the FA supplementation group (0.92 and 0.72 vs. 0.75 and 0.65 per 1,000 births, respectively). FA supplementation during the periconceptional period significantly prevented CH (odds ratio [OR] = 0.29, 95% confidence interval [CI]: 0.12–0.69) and non-NTDs CH (OR = 0.34, 95% CI: 0.12–0.97) in northern China, especially in a high-compliance group (≥80%). Conclusions: Periconceptional FA supplementation did not significantly prevent CH overall in this study. however, in the north of China with common maternal folate insufficiency, there was some evidence.

The Prevalence of Anemia among Pregnant Women in China: A Systematic Review and Meta-Analysis

“…While prioritizing IDA among pregnant women, attention should also be paid to other causes of anemia. The nutritional status of FA among pregnant women has remarkably improved after the national FA supplementation program for preventing neural tube defects took effect in 2009 [ 88 ]. Nonetheless, one cross-sectional study conducted in northwestern China showed that about 12.1% of women in late pregnancy were deficient in FA, and 69.6% of the women were deficient in vitamin B12 [ 89 ].…”

Epidemiological Comparison of Anorectal Malformation With Other Gastrointestinal Abnormalities in Patients in the Pediatric Ward

“…The etiology of anorectal malformation is thought to be multifactorial and therefore both genetics and environmental factors, such as tobacco, caffeine, and alcohol, are likely involved in its development [ 6 ]. On the contrary, folic acid supplementation has been reported to reduce the risk of occurrence of anorectal malformations [ 7 , 8 ]. These lesions can be diagnosed prenatally by MRI, ultrasonography, and examination at the time of birth [ 9 ].…”

The effect of living environment on developmental disorders in cold regions

“…Studies have found that supplement of trace elements is one of the most sustainable, safe, effective means to prevent offspring from CH during pregnancy. A large population-based cohort study demonstrated that folic acid supplementation can notably attenuate the incidence of CH, especially in cold areas at high latitudes (OR 0.29, 95% CI 0.12-0.69) [62] (Table 1).…”